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My Dad fell and broke his hip last week. We decided on surgery since he was a good candidate. We had to take him off hospice care for the surgery as the broken hip was considered a result of his dementia, which is his hospice-admitting diagnosis. Dad ended up getting a new ball and socket in his hip, as part of the hip bone had broken off rather than the hip sustaining a fracture. He was released from the hospital yesterday and re-admitted to hospice care (God Bless the folks who are part of hospice, they spent their entire Sunday afternoon getting this done!). His first day back was spent sleeping, which left us quite worried, but today he was awake, ate well and told us he needed to stand up! (The hospital staff only ever got him moved between the bed and a chair a couple of times, never had him walking, which I thought they had to do before releasing a patient?). Tomorrow one of the aides is going to get him up and into a chair and they'll begin some light therapy (we opted out of sending him to a rehab place because we didn't feel he'd get any better "therapy" than he does at his nursing home and with his cognitive problems a rehab place wouldn't have kept him around long!). We are very optimistic about Daddy's chances at a good recovery. Has anyone else (probably a stupid question!) gone through this experience, and if so, how did your loved one cope?

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NYC2015, have you consulted with an expert to see what your mom might be entitled to benefit wise?

Most of my LO's fractures did not require surgery and I'm glad, because she was not a good candidate. I have known a couple of people who had dementia, who had surgery and none of them did well. They actually were not able to survive for long. I'm not sure why, except they seemed to just go downhill physically, after the surgery.
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My mom has LBD and has been in an ALF for the past 2 1/2 years. She's been falling quite frequently lately and this week she fell again and it was determined that she had fractures in both femurs. Day 1 after surgery and she's already refusing to participate in physical therapy. Let me backtrack, a therapist was also coming to the ALF to perform occupational and physical therapy on her, but she was resistant to that as well. She does not have LTC insurance so I've been spending down her savings. It's at a point now that she needs additional/memory care and I am hoping that I can get her into a skilled nursing/rehab facility and then apply for Medicaid. Otherwise, I have no idea what I'm going to do.
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My mom is 83 and has some dementia. She fell at home and broke her pelvis in 2 places and has a back fracture. After she left the hospital with no surgurey, She went to a nursing home for skilled nursing abd rehab. She fell 4 times in a week because she kept forgetting she can't walk. Then she went wacko grim all the meds. they have her in there. Now she is in a behavioral psych. Unit to get the meds. straightend out. She only took 1 b.p. pill and a baby aspirin before the fall. Now she is on accept, namenda, remeron and lexapro! Whew! Seems like a lot. Still not walking and stuck in wheelchair and totally confused. Next of to a new nurseing home, hopefully without roaches. This is a long exhausting journey for all. Just wanted you to know that you are not alone. Dementia is awful. She just wants to go home.
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Worried child I am afraid I do not have any reassuring words for you.
Any kind of proceedure on the elderly takes a lot longer to recover from even without the complication of dementia.
Depending on her general health before the surgery the Drs could consider some form of supplemental feeding or at least rehydration to see if that jump starts her recovery. I would not consider that as a long term treatment because if she is actually begining her journey to the next life it will only add to her suffering. I think you are at the time when you can only prepare for the worst and hope for the best. As long as she is pain free, not distressed and has loving family at her side that is really the best you can do right now.
It is a very worrying and difficult time and no one wants to loose a loved one but it is very important for you to take care of yourself and if you can't eat at least use nourishing drinks.
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My mom is 88 and in late moderate stage of vascular dementia. She fell 2 weeks ago and broke her left hip. They had two wait 2 days to do surgery, as she is on Plavix and aspirin, due to carotid arteries being blocked, which has caused multiple strokes and TIAS. She did well for first two days after surgery, but then, after being given dilaudid for pain, she slept all the time. She was released to NH with rehab. She was in a memory care unit prior to fall. She is not drinking nor eating hardly anything. She has a catheter, due to her bladder not functioning. They plan to remove catheter on Monday and do a void test and then see urologist next day. Her urine is very dark, due to lack of her drinking water. She has most definitely declined in mental capacity. She cannot feed herself or hold cup. Sometimes she forgets how to use straw. At my wits end. She refuses or will not help when given therapy.
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I want to thank everyone who took the time to share their experience. My Mom who is 85 and in the mid to late stages of Alzheimer's, fell last night and broke her hip. Your forum has provided insight and answers during this time of uncertainty.
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I want to thank everyone who took the time to share their experiences. My Mom who is 85 and in the mid to late stages of Alzheimer's, fell last night and broke her hip. Your forum has provided insight and answers during this time of uncertainty.
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My mum has Alzheimers but still recognises all her children. We are lucky in the way that all of us are able to see her regularly. She is in a nursing home and five weeks ago fell and had a hip operation. Since then she is not eating much or drinking much. She also suffers from diverticulitis and has had operations in the past for this which were very traumatic for her. This coupled with her inability to go to the toilet on her own is causing all sorts of problems like urine infection amongst other things. Saying that before the hip fracture she had no problems walking and we took her out regularly. Only recently has she started to walk with help and assistance with a zimmer frame but due to her being quite weak from lack of food and water intake she seems to only want to sleep even though she does perk up after some walking. She is receiving physiotherapy assistance a few times a week too.
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If your loved one has dementia and been through a hip operation, you should always start therapy as soon as possible. My mom has dementia and just had a hip operation, and the surgeon suggests to mobilize her as soon as possible. Hospital staff will not do much with the patient. You should get a physical therapist and have him come over like twice or three times a week. Always be there at the sessions and you will see what kind of exercises they are doing with the legs. You are then able to do the same exercises with your loved one every day. This save you alot of money. I had been to my mom's session everytime and do the exercises with her everyday that she is doing very well and right now i am training her to walk with the walker. You observe the therapist and you are able to do the same things with your loved one. My mom is 88, and she is doing very well right now..she even forgets that she had operated on her leg, and talks about walking by herself. I have to remind her everytime that she cannot do it by herself. She needs a peron to be present. Right now i am trying everyday to walk with her for 30 minutes. You cannot leave everything on the rehab.
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My dad had this situation on new year eve 2014/2015.
it was bad terrible and whatever ugly word to describe it.
he was delusional agitated and not responsive. we tried all things and medications and physical therapy, but the doctors say he shall never return to what he was.
they all relate it to the general anesthesia. I recommend for any one who has Alzheimer or any type of dementia to have some sort of local or half anesthesia, an epidural or something. the results will vary a lot.
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Wanna-
Hind sight is always 20-20. She was newly married for about a year, and her husband made the decision, she had not even been formally diagnosed yet. Cancer in the 80's is very slow progressing, so given if we knew then what we knew now, then probably. Medical POA for mom was not engaged in the decision.
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See if my mom had cancer and dementia, I would have opted to let the cancer take her. I can't see prolonging Alzheimer's. What is the purpose of having surgery and then sitting around waiting to die form AZ. I guess I sound cruel, but I think it is cruel to keep a person alive with Alzheimer's if their is an alternative. Sorry I don't mean to be mean!
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Not a hip but mom had hysterectomy at the age of 81, cancer what a shocker that was! We almost lost her to an infection that developed about a week after the out patient surgery. She was then admitted to hospital and was there for two weeks. The surgery is what made us all realize how bad the dementia was getting, and anesthesia definitely had a significant effect on her ability to function.

