Broken hip

[Grable]

Not content with worsening vascular dementia and the most difficult to spell cancer imaginable - oesophageal - Mum has now broken her hip!

She was in her room at the care home on Sunday night. When the carer was doing the midnight rounds, she found Mum face down on the floor by the door. (Bruised wrist and sore shoulder.) We don't know what she was doing out of bed or what had happened.

On Tuesday night, Mum was fine at the time of the midnight round, but when the carer went to get her up, she was face down on the floor by the door again. Again, we don't know why she was out of bed. This time, she had a displaced fracture of the hip.

She had an operation to fix it this morning and I've been told it went well.

Now what? How long are people generally kept in hospital after such an operation? Apparently, the care home will take her back only if she can bear her own weight. Is that likely? Aaaargh!!! Do we have to start the hunt for a nursing home, having only a couple of months ago managed to find her a residential care home (which she hates, of course!)?

 

[vivcares16]

Broken hip/my rights to information as a relative

I know what you are going through.
Mum has Alzheimer's and is going through a depression as well.
She fell in the psychiatric assessment ward she is in and has been transferred to another hospital where she has had an operation.
I visited today and was shocked by the unwillingness of the nurses to give out information to me about her medication.
I had already been given info ~ conflicting info ~ over the phone by another nurse, one who said she was no longer on morphine and only on paracetamol.
I told them I was POA Welfare and then reluctantly I was given the information verbally, but told if I wanted to see her cardex I would have to apply in writing.
Is this true?
Am fed up of hospitals getting my mother's medication wrong, which happened in another hospital she was transferred to for a scan, and now when I try to keep track of things they are withholding info from me despite Welfare POA.

Can anyone advise on this?

 

[sleepless]

Not content with worsening vascular dementia and the most difficult to spell cancer imaginable - oesophageal - Mum has now broken her hip!

She was in her room at the care home on Sunday night. When the carer was doing the midnight rounds, she found Mum face down on the floor by the door. (Bruised wrist and sore shoulder.) We don't know what she was doing out of bed or what had happened.

On Tuesday night, Mum was fine at the time of the midnight round, but when the carer went to get her up, she was face down on the floor by the door again. Again, we don't know why she was out of bed. This time, she had a displaced fracture of the hip.

She had an operation to fix it this morning and I've been told it went well.

Now what? How long are people generally kept in hospital after such an operation? Apparently, the care home will take her back only if she can bear her own weight. Is that likely? Aaaargh!!! Do we have to start the hunt for a nursing home, having only a couple of months ago managed to find her a residential care home (which she hates, of course!)?

My husband (now in 14th year of Alzheimers') fractured his hip and had an operation to repair it which was successful, but sadly despite the efforts of the physios he was no longer able to weight-bear. Another man on the ward, almost twenty years his senior but only in early stages of dementia, regained his mobility.
After six weeks in hospital my husband came home. He is hoisted from bed to chair/wheelchair and commode, and we have a carer three times a day to assist with this, and washing him. I have to keep a close check on his pressure areas and skin integrity and turn him in the night. His needs are obviously greater as he can do so little for himself now.
But eight months on he is as well as, or even slightly better than he was when discharged from hospital.
After the operation I was told that he would need nursing care, but I persevered in getting the equipment and care package needed to bring him back home. But the assumption was for nursing rather than residential care.
Much will depend on how well your mum recovers from the operation, and whether or not she is able to weight-bear. It really does make a huge difference.
Best wishes.

 

[BIWO]

My Mum had a fall in August and broke her hip. The problem with my Mum, that after the operation, she had difficulty in retaining instructions on how to use the walking frame and had no sense of danger and whilst in hospital had another fall. Although she had limited physio in hospital, she really did not progress in hospital due to the impact of the dementia. In her case the fall made her dementia worse and the SS assessment of her was that she needed a nursing home. We found a nursing home and TBH her walking has started to progress slowly after she arrived there. In hospital they were really not geared for a patient wanting to get up and move around and as a consequence whilst in hospital she was seated on one of the pressure alarms. She was in hospital for around 4 weeks- whilst other elderly patients without dementia who had a similar operations were up, walking around and out of the hospital in around 5 days. In my Mums case, the hospital got her to the point of 'medical discharge' which in her case meant they could get her out of bed, she could sit up in a chair and could walk on a frame a few steps with supervision.

