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While it may be safe for her to have hip surgery is it really necessary at her age. Hip replacement has become very common for elders at very advanced age but it's an ordeal for someone her age. Is she in pain? How was her mobility before the injury? Would she survive surgery and get through rehab? My mom went through it at 83 and it truly improved her life but it was quite an ordeal for her.
Going under at her age can cause memory probblems. I would talk to a orthopedic. At her age maybe there is an ulternative. Just the pain pills could effect her.
We faced a similar dilemma when my father suffered his second hip fracture at age 93 in 2013. The ortho surgeon had to have concurrence from a cardiologist, as all the risks have to be identified and evaluated. The cardio surgeon was uncomfortable and in a dilemma - he was concerned about the possibility of a cardiac event during surgery.
However, he freely admitted that Dad couldn't live with a fractured hip and eventually gave his concurrence.
Fast forward to today: the surgery was successful; Dad's now walking with a walker only when he goes for walks - doesn't use it for medical appointments or to go shopping (although he does use a little battery powered scooter).
Bottom line - everyone is different, with different medical issues. If your mother has lived to be 100, perhaps she has an iron clad constitution and could survive it. I think the issue is the same as my father faced - how can someone live with a fracture, or is the risk of surgery acceptable if the fracture can be set?
For me, I'd rather gamble on the surgery and end it all on the operating table than be mobility compromised in my old age, with no one at all to help me.
At 100 I doubt she is stable on her feet. With my Mom, all she has to do is turn a round too fast. She has neouropathy in her ankles. Its easy to break a bone when ur older especially for women.
JoAnn, my grandmother was - stable on her feet ,that is, at 100 - otoh my dil's grandmother, in her 60's has the neuropathy; is your mom diabetic? this granny could be like ga's dad; understand,however, it would be a gamble and might need to be prepared to pull the plug if they crash; on the other hand, still not too sure I'd be too quick to do it even then - wasn't under a knife but we still waited a week after my dad's fall because before then he'd been up and going so didn't want to move too soon
Putting someone that age under General Anesthesia is likely to stop her heart. And even if she lived - she may never heal. The body's ability to heal at that age is greatly compromised, especially in women, where osteoporosis is a problem.
does she have any already known heart conditions? - they wouldn't do surgery on my dad because of that - learned about all kinds of alternatives then - but weren't talking about hips
The person you need to talk to is an orthopedic surgeon who can look at her entire medical history and examine her and consult with her primary care doctor. If she has any lung problems or heart problems, for sure it would not be recommended at her age. Also if there was severe osteoporosis. I am a retired RN. In the medical field, we often call the fractured hip in the elderly 'the stairway to heaven' because folks CAN do so poorly with it, and even in the post op period. There is a lot of physical therapy needed afterwards...and a long time of walking using a walker to assure there is not another fall while healing is happening. Now, you aren't saying it's a fx hip...but a break in the femur it sounds like. Don't know if there are new ways to stabilize something like that, short of general anesthesia and a long incision. That's why a consult with an ortho surgeon is where you should start.
Sorry...I reread it and see that you did say a big crack in the hip. Not the long bone known as the femur. But I still say, she needs a consult with an ortho surgeon.
My mother had her first hip replacement at 85 and her second one on the same hip at 99. She is healthy, in terms of her organs and her pre-op assessment was A1. She does not have osteoporosis, but arthritis in her hip. She is103 now and slowing down. Her recovery was unremarkable - no problems. She had a sedative and local maybe spinal of some kind for the first op and full anaesthetic for the second. I am not saying that this is the way to go for everyone, but an example of one that worked in an older person because she was basically healthy. She has developed vascular dementia in the last couple of years - I doubt due to the op as she has been in BP meds for years.
I agree your gma needs an evaluation by a good ortho surgeon and a general evaluation to see if she could tolerate surgery. If it is only a crack I suppose it might heal given the right conditions. Sig other broke his pelvis 10 years ago in 4 places and they did not do surgery and he healed. Of course he was much younger than your g\ma and he was/is very healthy.
Please give us more info about your gma's condition.
What does her doctor say? I find it amazing that any doctor would consider it but if he or she does I would certainly get a second or even third opinion. It is a lot to put her through at that age. The recovery is very involved, a lot of physical therapy and she will have a lot of pain. Is this what she wants? Does she understand completely what it means? Do you? Very risky. Quality of life at 100 in a wheelchair or with limited movement but still able to visit with friends or family is better than no life. Consider the reality of what you are asking.