Two years ago moms hubby had a hip revision, second time for that hip that had been done 15 years sooner. The part that screws into the femur had come loose and was causing him significant pain. For about two weeks following the surgery we were very worried that there had been significant effect on his cognition. But, thank goodness he returned to normal and spent nearly 3 months in rehab because he was progressing.
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My Mom broke her hip 6 years ago. They told me she wouldnt walk again as she was 86 with dementia. I took her home after the surgery and she was happy in her mind being home, and therefore recovered fully. She got 100% attention, love and care one on one and PT came to the house 2x a week. Had she stayed in rehab she wouldnt have made it because she was one who just had to be home. I took a FMLA and after 7 weeks of not being able to put any pressure on it, she went from a wheelchair to walker to dancing again with no help within 3 months.The anesthesia does knock them down a notch mentally. She kept going to get up, forgetting she had a bolt and 4 pins in her leg, it was so difficult, I had to wheel her into the bathroom with me and sleep on the floor next to her at night, haha. They tried to do a Spinal because she had dementia but her arthritis was too fragile in her back.
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my mom broke her hip in the nursing home...she had surgery and did fairly well...her dementia increased slightly....she went thru rehab and survived for a few years after...I have no regrets about the choice to have surgery
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My mom broke her femur and her arm, had major surgery to fix the femur, was non weight bearing for 8 weeks. Many trials and tribulations and her dementia worsened but she regained her mobility, walks with a walker for fall prevention. She was 89. Luckily she forgot all the unpleasantness.
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igloo572--
Thanks for your response. Dad also has LBD. He is in the latter stages and does not do well among "crowds" of more than two people. He gets agitated when people hover or when they try to touch him. Even a pat on the shoulder can agitate him. So that is another reason he wouldn't have done well in a professional rehab setting. And so many (most) people, even medical people, don't seem to grasp this, even if you explain it to them. He has bad days and worse days! But his physical health is pretty good. He is used to the nurses and aides who take care of him, which is why we believe he'll do best "rehabbing" in a setting that he knows with people that he knows.

