Adequate intakes of calcium, vitamin D and protein are also an important component of the rehabilitation program. Dietary calcium and vitamin D have been shown to help preserve bone mass and bone strength and should be considered in all elderly patients and in those patients suspected to be vitamin D deficient. The NOF recommends a calcium intake of at least 1200 mg/d in postmenopausal women. The NOF also recommends 800 IU/d of vitamin D for older adults, as well as for chronically ill, housebound, or institutionalized individuals.⁶ However, many experts recommend more for the frail elderly.⁷ Severe cases of vitamin D deficiency can cause osteomalacia or rickets; patients who are either vitamin D insufficient or deficient require treatment with higher doses of vitamin D. Patients can be treated with 50,000 IU once a week for up to 3 months with follow-up blood tests of vitamin D, calcium and PTH levels; some patients may require longer courses of treatment. Additional studies have shown that supplementation with vitamin D, protein and calcium significantly improved both the hospital stay and rehabilitation of elderly patients following hip fracture. ^8-9