Effects from anesthesia would be my first concern. The cardiologist and anesthesiologist would be good to consult. Second concern would be recovery from the incision. If surgery is selected i would consult with an orthopedic surgeon who ia familiar with an anterior approach for a hip replacement or repair . This method has a smaller incision, less chance of popping out of the socket and a faster recovery time. As the others have said it would be wise to talk to her doctors about the pros and cons of doing the surgery versus other options and quality of life.
Did anyone see the 92 year old lady that just ran a full marathon on the news tonight?? I think that's great and wonderful and hope to someday run a 10k or half but to put someone who is not that physically active and 100 under the knife?? Unless she can't live with the pain one second longer and is ok with leaving this world if something happens on table, I wouldn't do it. My dad who is going to be 93 shortly is in pretty good shape even after a massive heart attack 5 1/2 years ago and his internist, cardiologist and gastroenterologist have advised him not to do even a colonoscopy anymore. Just too dangerous at his age. If she can tolerate pain meds I would go that route before putting her under the knife until the very last minute. Good Luck and God Bless
My uncle had a full hip replacement done with an epidural block for anaesthesia and reported that it was fine except for the alarming loud noises. But he was quite a bit younger, in his eighties, and it was an elective not an emergency procedure, so there was plenty of time to line up the right specialist surgical team.
Age itself isn't the issue: it's the risk versus benefit calculation that has to be made, and you'd do best to rely on the advice of her doctors. If they advise against operating it's likely to be because she was too frail or ill even before this latest accident, and all you need to check is that they're not making sweeping assumptions about how tough she might be. If they advise in favour of operating, ask probing questions about what the risks are, both for and against surgery, and you will probably find that they have thought about it carefully and can give you satisfactory answers.
But be clear: a full hip replacement is a big, violent operation and you need to be ready to support your grandmother through the hard work of recovery. On the other hand, if she doesn't opt for surgery, then total immobilisation with a fractured hip is bad news for anyone's health. There are no certainties, I'm sorry to say.
Do the benefits outweight the risks or vice versa? Will her quality be equal to or better then before the surgery? Are you prepared to lose her if complications should arise, suck as staph infection, pneumonia, stint in rehab, etc. there are many pros and cons in this situation. Good luck
Hi Pfaith! My mom was 94 when she fell and fractured her hip. She had surgery and made a full recovery. I realize your grandmother is older, but you really need to get several surgical opinions. Even with a number of other health conditions, my Mom's fierce desire to live carried her through the surgery and the recovery. In the emergency room we asked and were told she had an "intertrochanteric hip fracture" which would require surgery -- not a full hip replacement, but rather a pin in the hip. So unless a doctor has told you "full hip replacement" don't assume that's the only procedure available. We were also told by the orthopedic people that my Mom had a greater risk of dying WITHOUT the surgery because the inability to move around would quickly lead to loss of muscle and weight and would leave her basically debilitated to a dangerous degree. In my Mom's case she also had allergic asthma, copd, atrial fibrillation and congestive heart failure. In spite of that long list of illnesses, my Mom basically felt petty good and got around safely most of the time prior to falling. (She fell as she was standing on one leg to pull on her pants and she grabbed a rocker to steady herself and instead it threw her down at an angle.) Here's my point: consult with several good orthopedic surgeons. As someone else mentioned, every case is different. In my Mom's case we encouraged her to have the surgery; she fussed at everyone all through the preparations, but came through the surgery remarkably well, considering they had to intubate her. The biggest hurdle was FEAR. She had read all the horror stories and believed that a fractured hip was a fast ticket to death. She wound up spending one week in the hospital, and 6 weeks in rehab at a nursing care facility, followed by 3 months of in-home rehab. By the end of the year in which she fell she was 90% back to her normal. She did experience hallucinations right after surgery from the drugs given for the surgery and from the morphine they kept giving her. Those disappeared when she went off the morphine and just used Tylenol. She was not in a great deal of pain ever from the placement of the pin in her hip; mostly she was out of breath from the asthma, because she fell in the spring in the middle of allergy season. Anyway, do consult with the medical people most familiar with your grandmother. As others have pointed out, if she has other health problems, surgery may not be the best option. I just wanted to let you know that a 94 year-old with health problems made it and will soon celebrate her 99th birthday. Good luck to you and to her and God bless you both.
