urgent advice needed

[steve58]

Thank you all for your support and messages.
Due to the lack of care at the Nusing home we found she had a seizure. They didnt call the Doctor out.
WE had to call the ambulance ourselves.
She has a broken hip, and due to the lack of care she is suffering low blood levels, aneamia and other things. This happened on Monday. The surgeon is trying to build her up for the op. We dont think she has much chance of surviving.She is so ill. How dangerous is it for someone with later stages of vascular dementia to have an aneasetic.
Im sorry for the badly written post , we have just left the hospital and are desperate for help

 

[Helen33]

Dear Steve

I am so sorry to hear this shocking story Regarding the anaesthetic, it might be a good idea to talk to the consultant and the anaesthetist. When my husband needed a major hernia operation, the matter was thoroughly discussed and a suitable anaesthetic was used.

This really is an appalling situation but for the moment I hope that all goes well at the hospital and that you find the support and information that you require at this time.

Love and best wishes

 

[Skye]

Steve, I'm sorry you've had such a distressing day. It does sound as if there is a lack of care if an ambulance was not called immediately.

As for anaesthetics, they are ertainly no recommended for someone with dementia. Having said that, however, .some residents of John's EMI unit have had operations for broken hip or pelvis, and all have come back OK. One gentleman was 92.

I don't think there really is an answer to how successful or how risky an operation would be.

 

[jenniferpa]

Firstly, I'm so sorry it's come to this.

I'm am by no means an expert, but I'm not sure that the anaesthetic is itself dangerous. It's what caused the vascular dementia in the first place that could cause the problems (high blood pressure, atrial fibrillation etc.) plus the fact that when someone with any form of dementia has anaesthetic they may not recover to their former level.

I think the reality is, though, if the surgeon thinks it's necessary, it's necessary: they are far more likely to say "no" rather than "yes".

 

[Cate]

Hi Steve

I am so very sorry to read what has happened to your mum.

How somebody reacts to anaesthetic I would think will very much vary on the individual, age, physical condition etc., whether or not this will also have an effect on your mum's AD, sorry I dont know. I would contact her Consultant Psychiatrist for advice on this, I doubt that the general surgeon doing the surgery will have had much experience of patients with AD and the effects if any, after anaesthetic.

If you can make some notes about the sequence of events that has happend to mum for when you might need them. I would also use the time mum is in hospital to do some research on other NH, I doubt that you would want your mum to return to this one.

Try not to lose heart, hope all goes well
Cate

 

[JPG1]

Steve

Perhaps the only person qualified to answer your question about the anaesthetic is a medic, either the consultant or an anaesthetist, or preferably a combination of both. We were told that it required an evaluation of the patient, of all the medications being taken at the time, the degree of confusion (only word I can find to use) before the need for the op, and the likely degree of complications after the anaesthetic. And that’s the big unknown, sometimes.

Sometimes someone with dementia who undergoes an anaesthetic can become more confused and more in need than before. Not always; but sometimes. That’s what we were given to understand. But no two people are the same.

Talk to the medics. Ask any questions you need answered. And ask what happens to the broken hip if there is no op with no anaesthetic? Can they do anything without an anaesthetic to assist the broken hip? I think the answer to that one may be no.

Sounds like you have had one hell of a day, and that there is a problem in that nursing home ... if they don’t dial 999 quickly. You did say it was a Nursing home, didn’t you? Were the nurses all off-duty?

Sorry, no easy answers for you, just more questions.

Hope things improve for you all,

 

[Vonny]

Dear Steve,

I am so sorry that you and your mum find yourselves in this distressing situation.

As previous posts state, a lot depends on the physical state of the sufferer. My mum was considered (at around 5st) to be too weak for anaesthetics, local or general. However, she had not eaten properly for around 12 months so your mum may be in much better physical shape and come through an op with no trouble.

Please make sure that the "unhelpful" SW and CPN are made aware of this in order to hurry along the assessment for your mum to be moved home to you, if that is what you still wish.

I wish you and your sister, and of course your mum, the very best

Vonny xx

 

[steve58]

Re my Mom

Thank you all for such quick responses. We are both in a terrible state and you have all given valuable advice.
The social worker in on Holiday and so is our advocate so we are totally= alone and feeling very weak and vulnerable . My moms life ia so precious to us. Why are there no caring knowlegeable people in the Health service. If there are, why are they so hard to find and help.
My mom has to have 3 packs of blood. She has had two today and is going to have one in the morning. For some reason I forgot, they cant give the last one overnight. I doubt if the op will go through tomm. If we can stop panicking and try to get someone to help us it will give us time to give information to the medical team. They know she has Vascular Dementia but when we talked to the Doctor today he looked fresh out of Medical School and couldnt grasp the dangers of Vascular
Thanks to you all, you are really caring people
stevexxx

 

[burfordthecat]

Hi Steve

What an awful situation for you all to find yourselves in. I do hope that your mom will be able to kept comfortable, in hospital, tonight. I too would agree with others who have said that you need to make all the medics aware of your mom's vascular dementia. Make a nuisance of yourself, if that is what it takes. I remember being told by someone on TP, not long after I joined, that" it is the squeaky wheel which gets the oil". So very true, so get noisy.

Sending you love and hugs

Carina x

 

[nellbelles]

My Mum (no dementia) but a heart condition had her hip repaired with an epidural, so maybe mild sedation and an epidural could be considered,, My views only, not medical fact.

