Hip Surgery

[marionq]

I haven't posted much recently as I didn't trust myself not to lose it completely. John went into respite on the 9th September to a care home we have used several times and which is excellent. He fell on the first day and two days later they realised he had a broken hip. I cancelled the holiday I had booked with my youngest daughter and have been at the hospital with him every day since. He had half hip surgery and it has had a devastating effect.

He has now lost his swallow reflex (dysphagia) and from what I read is unlikely to get this back. His meals are a few teaspoonfuls of puréed food and specially thickened liquids. He is now doubly incontinent and can only walk a few steps when held by two people.

This last year he was declining but the suddenness of the change after surgery has been dramatic. We are now looking at care homes for long term (if he lasts) care. What a minefield! I need somewhere closer so I can see him every day and make sure he is being properly looked after and it needs to be able to provide the higher level of nursing care which he now needs. The social worker on his case has liaised with the hospital and has written up a report of his needs but has warned me that some of the homes we are approaching may think he requires more staff than they can offer. He is not at all aggressive and never has been but doesn't always cooperate as I know only too well. He has glaucoma, CKD, and bad arthritis in his knee too.

So much of what I have read on TP over the years has come true overnight and I haven't even begun to address the financial side. He will be partly funded although to my surprise I have been told that if he goes for assessment to an intermediate care home I will be charged £139.50 a week for four weeks. I would have thought that assessment still comes under NHS but apparently this depends on where the assessment is done. My head is full of information which may or may not be correct and useful. Each day I start again with some new issue to address. It remains to be seen how it will all end.

 

[Grannie G]

I`m so sorry to hear this @marionq.

You have always been one of the stoics on this forum and if you have been in danger of `losing it completely` it must be bad.

I have to say how much more difficult it seems to be to find the care you need since I was looking 9 tears ago.

I can only keep everything crossed and hope you manage to find the right place.

 

[marionq]

Thanks Sylvia. This is yet another level of expertise I didn't expect to acquire. I thought care homes were good or bad but I now find they are categorised in all sorts of ways, residential, nursing home, nursing with dementia, intermediate care, extreme etc . John's dementia is now of lesser concern than his nursing needs. Didn't expect that. While he is still in hospital at least the care is good and I get reports from some of the other patients as well as the nurses as to how he has been. People in Glasgow just can't stop talking so I get a run down from them all. Unbelievably I even get a few laughs. Poor John is beyond laughs but it makes the visits easier.

 

[Guzelle]

So sorry to hear this you get used to the trials of dementia and then something else hits you. Sending hugs xxx

 

[canary]

Oh @marionq , I am so sorry

A similar thing happen to my mum, she was already a resident in her care home when she fell and fractured her hip. It had a devastating impact on her too and she also lost her swallow. I am not surprised that that you felt you would lose it.

((((((((((((((((((((((((((((((((((((((((((((((((((((hugs)))))))))))))))))))))))))))))))))))))))))))))))))

 

[marionq]

@canary did your Mum recover her ability to eat properly? John was a two apples a day man with a dish of grapes or berries always at the side of his armchair. Now I’m buying jars of baby fruit for a 4 month old.

 

[Helly68]

@marionq - so sorry to hear your news.
My mother (in a care home mid to late mixed dementia) had a very sudden downturn in her condition after emergency surgery for appendicitis and collitis that none of us realised she had. She went from walking around to needing help to transfer, but she did regain some function - in terms of communication and understanding. I can see that your circumstances are different and all you can do is to try and respond to what happens.
This disease is awful and I felt a lot of guilt that I hadn't realised Mummy was ill and she might have had a better outcome if I had. However, guilt serves no purpose (never stopped me feeling it though) and so many things can affect dementia - such a cruel lottery.
The speed that things change is truly terrifying. When Mummy had surgery I tried to take things one day at a time. In terms of the care home types, I think they will assess him and you may find that only certain homes would be able to meet his needs.
I am thinking of you and hope that the coming days bring better news

 

[Sirena]

Marion I'm so sorry to hear about what has happened to John. Good to hear he is receiving good care in hospital though, that isn't always the case for dementia patients.

