Broken Hip but No Operation

[SkiSarah]

Hi all,
My Aunt (I'm next of kin), 88 years old, has advanced dementia. She fell & broke her hip 4 weeks ago. The hospital initially said they would operate because it would be very difficult to care for her otherwise. The following day they changed their mind & advised me she was unlikely to survive anyway given her advanced age, dementia & frailty. I was told any pain or discomfort would be dealt with by medication. Then they discharged her, saying the best thing for her is palliative care.
Now 4 weeks later & she's still very much alive in a nursing home. Every time they tend to her with personal care she screams the place down in pain due to her broken hip - it is awful to hear. Surely that is not palliative care? How is that managing discomfort with meds?
Has anyone else been in a similar situation, ie. a broken hip not being operated on?
I am starting to think the hospital just washed their hands of her.
I have spoken to the care home but they just talk about another morphine dose which doesn't seem to touch the sides.
Thank you all for reading this,
Sarah.

 

[sdmhred]

Gosh @SkiSarah
This happened to someone in mum’s nursing home. Hearing him scream out was awful. They eventually got on top of the pain after a few days, but I remember them saying the doses weren’t lasting long enough. He however died after a week so it was relatively short lived.
have you spoken to the GP about the pain relief? That is cruel to leave her in so much pain 😭😭 How do the NH feel? The staff in mum’s were horrified at the situation

 

[SkiSarah]

Gosh @SkiSarah
This happened to someone in mum’s nursing home. Hearing him scream out was awful. They eventually got on top of the pain after a few days, but I remember them saying the doses weren’t lasting long enough. He however died after a week so it was relatively short lived.
have you spoken to the GP about the pain relief? That is cruel to leave her in so much pain 😭😭 How do the NH feel? The staff in mum’s were horrified at the situation

Thank you for your reply - it doesn't seem common for them to be discharged from hospital without the op. But not that rare judging by your experience. I am awaiting a call-back from the GP & the NH are sympathetic but seem incapable of aligning the times they do her personal care with the maximum efficacy of the meds. I will keep on at them!

 

[Sterlingtimes]

Yes, I have come across circumstances where hospitals had refused to operate in hip fractures having regard for all of the circumstances.

My mother had an operation two years ago on a fractured hip but has been in pain ever since. Upon later investigation, she has a chronic acute periprosthetic fracture, which I understand to be a secondary fracture along the line of the hip screw. Owing to her age (95) and conditions, an operation is out of the question. So she is likely to go down a palliative care route. The screaming is dreadful.

 

[leny connery]

oh dear. this is new to me and dreadful to read. How can one be left with such pain? I fractured two fingers and it was painful enough!! a hip?????

 

[SherwoodSue]

My mother in law died aged 102. Fractured her pelvis. No op. Died slowly. FIL.
Broke his hip aged 100. Operated on died days later post op in hospital.
I know which was the better outcome to the observer.

 

[sdmhred]

That’s really interesting @SherwoodSue

So even if the likelihood of recovery from surgery is very poor - that still might be the kinder option all round. I wonder how the NHS would respond if we insisted for that very reason.

I shall bank that thought!

 

[Waitinggame]

I have a friend aged 80. She does not have dementia but has multiple other conditions. She recently had a complicated break to her leg. Initial choices put forward by surgeon were either to operate to do minimum to set leg but she was likely to be bed bound or second option was to operate more extensively but due to her other health conditions the possibility of her not recovering from the operation was an issue. She was able to make her own decision and opted for the second option. She had operation using epidural rather than general anaesthetic. She is now home and comfortable. As I say she was able to make her own decision. Making that decision on behalf of your aunt is more tricky.