Broken hip

jeannette

Registered User
Feb 27, 2006
55
0
Sadly, my mother's done what many of us fear: she's fallen and broken her hip. So far, so good. Though 96 and fragile looking, she's come through surgery, thankfully, but she's so confused and - because the nerve block from surgery is still keeping her pain-free - doesn't understand why this awful "cruelties" are being visited on her. The nurses are lovely, but my sister and I are dreading the inevitability of the real pain and suffering, physical and mental, ahead of her.

And of course, part of the real sadness is that finally it seems likely that she may not be able to go back to her home - though that's not certain yet; nothing is certain now.

I'm sure some of you have gone through this experience - and any useful advice will be gratefully received for the long road.

Right now, she doesn't believe she's broken her leg, thinks we're mad and cruel, and when can she get out of bed and go home! Not yet, we tell her. No intention of telling her anything like the possible truths - as so often with AD, white lies are so much better.

Anyway, thanks for listening and good wishes to you all.

Jeannette
 

dmc

Registered User
Mar 13, 2006
1,157
0
hi jeannette,

so sorry to hear of your mums fall, my nan was 91 when she broke her hip, she did come out of hospital afterwards for a year, but she never really recovered,
i think her confidence went and she was frightened to do anything, she didnt have dementia though.
my mum is the one with dementia, she's 65 and as yet havent broken anything when she's fallen quite a few spectacular bruises though:eek:
i think you just have to take it one day at a time at the moment, keep telling those little white lies as often as you need to to get mum through this.

sorry i cant offer any advice that will help but im sure there are others who can, just wanted you to know your being listened to

take care hope mum gets better soon x
 

noelphobic

Registered User
Feb 24, 2006
3,452
0
Liverpool
My mum fell and broke her hip in November last year. At the time she had been in an EMI care home for a year. She was in hospital for a month and then went to a nursing home as she was unable to go back to the previous home as she was no longer mobile.

She did have some physio in hospital, but not enough, and it all stopped after she left hospital. Therefore she has been in a wheelchair ever since. I think if she hadn't had dementia she would have been walking again. She still thinks she can walk and tries to get out of her chair frequently.

We did find that the hospital were in a great hurry to get my mum out of there because they needed the bed. They discussed the possibility of going to the rehab ward but she was refused, I think because of the dementia.

I know if it is decided that your mum needs to go into residential care it will be hard for you. What I would say is that you should not let your decision be influenced by pressure from the hospital. If you decide on a nursing home then take your time looking around as much as you can. Also, if you feel that your mum would benefit from physio AFTER leaving hospital then get it put in place before she leaves. Once she goes into a nursing home the NHS doesn't want to know.

I hope things work out as well as they possibly can.
 

Kayla

Registered User
May 14, 2006
621
0
Kent
My Mum broke her hip last October and was in hospital for nearly four weeks. She didn't seem to be in pain from the hip operation, but they didn't operate for 48 hours, which meant that she got too stiff with her rheumatoid arthritis and they couldn't get her back on her feet without hurting her. They were afraid of her breaking something else, because she is very fragile. I'm sure if they had operated the same day or within 24 hours, she'd have been able to walk again.
They refused her physiotherapy, because they said she couldn't listen to instructions. Although in an ordinary care home before the fall, with early, manageable symptoms of dementia, she had to go into an EMI nursing home after leaving hospital.
She did start walking again briefly, but can't stand up any more now. NHS hospitals are no place for the elderly, because they are too impersonal and clinical. There's not much point preventing infections, if patients forget who they are, because they are not treated as individuals and called by name each time they are attended to. In Mum's ward, there were other elderly patients who were just as confused as she was, so they should provide special carers for the elderly, in the same way as they provide teachers for children in hospital.
Kayla
 

jeannette

Registered User
Feb 27, 2006
55
0
Story so far...

