Surgery or hospice? She was mobile and enjoyed life. We had her scheduled to go to memory care next week, since the wondering at night was becoming dangerous. But, she fell while we were out for a walk (with her walker). ER doc is suggesting surgery. Opinions?
My mother broke her hip when she was 91 and her surgery went very well. She was able to stand within hours of surgery and is still with me at 97 years old.
The anesthesia cause some confusion for awhile but it would be heartless to leave her in pain.
If a surgery will lessen everyday pain then it should be undertaken, even if the procedure could lead to an acceleration of dementia. Chronic and extreme pain also leads to confusion and contributes to a deterioration of cognitive abilities, anyway, so the risk may as well be taken.
Quality of life is more important than quantity, and pain robs you of that.
blocker when repairing my mom’s hip recently. I was told it is easier on cognition. ? She is still much worse than before.
My mom was in her 90’s and had Parkinson’s disease.
She had rotator cuff issues. Also, the bone on bone knee condition. She wasn’t a candidate for knee surgery.
They did X-rays to determine the severity of her shoulder issue. Mom’s doctor said that she wouldn’t recommend surgery for her due to her age.
She ended up doing home health. Her doctor decided on palliative care since she was in her 90’s.
Mom took her share of tumbles but she had strong bones. She never broke any bones. She used a walker but never ended up in a wheelchair.
She wasn’t bed bound until she entered her end of life hospice care home.
again, thanks and I'll keep you posted!
She cannot live with a broken hip.
She was active.
She well may not survive the surgery, but she CERTAINLY will not survive the lack of it.
I don't see the choice. We don't at this point allow people to live with broken limbs that can be mended. Were this a cancer, a kidney failure, a heart failure I would call in hospice, as these organs cannot be fixed. A broken limb can.
I do want you to understand that the surgery itself may lead to hospice if she survives. Some cannot tolerate anesthesia at this age. Blood clots and poor healing and failure of major organ systems are a risk.
Get the recommendations of several doctors; her own doctor and a surgeon. Fully discuss.
Also ask her for her own wishes. I can imagine she is in quite a lot of pain now. But hopefully she will give you some idea. Be honest with her that a failure to not have surgery does mean death almost certainly, and no little pain (which can be addressed).
Your and her decision not an easy one, and I am so sorry.
I am 81. There's LOTS I won't do now, node testing, chemo, radiation, dialysis, tube feedings, etc. But I WILL do other things, such as surgical removal of a tumor, repair of a broken bone, and so on.
At this age am down to the "What-I-will-do-and-what-I-won't" stage of life.
That is what eventually happened with my Husband. I stopped in at the Hospice building and asked about Hospice and how I would know when he would qualify.
BUT he had already had the surgery AND...this is the biggie...he went through rehab AND participated.
If your mom can not participate in rehab there does not seem to make sense to put her through the surgery.
On average though a Hospice patient with a broken hip that is not repaired will die within the 6 month time frame.
Some things to think about.
Surgery is tough at any age but at 99 it is going to be very difficult that I think is the biggest thing to think about.
She WILL decline due to the anesthesia.
MC probably will not accept her if she is not mobile.
She WILL decline more when she is moved to Rehab, Skilled Nursing or MC. ANY move will result in a decline. As will the hospital stay for the surgery.
If she CAN NOT or WILL NOT participate in rehab there is no sense to put her through the surgery.
What is her cognition now? Does she understand the options? Have you talked previously about Health Care choices? End of Life, and "life saving measures" i.e., DNR, Feeding Tube, Intubation? If you have discussed this in the past or she has made comments those are your guide posts in making decisions. (within reason)
I hope this is now as clear as mud...😂 all serious now when making decisions you always have to weigh the Benefit VS Burden and you have to make the best decision you can with the facts that you have. If you do that then decisions are coming from the Head and not the Heart. Those are the tough decisions.
Surgery goes well but the hospital delirium started. At two weeks in the hospital his decline was quick. He couldn’t talk to do physical therapy. Week 3 in hospital he stopped eating and would barely be awake. We decided against a feeding tube. Quality not quantity. We moved him to hospice week 4 and he passed away a few days later.
the doctors said my grandfather was living in the perfect balance. He stayed at the same home, had a daily routine so he was still able to function prior to his stay. Hell we had some cooking scares but he was smoking cigarettes up until the hospital stay.
wishing your mom a speedy recovery. The change in environment can really speed up the decline. Make sure you go visit her every day while she is in the hospital. You are familiar. That will definitely help prevent any issues while she is recovering in the hospital.
For surgery, she will need to cooperate with things and keep her IV in, and hope she doesn't get delirium afterwards.
To do the rehab she'll need to take the pain meds (and endure the extreme constipation from those). Someone will have to stay with her all the time to make sure she doesn't attempt to get out of bed and make sure she's eating and drinking and advocating for her. In the end there's no guarantee she'll walk again.
When my 100-yr old Aunt with advanced dementia fell & broke her hip, we decided against surgery and she went to rehab just to learn how to pivot on it. She passed away in the rehab. She continued to try to get out of bed, and wasn't eating or drinking unless a family member helped her.
In hindsight I wouldn't have put her in rehab but didn't have a way to keep her from thinking she could walk no matter where she ended up.
Putting a 99 year old person through surgery that will only cause her dementia to worsen sounds rather cruel and inhumane to me.
If it were me, I would want my family to put me under hospice care where they would keep me pain free and let me live out my days around my loved ones.
But that's me. Has your mom ever discussed before her dementia what her final wishes were? If she had, that should help make your decision a little easier.
Know that even if you choose to have surgery for your mom that she will more than likely never walk again anyway, and will be completely bedridden, so I'm not sure any of that is worth putting a 99 year old women through.
I would instead just keep her pain free until she leaves this world for the next.
And on a side note, of course the doctor is suggesting surgery as all the majority of them think about is money any more, and not what is in the best interest of the patient.
Why don't you ask them if it was their mother what would they suggest and why?