NancyH -- Oh my! Your MIL must be one feisty lady! Dad also likes to walk, though I think its more of a fixation of his dementia. He can walk circles around the inside of the nursing home. He is already starting to tell us that he "needs to stand up". The need to walk has really been one of his problems if some ways. Sometimes he just can't sit still. Even if he walks to the point of tiredness (sometimes on his own and sometimes in his merry-walker) he just wants to keep going to the point where its a foregone conclusion that he'll end up on the floor. He just tends to get so agitated in the late afternoons and evenings that all he thinks about is walking and wandering and fixating on things.
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virtual, been there, done that TWICE with my mother-in-law who has dementia/alz. First time she actually kinda remembered where she was and why. Second time was awful since her dementia had progressed to the point where not only did she not remember falling, but also she thought we'd all conspired and abandoned her to a strange place. Even though she has dementia, the rehab was crucial to get her up and walking again. Most old people who break their hip, if they don't get up and walking quick, will end up in a wheel chair for the remainder of their life. She's someone who loves to walk, and add the fact that she's really stubborn and/or determined to walk again, is now walking with her walker after breaking both hips. She has no idea of where she is and why she's there in her memory care unit, but hey... she's walking. ha
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My mid-90's mom has Lewy Body dementia and has been in a NH about 3 years. She probably has had dementia 10 years. She broke her hip in June.

Maybe 8 years ago she had surgery for repair to torn rotor cuff, she was still living @ home at the time. Lewy is a long range dementia and they can continue to appear pretty cognitive & competent for a long time. This went well for the surgery but the rehab not so.I was there for the first couple of post surgery weeks and worked with her 3 times a day plus taking her to 3 X a week PT (I am pretty much a bad bitch bossy on this type of stuff), then we hired home health for a couple of months afterwards to work with her plus drive her to therapy. Maybe 4 months of daily someone working with her to enable the use of her arm. She set her own goal to be able to roll her hair & sew a button, which she could at 4 months. Things went well for maybe a year and then she had trouble remembering that her arm was damaged and she would do things (reach, pull) that she could not do. She flat didn't remember she had a break and surgery.

Maybe a year after the surgery, she moved to IL where things were manageable as they provided meals, shopping trips, etc. She went from IL to NH 3 yrs ago.

This past June she fell and broke her hip. Really more of a hip shatter than a break. Her overall health is excellent as she has no major chronic diseases, but her dementia has gotten worse. She could have gone through surgery probably with minimal issues but no way could she do the rehab needed. She cannot remember that she has had a hip break. She will complain that her foot is sore or her foot has a cramp (other non break side too). Just no way she could do rehab or be able to work with the PT/OT to determine pain or strength. As Lucy said, rehab is paid for and done only if they are "progressing". Medicare rules on rehab are very specific and the therapists have to follow them to a T and with repetition and weight and exercise documentation. For those with latter stages of dementia that is a pretty high bar to do and continue to do for the weeks needed. She is now totally bedfast and on hospice at her NH. Hospice has been wonderful, what a great benefit of Medicare!

Think if successfully doing rehab could be an issue for your dad. I would speak frankly with the PT or OT who are working with him.

Oh and the rehab group we used was one what specialized in sports medicine (some of the Spurs were there for tweaking injuries). So the equipment was all just the latest. the good part is they were almost always empty in the mornings and their client base was people who work. The place was packed in the afternoon and evening. So for my mom, who went first thing in the AM, it was ideal as she got lots of "she reminds me of my grannie" attention. best of luck.
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Thanks again for all of your replies. As far as rehab is concerned...Dad probably would have been able to take some steps while still in the hospital if he hadn't been so out of it the entire time. The surgeon was aware that we just wanted him back at the nursing home with no "prescribed" rehab, but the hospital doctor sent him back with prescribed rehab for 28 days. We had already talked to the nursing staff and the NH, knew from them and from our own observations that he would in no way be able to go through actual rehab due to his cognitive and physical limitations, and knew that what the NH provided would help him out more than any rehab facility could. They knew we didn't want the rehab so they didn't order it. He will be getting his 24 staples out on Tuesday. The surgeon will do that. At that point, once the skin has healed, I think (hope!) he'll become more mobile. The only "pain" he has is around the staples, probably more of a soreness, when he has to twist around to sit up. Hopefully that will subside and he'll be able to get up and about more. At this point I think everyone is just trying to be sure the healing process continues and the staples don't pull out.

wamnanealz -- isn't it wonderful to know that when our loved ones do eventually leave this life of suffering that they'll have new bodies in Heaven! And, as you said, brains! At least out of all this suffering something wonderful will come and someday we'll see them again as we knew them before this horrible disease took their lives while they were still living.