oh, wow, Artist, that is so wonderful! apparently she's also been more careful getting dressed since then! but question - 3 mos. in-home rehab - after 6 wks. in rehab; was that because of the pin and not having replacement - or because she was older - my mom was 83 and only had the 6 wks. in-home; she didn't go to rehab but had the replacement
Hi debdaughter! I'm guessing it was a combination of both her age, the rehab process itself, and fear. I don't think the fact that it was a pin had much effect on the length of her rehab because she had very little post-surgical pain, and they had her up and trying to move as soon as possible. Immediately after surgery, the big concern for the doctors was taking out the tube; she had been entubated when they had not originally planned to do that. Her biggest obstacles were breathing problems and FEAR. Because my Mom had allergic asthma as well as emphysema (COPD) she was constantly battling breathing difficulties and the fear of shortness of breath when it was time to do rehab exercises. This made her rehab sessions go much more slowly than they would have otherwise. I know the rehab people were always asking her to do something that made her ask, "Are you crazy??! I can't do that!" But apparently the requests were made because it was time for her to begin mastering a particular exercise. So apparently there was a schedule of some kind in place. I only know that the rehab personnel always answered her, "You can do this. You're not crippled, and you ARE strong. So let's get going." If this had happened when she was 83, she probably would have progressed more quickly, along the lines of your description of your Mom, with just the six weeks in home rehab. At 83, my mother was still very active, driving herself everywhere, including picking up her grand-daughter from dance class and dropping her off at the orthodontist. Mom also loved gardening, and might be out in the yard all day, weather permitting. At 94 she had been forced to slow down a little, so age might also have been a factor. However, I think the other thing that slowed her down was all the articles she had read about how a broken hip is a death sentence for the elderly. Until we could get that fear out of her mind, it was very, very hard for her to make any quick progress. I also looked back at my notes from her first visit with the orthopedic people while she was in the ER, and was reminded that my Mom's "intertrochanteric hip fracture" was identified by the doctors as the best hip fracture to have if you must have a hip fracture. They said it was a very common fracture, and fairly easy to fix with a pin in the hip. And yeah, we have discouraged her from any more "acrobatic stunt dressing". [grin]
trust she sits down now to get dressed! and completely missed the part about her being intubated; know mom was afraid of that; she'd had issues before with her last surgery - 50 yrs. before! - with it but when learned about mac, that they don't normally intubate for hip surgery but can see with your mom's issues; just went through that with dil just had gall bladder surgery, now turns out apparently she's been having breathing issues in her sleep since did even out there after surgery even with breathing treatments so now she's wanting to go for a sleep study though wonder how much she's actually looked at her chart to realize she has asthma and pretty sure she doesn't have all her stuff she's supposed to have and I've just now realized that and her I was making her an appt. for this sleep study - duh - eager to see how tomorrow goes - but that is so cool how she was at mom's age; no, mom was not like that then, now 10 yrs. before then for her, at 73, yes, but by then she was no longer driving - eye issues at least - no longer gardening - even her flowers, which she dearly loved, so she might have been more like your mom at 10yrs. older with the exception of not having the asthma and COPD stuff but she was scared even with the low-key in home rehab, part of why it was only done that way because they didn't think she'd be able to handle the push of it being done in facility but so glad she did so well. I think a lot of that "death sentence" comes from when it was, before they had all this rehab and getting them up and all, when they did just pretty much just lay there and die, so sad. not sure exactly what that term means she had but just so glad she had the surgery because if it means what I think is what friend's mom had and she didn't have the surgery then and kept walking with it even until she fell again and twisted it such that she couldn't have that simple pin in the hip surgery and had to have the replacement but they also said that if she'd had that she'd have to be immobile for 6 weeks, so may not be the same or maybe it's because she has dementia and wouldn't be able to understand the rehab - gotta go, gn
Hi debdaughter! Yes, she absolutely sits down now to get dressed, especially pulling on her favorite pair of pants.(smile) Don't want to go through hospitalization, surgery, rehab again!