 

[fizzie]

my mum had a fall and broke her hip. After the second day i insisted they took out the catheter and then I spent a lot of time at the hospital with her. I had to force the issue with a physio and be there for each session and if she didn't turn up I went and got her. I knew that if my mum didn't get her mobility back then she would be depressed beyond belief. I took 2 weeks off work and I helped her to exercise at least 3 times a day and then walk many more times a day than that. We did it slowly but really regularly - every hour when I was sitting with her. Then she went to a rehab and then home and she was walking unaided again within 8 weeks - it was hard work but she lived another 4 years and was mobile right to the end so it was worth it. Everyone is different of course

 

[sleepless]

my mum had a fall and broke her hip. After the second day i insisted they took out the catheter and then I spent a lot of time at the hospital with her. I had to force the issue with a physio and be there for each session and if she didn't turn up I went and got her. I knew that if my mum didn't get her mobility back then she would be depressed beyond belief. I took 2 weeks off work and I helped her to exercise at least 3 times a day and then walk many more times a day than that. We did it slowly but really regularly - every hour when I was sitting with her. Then she went to a rehab and then home and she was walking unaided again within 8 weeks - it was hard work but she lived another 4 years and was mobile right to the end so it was worth it. Everyone is different of course

I too was at the hospital every day of the six weeks my husband was in, and tried my best along with the physios to help him to stand and walk, but to no avail. In fairness I was told before the op that this would be the most likely outcome. At the time I was upset because there didn't seem to be enough input from the physios (cutbacks) but I know that they went above and beyond what they were allowed to do in an effort to help him. Believe me, I grieved for his mobility, but we have adapted to it, and we get around in a wheelchair adapted vehicle. I think it is possible that by now (8 months on) he would have had little if any mobility anyway.
Much must depend on the stage of dementia and mobility prior to the fracture I think.
You did a wonderful thing for your mum Fizzie, and I am so glad she remained mobile to the end.

 

[vivcares16]

Broken hip/my rights to information as a relative

my mum had a fall and broke her hip. After the second day i insisted they took out the catheter and then I spent a lot of time at the hospital with her. I had to force the issue with a physio and be there for each session and if she didn't turn up I went and got her. I knew that if my mum didn't get her mobility back then she would be depressed beyond belief. I took 2 weeks off work and I helped her to exercise at least 3 times a day and then walk many more times a day than that. We did it slowly but really regularly - every hour when I was sitting with her. Then she went to a rehab and then home and she was walking unaided again within 8 weeks - it was hard work but she lived another 4 years and was mobile right to the end so it was worth it. Everyone is different of course

thanks for this, really helpful, I think Mum is getting a good bit of physio at the hospital but will keep an eye on it.

 

[Grable]

Thank you all for taking the time to post your answers - helpful, as always!

 

[Grable]

Update

Well, we're 10 post-op and Mum's still in hospital. She can transfer from bed to chair with a rotunda, but hasn't yet been able to walk at all. She's eating hardly anything and rarely drinking unless I'm there. I've taken time off work to be with her, but need to go back soon - bills don't stop coming in just because you're not being paid, do they?

Right now we're waiting for an assessment by the care home, but I know they won't take her unless she can transfer from chair to wheelchair/wheelchair to bed with the assistance of just one person - and no equipment. I've found a nursing home that I would like her to go to if it comes to that, but they haven't got any rooms at the moment.

I hate this feeling of being in limbo and am really not used to not being able to do anything to improve a situation!

 

[chrisdee]

I know how frustrated we felt when Mum could not mobilise after a hip fracture - she had never had mobility problems, ever, but the stage of dementia, in my opinion, is the factor that trumps all the others. We found an excellent Nursing home, kind and patient staff but somewhere in her head she could not accept the wheelchair situation. Your Mum sounds as if she is doing rather better, but you are best to be prepared I think.
Make sure Mum has a proper discharge plan before she goes anywhere.

 

[BIWO]

I would agree with previous comments that the dementia has a major impact on the mobilisation. After my Mums fall and subsequent hip fracture/replacement, my brother looked at some back ground research (he is in the medical profession) into hip replacements with dementia and mobilisation and sadly the prognosis is not generally good in terms of getting their mobilisation back to where it was prior to the operation.
My Mum is now been in a NH for 4 weeks and around 8 weeks from her Op and she still has to be reminded that she needs a frame to walk with and still has no sense of danger.

Something to consider is whether a CH would be able to meet your Mum needs or whether you should consider a NH at the outset. TBH before I started on this 'journey' I had no real idea what the difference was between a CH and NH. I now do understand and could see that a CH may have met my Mum's needs in the early stages of dementia but after her fall, which moved her to the advanced stage, I realised that a CH would not be able to look after her.

 

[Grable]

I think I would be happier to have Mum in a nursing home now - I just need the care home to refuse her so that we can go for funded nursing, from what I can gather. I also need to find a nursing home in the area which has a space!