My mom has taken a pretty steep decline in the last couple months. She is extremely frail. Been diagnosed with diastolic heart failure, chronic respiratory failure with hypoxemia on oxygen most of time now, reactive airway disease and atrial fibrillation for 20 years on Coumadin. She fell out of bed this morning and broke her hip., a hip she had replaced 8 years ago. They’ve decided to do surgery after her INR normalizes. I’m preparing myself for what’s to come. From what I’ve observed with others especially when frail this really changes things. Any thoughts on what i can likely expect? Thanks.
I may be wrong....
There is a good possibility that your mom will not be mobile after the repair. It would depend on how well she does in rehab. But the fear of falling again my hinder her.
Given her medical conditions there is a good possibility that with or without the surgical repair mom my have 6 to 9 months.
Once the repair is done you might want to get an evaluation for Hospice. They will provide you with all the equipment that you will need as well as all the medications that she needs and personal supplies. Nurse will visit once a week, more often if needed. A CNA will come 2 times a week to give mom a bath or shower. Bed Bath if needed. And you can ask for a Volunteer that can come sit with mom while you can get things done or the Volunteer can do other tasks. About the only thing a Volunteer can not do is "hands on care".
If mom is currently in a facility she may have to move to a Skilled Nursing facility as most other facilities can not sue equipment to move a resident.
This is a tough decision if you are asked to decide on surgery or not.
You already know and have been told by MD the complicating factors, as you have told us here. There is in an distinct danger of stroke in one with atrial fib. Clots in healing where extremities are concerned are complicating and the fact that this is already a total hip with a fx. may be further complicating.
This is something you clearly cannot predict, but living with a fractured hip truly isn't an option. Speak with the doctors who know this case best, hope for the best. I wish you well and hope you'll update us.
I am surprised but then again not really that the doctors have not mentioned Hospice.
Seems to me that if a doctor mentions the word Hospice they are denying their training.
Doctors are taught to CURE. And sometimes that means to cure at all costs.
I think there should be a full rotation in med school on Hospice. Not a few hours but enough so that they TRULY see the benefits of Hospice.
I wonder if your your brother and SIL would accept Hospice as the best option if the doctor recommended it.
Sorry you have to watch your mom go through this.
And I wonder what she would say if she were cognizant. (another point to ponder)
As a co-POA I went ahead even before this and had gotten palliative care on board hoping for hospice eventually but have met resistance. He has refused to even discuss how to handle her care in the future at all but have taken control of things. I’ve just this week pulled back for my own health and well being and left her healthcare totally up to them, other than staying with her at our previously agreed times. it’s like pushing against a brick wall. Really stressful and have been having attacks of anxiety with chest pain.
I’m hoping someone at the hospital will speak up. they’re saying it will be at best 6-8 weeks of non weight bearing. How in the world will we handle it? Absolutely hate that they are going to put her through this.
in preop the drs asked my mother if there was anything wrong with her heart or lungs and she basically said no. I was, again in disbelief. But I do believe she thinks she will get back to her independent status or at least where we can be at her beck and call in her own home. Then I spoke up and told him the actual diagnoses made by a pulmonologist less than a week ago. The anesthesiologist did not want to intubate her because of potential complications and explained she would be breathing on her own. After we talked to the surgeon they came back and said yes she would be intubated after all. I believe the surgeon has some definite ideas of the issues that will affect her in surgery and out. He was pretty straightforward.
so here we are and no one but me wants to discuss what might be the game plan going forward. My brother says to the surgical care team, as she turns 90 in a couple weeks, that we’re trying for 100 yo. I just can’t even fathom…. I truly believe they think she’s going to bounce back as she always has. But back to what?? Because of family dysfunction I believe there are some deep psychological issues in someone who wants to keep a frail 90 yo woman alive at all costs. He wants total control of her care and I’m about ready to give it to him.
We just dealt with very unrealistic mother in law who had fallen and broken her pelvis . No surgery , but she had 4 comorbidities . She became unresponsive in rehab . Then with speaking with the doctor , My husband filled out and signed a Molst form , just to give basically hospice care . She died 3 days later. A bad fall can be the beginning of the end . She had been declining more rapidly before the fall . I believe had she not fallen she only had a few more months left anyway .
my mothers situation was very similar to yours. She was already very much on the decline and I also believed she had only a few more months. Then this happened. The dr said she would be going to rehab. But everything at this point is very uncertain because we don’t know what she’s left with as far as ability to recover.
Hope this doesn’t offend but I believe she and you were better off the way it played out in the end for your mother, you and your family. No more suffering for all involved. Best wishes to you as you move forward.
I went in to see her in postop. She’s been through many surgeries but I’ve never seen her like that. Her face didn’t even look the same. She looked totally lost. She didn’t even recognize me or my brother. I was reading about post surgery delirium in the elderly as a real thing with various outcomes. So I guess time will tell. When I try to peer into the future in my head all I see is one big question mark. Obviously we couldn’t have avoided this as she was in incredible pain with the broken hip replacement.
Thank you so much for your update to us.
My neighbor, age 77, broke her left shoulder and right hand tripping over a parking lot bumper. She is going to PT but is fearful of walking now.
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