Hi,
88 year old Mom broke her left hip from a fall and had surgery this past Sat evening...she came thru ok but is having a difficult time in recovery due to her moderate severe dementia and anesthesia..... it's been just about three days and she is really out of it with delirium.... doc says today that she still needs to be in hospital until this clears(if it clears)...she can't even do recovery currently
because cognitively she is not at her base line yet...she also
had a small blood clot in lungs area which has been treated with blood thinners etc...anyone else had this type of situation after hip surgery or surgery in general with regards to dementia and anesthesia?
The blood thinners can cause bleeding strokes in the brain, and elsewhere, so worrisome.
Her age is worrisome.
Does she have a DNR status?
She will, I hope go to rehab as a try?
The anesthesia and dementia is terribly common and as a nurse I saw a huge amount of it. I cannot know how many improved at home.
I hope some members here have experience with elders getting increasing dementia in hospital and improving after being home. Hospitals can bring on temporary confusion with even a mentally very fit elder, so there is that.
The doctors will guide you and this is a step at a time day by day process now. Each patient is as individual as his or her own fingerprint. Due to poor balance in the brain's system falls are very common, and broken hip a very common result of a fall.
For my mother, her first fall was the beginning of the end in her early 90s. Some do well. But there are many complications to get past. I wish you the very very best here, and your Mom as well.
She remained there as a LTC patient for
4 1/2 years.
That's how this scenario generally plays out. My father lasted 10 months after he broke his hip and failed to make progress in rehab......he had a brain tumor which prevented him from walking and being mobile again.
If you can get mom to walk, with a walker even, that's the best rehab for hip surgery to keep her mobile.
Best of luck.
Also, make sure she is getting enough fluids and food because some rehab facilities and hospitals don't spend a lot of time trying to encourage people to eat. They can't force them. They also can't force them to take the pain meds.
Where was she living: at home or in a facility? If she was at home, you may need to be open to her needing LTC now. Have very tempered expectations for her recovery and return to mobility.
Hold steady.
Await the delerium to settle.
Once medically stable, onwards to rehab.
Was Mom at home before? Or residing in residential care? If so, going back to her familiar room & adding Physio visits may be something to consider & discuss.
Besides blood clots, avoiding falls & pressure injuries (bed sores) will now be priorities.
Wow, you guys really bounce folk out of hospitals pretty fast eh?
Was it a total hip replacement?
You may find Mom doesn't remember the surgery & just gets up & moving with you! (Complaining of a sore leg or hip of course)
However, if it was a hip repair surgery, even though supported by metal screws, if the (broken) bone is still there I would expect it to still hurt.
But then again, pain is very individual.
What's the update on transferring out of bed?
If you didn't have this discussion and if her care at home is not going well, call the hospital discharge folks to discuss placement. I believe you may have a short window of opportunity to do this
NH will not be paid for by Medicare. Does she have Medicaid, or does she have the resources/assets to pay for Long Term care?
How is her mentation at home?
How are you managing?
If this doesn't work out you need to call EMS and it's back to the hospital.
While she may not qualify for rehab, she may require some SNF placement.
Hoping she is adjusting well at home.
Let us know how it is going for you.
Having gone through a total knee replacement this past summer, I'm wondering if your LO is on any pain meds (opioids or OTC like Tylenol)? Because if so, they are incredibly constipating. Post-op for me the constipation was the most frustrating thing. It made me feel sick. I was taking prescription laxatives, stool softeners, fiber pills, drinking tons of water and it was still a problem for the entire time I was taking the pain med, even though it was just high doses of Tylenol.
If your LO complains of stomach pains (even high up, like under her rib cage) or hasn't had a BM in a while you may want to consider contacting her orthopedist or primary physicisan for advice, who may then suggest taking her to the ER. This is one of the most common problems post surgically.
As a nurse I saw man enter ER for disimpaction. You would think I would have known better.
If you can afford help at home, I would not recommend pushing her into LTC at this time. Give her a chance to recover from the surgery before you look at moving her to long term care (if needed). Too many changes in a short time frame is harder for the elderly, especially if there is some dementia involved.
My Mom went to Rehab after a UTI. I swore it was the last time she would ever go. She sat around in a wheelchair most of the day. I asked them to sit her on the couch because the WC was too umcomfortable for her with her bad back. I was told by the PT person that she could not remember her exercises from day to day or as she was doing them. I said maybe because she has Dementia. By that time she was probably stage 6. She would have done much better at her AL.
Health problems can line up & have knock on effects.
I've heard a fractured hip called a 'game-changer' when past 90 (or close to). It's not just the broken bone, it's the total of anaesthesia, pain meds, delerium, being away from familiar home.
I've also heard medical opinions of likely/not likely to be here in 6 months. This is probably their best guess, based on their previous patients, plus your Mother's presenting illness & injury.
Mine had a huge stroke & nobody would have predicted she would be still here.
Only time will really tell.
Having hospice may be a good thing. It can change lanes - from the fast lane of rushing around all those Doctors & treating everything to the slow lane.. less meds, food she likes, comfort care.
I've asked many super aged folk now, what do you want? What would you like to do today? Often it is things like.. to sit here, to look out the window, some peace & quiet. One sweet lady just wanted to look at 'her tree' outside her window. She reminded me of a lovely baby, in a pram, gazing at the trees. It was enough.
I hope when the shock of that medical opinion settles, you can change down into the slow lane & find comfort in that.