Depressing scenarios being painted, but no point being unrealistic.
It's been like a roller coaster for us. Day of surgery, we were happily surprised at how well she came through. Yesterday was a different story. Several hours of hallucinations - actually happy ones for the most part, but a huge deterioration mentally. This turned into several more hours of anguished tormented hallucinations - awful terrors, so very very hard to witness. Thankfully they sedated her finally - if they'd done that a couple of hours earlier, it would have been better, but I know they were doing as best as they could. Very kind nurses so far - and a terrific staff nurse, who's been very amused by my mum's strength of will. From sticking her fingers in her ears (in Recovery!) because she didn't appreciate the ear thermometer to pulling out one of her IVs and telling them it was fine because she had another one. Anyway today she was calm and sleepy and very sweet and appreciative of visitors (hasn't been like that for a very, very long time), but she's not eating nearly enough. Early days. We just hope for the best possible outcome for her, but we're facing up to the fact that a broken hip for a 96 year old with dementia is not a good news situation.
Anyway, thank you for your stories - any "tips" for trying to ensure good rehab would still be gratefully received.
Meantime, good wishes and thanks.
Jeannette
 

Kayla

Registered User
May 14, 2006
621
0
Kent
Dear Jeanette,
The most important thing at the moment is to get your mother to eat properly. The hospital food is not usually very appetising for elderly patients and she may need help to feed herself. Visiting was very restricted in Mum's hospital, but if you could go at a meal time then you'd know how much she was eating and help her if necessary.
Not much physiotherapy or rehabilitation was offered in the hospital and the care home manager thought Mum had been neglected. The NH knew just what to do and their meals are designed to build old frail people up and are easy for them to eat. Lots of soup, milkshakes and snacks are provided, as well as proper meals. Mum is looking much better and has gained some weight.
Personally, I'd prefer to have Mum in a good nursing home than in a general nursing ward where the staff are not experienced in looking after elderly people. Maybe the hospital in your area is better than our local one though.
Kayla
 

jeannette

Registered User
Feb 27, 2006
55
0
Eating problems

Dear Kayla,
Thanks for this. The worst thing (today) is that she's not eating at all - neither the fairly awful looking hospital food, nor a very simple (and usually favourite) liquidized vegetable soup, nor her favourite little pot of choc mousse. Her teeth are causing big problems and when I did think I'd won with cut up little strawberries, she couldn't get past that problem. It's very worrying. And much too early to think of moving forward to a NH or anywhere. But the nurses, although stretched, are very kind and seem to know how to handle just about everything.
Tomorrow I'm going to start trying to speak to more people - physio, occupational therapy, etc. - and, of course, most of all, to discuss the eating problems.
Hard, isn't it.
Best again, Jeannette
 

noelphobic

Registered User
Feb 24, 2006
3,452
0
Liverpool
When my mum was recovering from her op and not eating much she was given a milk shake called 'Ensure'. I think it's something like Complan and is used for people who aren't eating. They come in different flavours. Has the hospital tried this?

I would definitely push as hard as you can for your mum to have as much physio as possible. I really wish I'd done this but there was so much going on at the time that I didn't.
 

jeannette

Registered User
Feb 27, 2006
55
0
Not doing well

Sadly, she seems to have given up on Ensure too - but thanks, Noelphobic (love your "name"). Water only, occasional half teaspoons of something (only sweet). No appetite, new incontinence problems, and today her hands, feet and legs were suddenly very swollen, which worries us a lot. Still no conversation with the doctor - the nurses are great, thankfully. The Occupational Therapist called me today with a questionnaire, promised to get the Social Worker's number for me, but didn't. If she doesn't start eating soon, I don't know what will happen. And of course, even if she does, the outlook is so damned grim.

Two redeeming (right word?) features: the dementia is shielding her from much of the distress she would ordinarily be experiencing in these circumstances. And two days running I had long visits with her when she was so sweet and glad and loving, and I could, for the first time in so very long, be kind and loving to her.

