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 Dad Fell and Broke His Hip 
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Joined: Mon Sep 09, 2013 9:16 pm
Posts: 29
Location: Texas, USA
Post Dad Fell and Broke His Hip
My 80 year old Dad fell five days ago and broke his hip. We opted for surgery as he was still somewhat ambulatory prior to the break (sometimes walked continuously through the nursing home) so he was a good candidate. The doctor ended up basically doing hip replacement, putting in a ball and socket. He told us that part of the bone had actually been broken off. The doctor who did the surgery did my Mom's hip replacement about four years ago so we were very comfortable with him. Dad broke the hip very early in the AM and had surgery in the early afternoon. He woke up from the anesthetic quickly but that first evening was quite bad as he was very agitated. The second day was somewhat better. On the third day he was almost back to his "normal" self. He did do a lot of sleeping. His appetite was very good (when he was awake!). He was moved back to the nursing home on Sunday (yesterday). While at the hospital his temp remained normal, but once back at the home the first thing the nurses did was take his temp and it was about 100.8. We visited for about 2 hours today. The temp was back to normal (thankfully) but he slept the entire time (except when the hospice aide bathed him and dribbled cool water on his chest -- he said "oh, that feels so good. I'm sure it did after not being bathed for 5 days while in the hospital! Do they not even do that anymore? He did eat some cream of wheat for breakfast. He did get bedsores on his bottom while in the hospital and is being treated for that. His oxygen level was down to 88, so the hospice nurse ordered oxygen; she said the low oxygen rate might be promoting his lethargy and sleepiness. We hope Dad will do well over the next several days, but we know that a broken hip, as well as surgery, can really cause the dementia to worsen. We had to "un-enroll" Dad from hospice care in order for the surgery to be done and fore Medicare to pay. He was re-enrolled yesterday evening. We will not be doing physical therapy through another entity as neither we nor hospice believe that it would be beneficial. They'd probably try for a few days and give up due to Dad's cognition problems.

I'd appreciate any info or comments from those who've gone the surgery route, declined physical therapy through Medicare, etc. Thanks!

Mon Jan 27, 2014 8:15 pm

Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Dad Fell and Broke His Hip
After your father no longer needs an abductor cushion to keep his legs apart, he would benefit from at least passive range of motion exercises as ordered by the orthopedic surgeon. A restorative aide in the nursing home can do those.

Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.

Tue Jan 28, 2014 2:05 am

Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3309
Location: Vermont
Post Re: Dad Fell and Broke His Hip
Holy cow - your poor dad has been through the mill! If my dad had broken something while in his final months, I certainly would have done whatever was needed to fix a broken bone (or broken hip joint). To me, that would be a comfort issue, not a life-prolonging issue. I'm surprised that hospice didn't see a badly broken joint as needing to be treated for the sake of his comfort, but I'm not all that well-versed on these things. Anyway, despite the AD and knowing and advocating for no life-prolonging interventions, I know that I would have done just what you did. I can't imagine leaving someone with a break and doing nothing about at the stage your dad was in.

We stopped PT after a while for my dad because he was getting nothing out of it and I think he was verbally abusive to the PTs who came to see him in his room at the ALF. I know several quit and I'm guessing that's why - they didn't understand what was wrong with him and thought he was a grouchy old man with control over his behavior. He wouldn't do the exercises on his own, and as soon as the PTs left his room he demanded to be put back in his wheelchair. So, my sister and I pulled the plug on future PT, as we didn't believe in throwing good money after bad, no matter who was paying for it. And, it just increased my dad's frustration and aggression level when he couldn't or didn't want to do what they wanted him to.

Good luck with all of this - every day is a new struggle with this disease. Let us know how he's doing. Lynn

Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.

Tue Jan 28, 2014 2:25 pm
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