Lucysmom -- I've heard and read that an anesthetic will most likely move a person's dementia to the next level. Dad has had a bad disk in his back for years that causes him pain off and on. His neurologist said that there was no way he'd suggest surgery due to possible problems with the anesthetic. But when something like a hip break happens to someone who, though he has dementia, is still mobile, what are you supposed to do?? It was either take him off hospice for the duration of the surgery and hospital stay, then readmit him to hospice, so that surgery would give him some quality of life during his remaining time; OR just leave him on hospice, which meant they would treat him palliatively with pain meds, etc. but he'd be bed-bound for the rest of his life! Whatever may happen in the future due to the anesthetic, other health issues, etc., we felt our only choice was to have the surgery. Mom is also paying out of pocket for his care, so I know where you're coming from where that's concerned! She has the NH fee budgeted but every time some small expense pops up she freaks out. I know their finances can handle it because I don't think Dad will survive beyond another year or two, but Mom worries about it, cries about it. She's very obstinate and wants things done her way, and to know exactly what's going on, so when something doesn't go quite the way she thinks it should she, as I said before, freaks out!

Again, thanks for your input!
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My mom went through a couple surgeries when she had dementia and did well. Unfortunately for me when she fell and broke her fema bone when she had dementia, she had too many other health issues and we chose not to have the surgery done. She was kept comfortable but passed away few weeks later from medical complications. You are fortunate to be able to have surgery for him. God bless
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To Lucy's mom: I worked in a hospital many years ago and it is a known fact that anesthesia in any senior patient will make the dementia worse! Or appear even if they have never had it before. And I agree that an Alzheimer's patient should not be put through the trauma of surgery! But for the broken hip, I think it has to be done. We had to do that and also to put in a feeding tube because he couldn't swallow, but he was still aware and capable of asking for the feeding tube. He wanted it so we did it. He only lived for 6months after that and his final diagnosis, cause of death, was malnutrition. So the feeding tube just didn't work! It only prolonged the inevitable. Looking back I don't know if we did the right thing, but he asked for it and he was very aware of what was going on. I guess you can't deny what a patient asks for!
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My mom had dementia and broke her hip. She was operated on and sent to rehab for 28 days. It seems that Medicare only pays for 28 days. If the patient isn't progressing, they're either sent home or to a nursing home. She refused to even try to do therapy. She screamed in what we thought was pain, but as soon as she was left alone the pain magically disappeared. I believe it was the dementia, but she was kept in the home as an inpatient, rather than a rehab patient. My dad paid out of his pocket for over 2 years for her care in the nursing home. She passed away from a triple A, which we knew she had for over 2 years. The doctor wanted to operate on it, but I refused. Since she had dementia and wouldn't even try to walk, I couldn't see putting her through the surgery. Back to the hip surgery, I believe that the anesthesia helped to move the dementia along, but you can't have her crying in pain with a broken hip. I believe the articles that say a dementia patient doesn't last very long after hip surgery is correct. I didn't agree with the Medicare decision to only allow her 28 days in rehab, but now I see that it was correct on their part.
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My brother-in-law broke his hip last April on Easter Monday. He did get up and walk eventually and it did heal nicely. However he went downhill starting in about July. I read statistics in AARP Magazine. It said that very few seniors survive after a broken hip for more than a year. But since he has dementia, it would be a natural progression. Just treasure your time with him for now. Hopefully he will be the small percentage that survives. Sadly, we lost my brother-in-law, who had Alzheimer's, in December. We miss him a lot but are so happy that he is in Heaven now, and has no more pain. And his brain is restored! He is normal again! God Bless.
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Thanks for your reply. I think Dad will be doing well (hopefully, you just never know). The staff used a lift to get him out of bed and into a chair today. That was at 7:45 this morning. He was still in it when we got there to visit at about 10:30, outside his room in a small area with a TV. A visiting student nurse was helping him eat some jello and a small thickened milk drink. He was nibbling on both but seemed tired. Being a little active, along with having his Seroquel with breakfast, I'm sure made him sleepy. He also had his "regular" clothes on, instead of the gown he'd been in for a week, so getting into them was probably a trial! But he was glad to see us. He was going to be taken to the dining room for lunch after we left, so he'd be back with his "people"! I think that will help. Hopefully they'll have him on his feet a little bit over the next few days.

I'm curious as to why my post didn't end up in the Alzheimer's & Dementia category as I selected and where I normally post. Oh well . . .
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My FIL suffered from Alzheimer's for 10 years before he passed away. Early on he required abdominal surgery and went through that quite well. The good thing about the disease was that he didn't remember that he had surgery and never seemed aware of any pain. Of course vitals were monitored so that he was given pain meds prior to any major discomfort. About a year before he passed, he fractured a hip and did quite well. I don't know the type of fracture, but it was decided not to operate. He, once again, never complained of pain. The staff was able to get him to a chair many times daily, but he needed total assistance.
I am optimistic about your daddy's chances at a good recovery if he does as well as my father in law. Yours having had surgery to repair the break makes me even more optimistic. All the best to you and your dad.
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