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
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Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
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However, he freely admitted that Dad couldn't live with a fractured hip and eventually gave his concurrence.
Fast forward to today: the surgery was successful; Dad's now walking with a walker only when he goes for walks - doesn't use it for medical appointments or to go shopping (although he does use a little battery powered scooter).
Bottom line - everyone is different, with different medical issues. If your mother has lived to be 100, perhaps she has an iron clad constitution and could survive it. I think the issue is the same as my father faced - how can someone live with a fracture, or is the risk of surgery acceptable if the fracture can be set?
For me, I'd rather gamble on the surgery and end it all on the operating table than be mobility compromised in my old age, with no one at all to help me.
I agree your gma needs an evaluation by a good ortho surgeon and a general evaluation to see if she could tolerate surgery. If it is only a crack I suppose it might heal given the right conditions. Sig other broke his pelvis 10 years ago in 4 places and they did not do surgery and he healed. Of course he was much younger than your g\ma and he was/is very healthy.
Please give us more info about your gma's condition.
Age itself isn't the issue: it's the risk versus benefit calculation that has to be made, and you'd do best to rely on the advice of her doctors. If they advise against operating it's likely to be because she was too frail or ill even before this latest accident, and all you need to check is that they're not making sweeping assumptions about how tough she might be. If they advise in favour of operating, ask probing questions about what the risks are, both for and against surgery, and you will probably find that they have thought about it carefully and can give you satisfactory answers.
But be clear: a full hip replacement is a big, violent operation and you need to be ready to support your grandmother through the hard work of recovery. On the other hand, if she doesn't opt for surgery, then total immobilisation with a fractured hip is bad news for anyone's health. There are no certainties, I'm sorry to say.
In the emergency room we asked and were told she had an "intertrochanteric hip fracture" which would require surgery -- not a full hip replacement, but rather a pin in the hip. So unless a doctor has told you "full hip replacement" don't assume that's the only procedure available. We were also told by the orthopedic people that my Mom had a greater risk of dying WITHOUT the surgery because the inability to move around would quickly lead to loss of muscle and weight and would leave her basically debilitated to a dangerous degree. In my Mom's case she also had allergic asthma, copd, atrial fibrillation and congestive heart failure. In spite of that long list of illnesses, my Mom basically felt petty good and got around safely most of the time prior to falling. (She fell as she was standing on one leg to pull on her pants and she grabbed a rocker to steady herself and instead it threw her down at an angle.) Here's my point: consult with several good orthopedic surgeons. As someone else mentioned, every case is different. In my Mom's case we encouraged her to have the surgery; she fussed at everyone all through the preparations, but came through the surgery remarkably well, considering they had to intubate her. The biggest hurdle was FEAR. She had read all the horror stories and believed that a fractured hip was a fast ticket to death. She wound up spending one week in the hospital, and 6 weeks in rehab at a nursing care facility, followed by 3 months of in-home rehab. By the end of the year in which she fell she was 90% back to her normal. She did experience hallucinations right after surgery from the drugs given for the surgery and from the morphine they kept giving her. Those disappeared when she went off the morphine and just used Tylenol. She was not in a great deal of pain ever from the placement of the pin in her hip; mostly she was out of breath from the asthma, because she fell in the spring in the middle of allergy season. Anyway, do consult with the medical people most familiar with your grandmother. As others have pointed out, if she has other health problems, surgery may not be the best option. I just wanted to let you know that a 94 year-old with health problems made it and will soon celebrate her 99th birthday. Good luck to you and to her and God bless you both.
I also looked back at my notes from her first visit with the orthopedic people while she was in the ER, and was reminded that my Mom's "intertrochanteric hip fracture" was identified by the doctors as the best hip fracture to have if you must have a hip fracture. They said it was a very common fracture, and fairly easy to fix with a pin in the hip. And yeah, we have discouraged her from any more "acrobatic stunt dressing". [grin]
not sure exactly what that term means she had but just so glad she had the surgery because if it means what I think is what friend's mom had and she didn't have the surgery then and kept walking with it even until she fell again and twisted it such that she couldn't have that simple pin in the hip surgery and had to have the replacement but they also said that if she'd had that she'd have to be immobile for 6 weeks, so may not be the same or maybe it's because she has dementia and wouldn't be able to understand the rehab - gotta go, gn