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After the break this past March, at age 91, Mom has not recovered nearly as quickly and was affected much more to her detriment by the anesthesia from the surgery. She is weaker and 3 years farther into her dementia, so she is now in a wheelchair with very little chance of ever walking again. She is so very afraid of falling again that she is hesitant to even try to get up and walk using her walker and with her Physical Therapist by her side. Mom is weaker and more frail than she was when she broke the first hip and seems content to be in a wheelchair all the time after the most recent break.
I truly believe that the level of dementia truly affects the recovery process and the ability to rehabilitate to a previous level of activity.
I expect you are still in the middle of this crises? Any turn towards a direction yet?
Yes! My dad fell and not only break his hip but his femur separated from the hip prostheses that was already there. he was 96. The surgery was quite complicated to wire his femur back to his hip prosthesis. He then went to rehab but he wasn’t good about doing the exercises or walking very far. He had dementia at the time. He didn’t make enough progress to ever walk safely with a walker so became confined to a wheelchair. He then had to move from AL to LTC because of it. He lived another 2 years and 8 months. Well past the “6 month projection” of the surgeon. He was a stubborn man but very unhappy after that.
my advice is see if you can continue PT after rehab to be sure she can get her strength back and that means you will have to motivate her and work with her. I’ve had two hip replacements in my 60’s and broke a hip in my 50’s repaired with screws. I’ve seen a big difference in my healing and strength with my hip replacements. It isn’t easy. So depending on how your mom was before the fall will determine recovery. Be sure she gets a minimum of 60 Grams of protein a day during recovery as it takes a lot for bone to remodel and heal. The body requires more calories during healing. My surgeon emphasized this. A really tasty protein drink if Orgain or Premier protein and doesn’t have all that extra stuff that Ensure has. Tuna sandwiches are high, as is Greek yogurt. These were my go to's.
After the first time, she had asked the osteologist whether this was likely to happen to the other leg, and the answer was "Well, they have exactly the same history..."
I wish you great luck, know that you did nothing wrong. And the ocean cures us all.
At 92, she fell and broke her right hip and arm. After surgery and 30 days in rehab, the doctors strongly recommended she move to assisted living as she refused to have 24 hr care in her independent living apartment. I found her a lovely assisted living facility however she never regained her mobility. I think she just gave up because she couldn't live independently anymore. She never wanted to be a bother, but she had the ability to get people to do what she wanted in her own quiet little way.
wanted in her quiet little way.
Msbarbie I do hope your mother's outcome will be much better. Just keep an eye on her as she works through rehab and if she looks as if she is giving up talk to her doctors. Medicine has come a long was since the 1980s.
My prayers to your family for your mother.
He did very well and after two weeks of rehab I was able to move him 600 miles to a nursing home near me. He regained his mobility and was a real handful for the staff who had to chase him all over the facility. Dad died peacefully in September of last year.
:-)
Sorry you lost your dad, he sounds like he was a real pistol!
Of course, it is upsetting to you. Speak with her doctor and if she isn’t able to go home, ask him to break the news to her.
Will keep you and your mom in my thoughts and prayers.
Have hope.
But also realistic expectations.
#hip in the very aged is a game-changer - for the whole family.
Fall #1: Long story, but basically mom broke her arm and hip but the er drs. missed the broken hip until we were sent back to another er a week later. She was 90, fully ambulatory and had been able to fully care for herself as far as dressing, bathing and toileting. Her dementia was moderate. In the hospital she had a bad reaction to Tramadol & started hallucinating. I think there was delirium going on too. Once meds were adjusted she settled down so by the time she was assigned to rehab, things were better but not great. This time period was before covid so we could visit every day and monitor progress. She was "with it” enough to know she needed to put in the effort to save her remaining independence. By the time she finished rehab, facility & home, she was able to walk again with just a 3-prong cane. Her dementia had moved to a more advanced level, but other than me now needing to help her with showers, things were not too different.
Fall #2: Mother’s dementia was worse by this time, she was more frail and covid was going on in it’s earliest, most strict phase. After she fell in her bedroom, she was taken by ambulance and I was not allowed to see her face to face again until her rehab discharge about a month later. She had a successful surgery too before going into rehab. All my updates on her PT progress were over the phone. I did window visits with her but it was hard for her to understand that the person on the phone with her was also the person at the window. By the time she was released, I was shocked at how much weight she had lost. She wouldn’t eat much,even at home, for the first couple of weeks. The home health people would come and try to get her to walk and she would just cry and beg me to take her back to her chair. She couldn’t understand or remember the things they were trying to coach her on. She was sooo tired and weak and flat did not have the ability to put in the effort she needed to regain her strength. I think if she didn’t have the dementia she might have been able to rally again like she did after the first fall, but who knows. Physical therapy was finally stopped and we had her accessed for hospice. She’s been on hospice ever since. She can only walk a few steps now (with someone directly beside her, her white knuckles holding on for dear life to her full-size walker) and even then she barely makes it from her bed to her sitting chair (about 8 feet). Every other move she makes is from my husband or I pushing her in her the wheelchair. She can’t do any of the transfers on her own and offers little to no help to whoever is moving her. It takes two of us to get her on/off/and cleaned up from the toilet now. That was a giant change that took awhile to adjust to. Hospice handles her bathing. Hospice has been a true Godsend.
Bottom line, at your mom’s age, even if she doesn’t have dementia and is in reasonably good shape, the weeks of rehab ahead will probably be a difficult and challenging process. I would start mentally preparing for the possibility that she will come home needing a different level of care AND proving to be an even greater fall risk than ever. I would also suggest watching for behavior and mood changes that can come from new meds and delirium from all the change and stress. And as far as PT goes, keep in mind, that sometimes what they “can do” and “what they’re willing to do” are not the same thing. Watching my mom go through PT at home after the 2nd fall was a misery. It got to where all the pushing and pushing was just more than she could handle mentally or physically. One last thing I noted with both falls was that once mom got home again, she started eating better and just doing better overall. So improvement can continue, just keep expectations real. Good luck & God bless.
I suppose at a somewhat earlier stage, elderly people try to be independent, and suffer the consequences of attempting activities they no longer can do safely. Then when this results in an accident, they eventually end up in physical therapy, but are unwilling or unmotivated to "push to the limit" of what they can do (sometimes due to residual pain).
I suspect from Ishep3750's comment, what the person is willing to do is a subset of what that they are capable of doing, at least in physical therapy. Soon after my mother entered a nursing home after moving to OH, physical therapy was attempted because she had gotten weaker due to reduced activity over time. Because she had some pain in one leg (which she believed to have resulted from the fact that the bone had broken a few years earlier, as I described in a response to a comment from rovana), she became reluctant to continue the therapy. Of course discontinuing the physical therapy resulted in Medicare no longer covering the expenses (but I didn't have the heart to tell her that this decision resulted in an additional out-of-pocket cost of ca. $16K).