 

[foxhound]

What a ghastly time for you. I suppose the silver lining (if you look very hard for it) is that now you can at least consider that particular NH well and truly behind you.

Epidural is certainly one way of doing it, but I do think any sort of op has risks if someone is old and run-down.

From my experience, the "technical" surgical side tends to be very very good - and a new hip or half-hip is pretty standard stuff nowadays. The problems come with after-care and recovery.

You should be prepared to push the nurses very hard indeed, and come up with a range of fall-back plans if recovery is slow. These might range from a decent NH you have recced to bringing yr mother home with carers and a community physio laid on (the latter is what I did). MORE pushing the sytsem to give you what you need, I fear, which is the last thing you need when you are so worried.

I don't know if it's a comfort or not, but I always feel that if people "deep within" want to carry on, they can recover from very sticky situations. If she doesn't (sorry to sound direct) at least she will have found peace. Very best of luck.

 

[steve58]

update on my Mom

Firstly I want to say thank you so much for all your kindness and support.
My Mom survived the operation even though it was 50/50
The Doctor said he thought mom deserved a chance. The first words of kindness we have heard in such a long time in the Medical world believe me!
We went to see her tonight in the Hospital and they said that she had had a good day considering what she has been through.My Moms a fighter and knows she has people who love her. WE KNOW !!!!!!!!!!
We got a call from the CPN today who said to phone the Social worker on Tuesday and Mom is definitelty NOT going back to that home!!!!!!! She is coming back to the people who love her. Of course the next few weeks are crucial to see how her mobility is affected but we were told to take one day at a time. As for any further damage to her brain due to her seizures or the truama she went through , we have no answers or will be able to tell. She is on the minimum pain relief for safetys sake but she is still very dazed and confused. At this moment in time we are just so grateful that she is still alive. This situation need never have arisen. Please pray for us that we have the strength to fight for moms rights and that she will be brought home to where she belongs when she is fit enough. We know that sadly a time will come when she will be admitted to hospital for good, but its not yet and we are not going to be mislead or persuaded otherwise just to make the Medical worlds life easier.
Thank you all so much for your kindness and humanity. All we have encountered is hostility or indifference and we have had to learn the hard way. Why do they think that people with Vascular Dementia or Alzheimers have no right to a good quality of life and love. Its not much to ask for . Thank God for this site and all you wonderful caring people

Stevexxx

 

[jenniferpa]

Steve I'm so glad that your mother is doing as well as can be expected. I don't think, either, that you should assume that eventually she'll have to return to hospital - it might be necessary and I don't think you should feel any guilt if that's the way it works out, but there is no reason, if you get adequate support, that she shouldn't stay at home until the end.

 

[steve58]

Thank you

Hi Jennifer

Thank you so much for your kind words. It is encouragement like that that keeps us going. Mom will be spending time in Hospital for , the Doctors hope, no longer than four weeks at the most. We in the meantime must try and concentrate on getting ourselves strong and fit again. We are going to suggest to the Hospital that we could be there when the Physios start work on Mom as it might help as we though time and error learned the best approach with Mom which is so important for her.
When you said about it might not be necessary for her to end her last days in Hospital has brought us both such comfort.
Thank you for your kindness and support Jennifer
Steve

 

[fredsnail]

My grandfather (97 with vascular dementia) has had 3 general anesthetics in the last 12 months - there seemed to be a deterioration around 6 weeks after the anesthetic for the first 2 - but with the third, although there was confusion and agression immeditely afterwards for a few weeks, once that had passed he went back to the same level as before.

He has broken both hips in the last 12 months - and is still gaining mobility with assistance and a frame from the last one 4 months ago.

I hope that you can get her mobile and home to you.

 

[Vonny]

Dear Steve,

Wonderful news about the op, just wanted to say don't forget we are here for you when your mom comes home as you will be facing new challenges as I know you are aware of.

Look forward to hearing about your mom's progress with the physio over the next few weeks. Hopefully during that time the relevant agencies will be dealing with the logistics of her coming home.

Vonny xx

 

[Margaret W]

Steve, hope mum is progressing well. It has been a hard time for you and your family. You deserve it all to come good in the end.

Love

Margaret

 

[Scottie45]

Dear Steve

Hope your mum is doing well after her op,and that you get things sorted out soon,all the best take care Marian x

 

[nbfb]

Dear Steve,

I hope that things are still progressing well? A few things we learnt over the last few months having been in a similar situation:


[*]Anaesthetic and/or painkillers can suppress distressing dementia symptoms in some patients. We were lucky to have almost 'normal' conversations with E in the few days post hip surgery due to blood transfusions (extra oxygen to the brain they told us)and the 'picking' behaviour subsided

[*]Dementia patients have often got a very high pain threshhold, which can often mask symptoms, but of course I am not defending the actions of the nursing home

[*]The shock of the fall and subsequent surgery can make the dementia accelerate. Make sure that they are aware that your mother may not be able to demonstrate that she is in pain

I do hope your mother continues to improve and wish you well. Start the ball rolling for eventual discharge into more suitable care as you have to feel happy that whatever you eventually decide, the wellbeing of your mum is the highest priority. On a more cautious note, don't be suprised if things do not progress as fast as they anticipate. If her general condition was very low she may not get back on her feet at all. Sorry if this sounds gloomy, but we found as others have mentioned here, that things can take a dip after a few weeks. We are 12 weeks into this now; it can be grim even with good nursing care.
I hope your ma is one of the lucky ones. Take care.
nbfb