The summer before last my mother had a fall in her CH and broke her hip, and had to have surgery. She did seem to deteriorate significantly while in hospital, but when back at the CH she regained mobility and got back to 'her normal' within a month. She didn't lose her swallow but she was reluctant to eat for a while, she was on Ensure type drinks for several weeks but returned to eating normal food.

In terms of different types of CH, even CHs which label themselves the same way will vary in which residents they will accept, so you'd have to visit each one to see if they could meet John's needs. My mother is in residential dementia as she has no other health issues, it sounds as if John may need dementia nursing?

My best wishes to you and John, I hope you find the right placement for him.

 

[jugglingmum]

So sorry to hear what has happened.

I can't offer any advice, but thinking of you.

I think a move to a 'home' of any sort involves an awful lot of stress and this stage will pass.

I am sure there is a home out there that will be right, but in the meantime it sounds like he is well looked after in hospital (I'm sure this is of no comfort to you).

You have always come across as calmly managing everything as far as you can but I'm sure that you have faced many issues before and got through them and you will get through this stage. It isn't long after the op and there is a good chance things will improve I'm guessing.

 

[Bunpoots]

I'm sorry to read about John's fall.
The same happened to my mum when she broke her hip and she went from being able to do everything independently to total immobility, incontinence and all the rest. It was later discovered she'd also had a stroke - wether before or after the fall I don't know.

In mum's case she recovered her ability to eat as she recovered - but she really liked those pots of baby fruit purée...

 

[marionq]

@canary did your Mum recover her ability to eat properly? John was a two apples a day man with a dish of grapes or berries always at the side of his armchair. Now I’m buying jars of baby fruit for a 4 month old.

Thank you one and all. I have read so much in the past about the effects of dementia with surgery but was totally taken aback how bad John was. He didn’t waken up for 3 days after the op.

Gradually getting things sorted though but a lot of adjustments for us both.

 

[LynneMcV]

@marionq I have just caught up with your news - I am shocked and so sorry to hear how suddenly and drastically things have changed.

I know how hard it has been for you to write your update and I can understand the turmoil you are going through.

We are thinking of you and John as you go through such a devastating time. I hope that with each day the options and paperwork become clearer as you gradually pick your way through everything. I also hope that you will find something close enough to make regular visiting possible.

Thinking of you and wishing you the strength you need right now.

 

[Starbright]

Hello @marionq ..I’m so sorry to read this and I do hope you find the nursing care John needs, also hoping you are looking after yourself too ...
I hope it’s ok to ask but did John have a general anaesthetic or spinal surgery. My husband has his pre ams and assessment in 2 weeks time for a spinal total hip replacement .
Take care A x

 

[charlie10]

So sorry to hear this Marion......such a wicked disease that pounces when you least expect it. My FiL broke his hip earlier this year and was in hospital for several weeks.....he was so bad we thought he was heading for a CH.....his mobility became non-existant, he had to be propped up in a chair with pillows, and requred 2 nurses to turn him in bed. For a short while his eating/swallowing was a worry.....fortunately it seemed to resolve itself. His mental state was also bad, we thought he'd leapfrogged into at least a middle stage of dementia. However he gradually turned the corner, and at Rehab (never thought he'd be well enough to get there)he learned to weightbear again. Long slow process but now, 9 months later, he is back in his home with a couple of carer visits, walking a few steps with his zimmer to his kitchen, and eating ready meals.

We were told it was delirium that caused his hospital problems. We're certain it masked/accelerated an underlying dementia as he isn't as good as before hospital, but I would never have thought he could recover so much, from when he looked at death's door. Don't give up hope, I know everyone's journey is different, but we don't seem to be able to predict the future even a day at a time. I do hope you can get to grips with the CH stuff, not easy when your mind is so anxious. Take care, and hugs from across the world x

 

[marionq]

Hello @marionq ..I’m so sorry to read this and I do hope you find the nursing care John needs, also hoping you are looking after yourself too ...
I hope it’s ok to ask but did John have a general anaesthetic or spinal surgery. My husband has his pre ams and assessment in 2 weeks time for a spinal total hip replacement .
Take care A x

As far as I know a general anaesthetic with his half hip replacement. I should have asked more but that early period was a bit of a blur due to the circumstances. The doc who did the op phoned the night before and told me to prepare for an outcome where John might not be able to come home so they are well aware of the seriousness of surgery on an elderly person with dementia.