Sad, bleak-seeming times. Maybe things will improve, maybe she'll have more strength to get the right amount of physio, but I have to say we doubt it at present.

Sorry to be so downhearted.

Best to all.

Jeannette
 

Kayla

Registered User
May 14, 2006
621
0
Kent
Just before Christmas, I really thought we were going to lose Mum as she was so weak and had lost so much weight. It sounds as though the lack of appetite is part of the recovery process, rather than failure on the part of the hospital. We weren't allowed to visit at meal times, and it would have been so reassuring to have had to opportunity to try helping with feeding ourselves. Why do they exclude relatives like this?
At least you know that you've done your best. It was surprising how quickly Mum started to regain lost weight once she started eating again. I guess a fall is very traumatic for any elderly person and it does take a long time to recover. Don't give up hope, as it is amazing how people can get over things. My Dad recovered from septicaemia after the hospital had said they could do no more for him, and he was nearly 80.
I hope your Mum is feeling better soon.
Kayla
 

jeannette

Registered User
Feb 27, 2006
55
0
Not giving up, but...

Hi Kayla.
Thanks for this glimmer. We're not giving up on her at all - but it's not looking great at present. No food, infection, massively swollen hands, feet and legs, and a sense of her somehow giving up in some ways. Maybe we will still get her past this - but we do fear what she has to look forward to.
We're trying, meanwhile, to keep up our spirits. There's so little normality at a time like this - everything else seems put on hold.
Thank you so much for the thoughts.
Best again, Jeannette
 

noelphobic

Registered User
Feb 24, 2006
3,452
0
Liverpool
Kayla said:
Just before Christmas, I really thought we were going to lose Mum as she was so weak and had lost so much weight. It sounds as though the lack of appetite is part of the recovery process, rather than failure on the part of the hospital. We weren't allowed to visit at meal times, and it would have been so reassuring to have had to opportunity to try helping with feeding ourselves. Why do they exclude relatives like this?
Kayla
My mum also wasn't eating much after she broke her hip. However, although I have many criticisms of the hospital she was in, they did say that we could go in at meal times to help her eat if we were able to. This made sense for all concerned. Mum wasn't really capable of feeding herself but the staff were very busy and it took a long time to feed her. If a relative took over this task then it freed up a member of staff and helped the relative to feel they were doing something to help.
 

jeannette

Registered User
Feb 27, 2006
55
0
Bad to worse

We're trying all that, but to no avail. Until today, when I phoned the ward in the morning they've said she was not bad and eating a little breakfast. Today she's not even done that, and is refusing pills. Only "normal" thing is she's saying she wants to go home. They're managing just about to get her antibiotics into her, but that's it. Water only. No Ensure. No homemade liquidized veg soup, no simple broth, occasional tiny scraps of something sweet in the evening, but not significant enough to call it eating. She's also let my sister and I feed her those - I cannot tell you how much that is not our mum. How much what we call the "real" her would hate it, fight hard against it.

Not good at all. And if she makes it through this, she's going to be so weak that physio will be that much less likely to succeed, which means all the full nightmare, all the terrible stuff we thought she would be spared because she'd begun AD relatively late, ie after 90.

Hard to see any glimmer today, except for the last few visits when, as I think I said, there's been more opportunity for love and kindness than in the last few years.

Sorry to be such a downer. I do hope I can report an upturn, not just for us, but for others facing this point.
 

Lila13

Registered User
Feb 24, 2006
1,342
0
I'm glad she (and the hospital) are letting you and your sister feed her a little bit.

(Hospitals are so different in that and in other respects, and most patients and relatives don't get a choice at this stage.)

And that there's this opportunity for love and kindness.
 

May

Registered User
Oct 15, 2005
627
0
Yorkshire
Hi Jeanette
Thinking of you. Holdfast, if Mum's taking water that's a plus, wishing you a better day tomorrow.
Take care