Objective To investigate the impact of Orem self-care mode on perioperative stress response and overall functional recovery of elderly patients with proximal femoral fractures nursing. Methods The elderly patients with proximal femoral fractures of the Second Hospital of Jilin University were divided into experimental group and control group, and the control group patients were given conventional nursing, when the experimental group patients were given Orem self-care nursing on the basis of conventional nursing. Contrastively analysis were implemented in the perioperative anxiety, depression and other negative stress reaction change, functional exercise compliance, hip joint function and daily life function change of the two group patients. Results When the patients were out of hospital, the anxiety (14.9±6.2) and depression (13.3±4.8) scores of the experimental group patients were significantly lower than that in the control group (t=2.303, 3.347; P 0.05) . After 3 months discharge, the daily life function total score was (68.4±9.2) in experimental group and (62.2±8.4) in control group (t=2.726, P<0.01) . Conclusions Orem self-care nursing mode can effectively improve the perioperative negative psychological stress reaction of the old patients with proximal femoral fractures, improve their behavior compliance and self-nursing ability, and it also has great significance on promoting the overall patients postoperative function recovery. Key words: Femoral fractures; Perioperative nursing; Orem self-care nursing; Stress response