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Caring for my 89yr old MIL who broke her hip in February, she wasn’t a candidate for surgery. It breaks my heart to see her in such pain. What should we expect to see? Will she get stronger? The bone hasn’t attached, so it’s just kinda floating.

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What??? My father was 91 when he fell & broke his hip and had surgery to fix it. "Not being a candidate for surgery" is not an option in a situation like this, for obvious reasons. What makes her 'not a candidate', exactly? And how is her hip supposed to heal without repairs or a prosthetic one if a repair isn't doable? Makes no sense.

If general anesthesia is the issue with your MIL, I had my right hip replaced with a prosthetic one under ONLY an epidural! I chose Propofol to knock me out during the 90 minute procedure, or else I could have stayed awake like some people choose to do. An epidural creates none of the same 'waking up' issues as general anesthesia does for many people.

Please get her into see a bone surgeon right away and if that doctor concurs, then she'll need hospice for pain management, at the very least. Seems inhumane to me to do anything less.

Wishing you the best of luck and sending hugs and prayers your way.
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Riverdale May 2020
Is Propoful an epidural?
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Your MIL needs to see an osteopath—a bone doctor. If there has been no healing in 3 months, something needs to been done for her. She must be in excruciating pain. Ask her primary care to refer her to one.
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I'd likely ask the doctor for his prognosis and recommendation for pain treatment OR get a second opinion. Long standing pain without treatment sounds horrible. What does the doctor say about it? Is she a candidate for hospice?
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When my mother broke her femur just above the knee (simple in place fracture allowed the femur to break away from the knee replacement prosthetic) and was not a good candidate for surgery, the doctor provided a wrap and brace to help hold the broken portion together, proscribed a period of no weight on the leg, then reduced weight limited PT using a walker, followed by more weight and longer duration PT. Basically, as much PT as Mom could stand without developing significant pain. Doctor monitored the break with xrays every 2-6 weeks and directed we come in for an xray with any sudden change. She still has some pain with her knee when she over does it or moves a certain way and she doesn't have full flexion, but she can independently walk with a walker the 150 feet that ended Medicare supported PT. Function in the leg with the damaged knee is currently better than the undamaged leg with nerve impairment from spinal stenosis.

I would think your mother needs some kind of treatment that promotes healing the break. Without surgery it is unlikely to heal in a normal position, but even bones that heal out of alignment greatly reduce the pain from simple movement. With unaligned healing, she may never be able to walk unassisted again, but at least her pain should be greatly reduced. Because of her age, your mother may have been written off as likely to die from pneumonia before the bone could heal. Since she cannot be really "fixed" you may have to be fairly aggressive seeking a doctor to just treat her. Many surgeons are not in any way physicians and really don't like treat people who will have ongoing issues.
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I am currently in the same situation with my 93 year old mom. She fell and has a displaced fracture of her hip. She was on hospice when this happened due to aortic stenosis for which she refused surgery. The hospital was going to put a pin in her hip until they consulted with her pulmonologist. He told them she could not be intubated; therefore she was not a candidate for surgery. It is likely her cardiologist would gave said the same thing about her heart.
She is now in an inpatient hospice as she requires more care than could be done in AL where my dad wanted so ge could be with her. She is in a great deal of pain, is refusing anything by mouth and is basically unresponsive. The hospice doctor gave her a week to 10 days max.
It is heartbreaking, but her living will said she did not want to be kept alive by any artificial means, so we are honoring her wishes. She also told us she did not want any treatment that would cause her pain.
I cannot imagine my mom being alive for months with this level of pain, so, Anonymous, if you can discus with your MIL, what does she want?
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My aunt was also not a candidate for surgery for her broken hip. She had heart and near end stage kidney disease and diabetes. The doctor told us she would be bedridden and in pain without the surgery or likely to not survive the surgery. We decided on the surgery. It was successful, but did add extra stress on her body and she ended up having to use oxygen all the time. She was also going to have to go on dialysis. About 6 months after the surgery, her hip had healed, but she refused dialysis and decided to go into hospice. She passed about a week later. She was 85. But she did it her way and without suffering in pain.
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Thank you all for responding. She is on Home Health Care. Her bones are to frail for surgery. If she was more mobile before the broken hip her bones would have been stronger. That’s where the saying comes from, you don’t use them you lose them. She is going on 3 months now, was in rehab for a while. Learning to move without the use of her hip. The pain is just getting worse. Heartbreaking
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dunn3350 May 2020
This Feb. my 89 mother fell trying to get out of bed in memory care. She fractured her femur terribly. We didn't want surgery and put her on hospice, because she had been telling us she wanted to go for years. Doctors told us she is very high risk for surgery and probably wouldn't make it, but it would be in humane to not do surgery on her. They did an epidural and she survived a 5 hour surgery. They said she couldn't go to rehab and would be bedridden. Memory care would not take her back unless we put her on hospice. Hospice started on myrophine right away.
She was still eating, drinking and talking and had developed terrible bed sores. I had a meeting with hospice and told them she doesn't want to live like this. They put her on a fentanyl patch and she was so out of it couldn't even speak. After 2 days she went peacefully in her sleep.
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My mother fell and fractured her hip at 96. The ortho Dr inserted 2 rods in her hip and leg. She went to rehab for 3 weeks. Uses a walker now.
My mom never had any pain whatsoever. Only when she couldn’t get up off of the floor we knew it was serious. But everyone is different. First time she ever had surgery. Only in the hospital two times to have her kids. Dr determined she could handle anesthesia so went forward with it.
Rather the surgery than lying in bed the rest of her life. She was always really active. Best of luck to you.
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My mother fell and broke her hip, had surgery, and a replacement hip. She was on a walker a few months and was ready to walk on her own, when the new hip collapsed. She lived the next ten years using a wheelchair and living alone. A very brave woman. She had six children who visited often and helped. My brother lived four blocks away and stopped every morning and afternoon to a from his work place. We offered to take her in, but she wanted to remain in her own home. At 87, she developed heart problems, so 24 hour home care was necessary. Things sometimes work out.
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That’s when we put our MIL on Hospice, when she fell and broke her bone just below her pelvis. Dementia( stage 5-6) made us decide not to have it corrected. The recovery and healing would have been impossible. Healing happened while she was nursed along in bed with pain managed. After about three months or more pain meds were pulled and she remained bedridden in our home with hospice for three years with very little pain if handled correctly. We still had 6 kids living at home from ages 5-18 and we all cared for her till she In her finale stage 7, passed with pneumonia.
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