 

[charlie10]

So sorry to hear this Marion......such a wicked disease that pounces when you least expect it. My FiL broke his hip earlier this year and was in hospital for several weeks.....he was so bad we thought he was heading for a CH.....his mobility became non-existent, he had to be propped up in a chair with pillows, and required 2 nurses to turn him in bed. For a short while his eating/swallowing was a worry.....fortunately it seemed to resolve itself. His mental state was also bad, we thought he'd leapfrogged into at least a middle stage of dementia. However he gradually turned the corner, and at Rehab (never thought he'd be well enough to get there)he learned to weight-bear again. Long slow process but now, 9 months later, he is back in his home with a couple of carer visits, walking a few steps with his zimmer to his kitchen, and eating ready meals.

We were told it was delirium that caused his hospital problems. We're certain it masked/accelerated an underlying dementia as he isn't as good as before hospital, but I would never have thought he could recover so much, from when he looked at death's door. Don't give up hope, I know everyone's journey is different, but we don't seem to be able to predict the future even a day at a time. I do hope you can get to grips with the CH stuff, not easy when your mind is so anxious. Take care, and hugs from across the world x

apologies if this comes multiple times, have tried to send it several times over several hours but it doesn't want to go

 

[Izzy]

Marion I’ve just caught up - I’m so sorry to read the update on John. Thinking of you both. x

 

[Starbright]

As far as I know a general anaesthetic with his half hip replacement. I should have asked more but that early period was a bit of a blur due to the circumstances. The doc who did the op phoned the night before and told me to prepare for an outcome where John might not be able to come home so they are well aware of the seriousness of surgery on an elderly person with dementia.

Thanks so much for your reply Marion... take care (((hugs))) A x

 

[padmag]

I haven't posted much recently as I didn't trust myself not to lose it completely. John went into respite on the 9th September to a care home we have used several times and which is excellent. He fell on the first day and two days later they realised he had a broken hip. I cancelled the holiday I had booked with my youngest daughter and have been at the hospital with him every day since. He had half hip surgery and it has had a devastating effect.

He has now lost his swallow reflex (dysphagia) and from what I read is unlikely to get this back. His meals are a few teaspoonfuls of puréed food and specially thickened liquids. He is now doubly incontinent and can only walk a few steps when held by two people.

This last year he was declining but the suddenness of the change after surgery has been dramatic. We are now looking at care homes for long term (if he lasts) care. What a minefield! I need somewhere closer so I can see him every day and make sure he is being properly looked after and it needs to be able to provide the higher level of nursing care which he now needs. The social worker on his case has liaised with the hospital and has written up a report of his needs but has warned me that some of the homes we are approaching may think he requires more staff than they can offer. He is not at all aggressive and never has been but doesn't always cooperate as I know only too well. He has glaucoma, CKD, and bad arthritis in his knee too.

So much of what I have read on TP over the years has come true overnight and I haven't even begun to address the financial side. He will be partly funded although to my surprise I have been told that if he goes for assessment to an intermediate care home I will be charged £139.50 a week for four weeks. I would have thought that assessment still comes under NHS but apparently this depends on where the assessment is done. My head is full of information which may or may not be correct and useful. Each day I start again with some new issue to address. It remains to be seen how it will all end.

Sorry to hear this news. It is shocking when they take a sudden downturn. I know because my OH has done just that in the CH he is in for respite, in fact enough of a downturn that he can't possibly come home. As for swallowing my OH is struggling with that, all I can say is that it has improved this week, so that may return for your partner in time.

 

[nae sporran]

Sorry to read of John's fall and the problems he is having since surgery, Marion.