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Old 09-22-2011, 02:42 PM   #1
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Mom broke her hip and had surgery

Hi everyone:

It has been a while since I've posted, although I've lurked! = ) My brother said he thought I was getting to obsessive about researching things and reading message boards so I promised I'd go cold turkey for a few weeks.

Mom and dad both have dementia and moved at the first of August to the locked memory unit in the retirement community where they'd moved just 3 months earlier into independent living. Long story.

The last time the geriatric psychiatrist visited a few weeks ago he did a MMSE and mom scored below 10 and dad was 12 - 17. It is so shocking that she's so much farther along than he is, because she's the one who alerted us to Dad's issues, the one who said she thought she and dad should move, and who was keeping things together when they were living at home and my brother and I were blissfully unaware of what all was going on! Finding this out just makes me love and respect her all the more! She still recognizes me and has moments of lucidity, and was walking unassisted before this happened. She fed herself but needed help dressing, showering and toileting.

Anyway, I got a call on Tuesday afternoon that they thought she might have a broken hip (she wouldn't get up out of the bed and her right leg was turned out and appeared shorter... textbook). So they called the ambulance and I met her at the ER.

She was in a LOT of pain so we deicded to go forward with the surgery, which was (finally) last evening/late afternoon. I knew from a friend that general anesthesia can exacerbate or accelerate dementia, and was just wondering if anyone has had experience with that? It's too soon to tell if Mom will have lasting problems, but I would love the benefit of anyone's experiences!

Thank you all!

Sarah

p.s. Dad is doing surprisingly well. He asks about mom but doesn't seem too terribly agitated, although he did have what my brother and I think is a "stress dream" where he awoke and thought some of the people there were accusing him of stealing something and had put him in jail.... = (

 
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Old 09-22-2011, 05:50 PM   #2
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Re: Mom broke her hip and had surgery

Sarah.... If it helps you to lurk or to post then don't quit cold turkey. We need comfort anywhere we can get it. I did find myself talking about it to everyone and anyone constantly so maybe your brother is hearing that. I had to dial it back some but continued to come here!!!

Yes, my mom too broke her hip and had surgery. It was a year ago last June. It was difficult for her. She had no understanding of why they were making her get up to walk...the pain was immense and she would scream out our names for help. She fought them every step of the way. After almost a week in the hospital, she was sent to rehab where she stayed til late July. They wanted her to stay longer but I took her out and got her back to her residence. Rehab was not suited for someone with Alzheimer's. She did not do well there. So I took her out and got her back and ordered outside rehab .. they came to her a few times a week. I thought she would never walk again but she did. She died July 29th...a little more than a year after surgery.

The anesthetic did leave her "fuzzy" for quite some time...she did come out of that but I am sure the trauma of the whole ordeal pushed her further down the rabbit hole of Alzheimer's.

Love, Meg

 
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Old 09-22-2011, 06:22 PM   #3
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Re: Mom broke her hip and had surgery

Good to hear from you Sarah even though I hate your Mom is having to deal with a broken hip. I can assure you that I will never ever go cold turkey on my internet connections or research. Not only does it keep me sane but it has also given me the information to make good decisions for Mom. Yes, we do become obsessive with this disease but it is what it is... all consuming. In time you learn who can take how much of your "talk" and you will find yourself migrating to those that can deal with it. Perhaps why I love it here

Are both of your parents diagnosed with Alzheimer's? Different dementias have different presentations so that can be the answer to what you see.... and each person will decline at a different rate even with Alzheimer's. Mom was Dad's caregiver and the one that kept life together until her diagnosis. Dad's Vascular Dementia presented itself very different from Mom's Alzheimer's. Even though he was diagnosed in 1998, it was him that picked up on Mom's cognitive loses in 2005. She was not diagnosed until 2006. At that point Mom's MMSE was much better than Dad's. But by 2008 his MMSE was better than hers. He took a slow downward decline and her's was much faster. Mom took a very sharp decline between 2006 and 2009 but has since leveled off. There is nothing normal, standard, or consistent about this disease!!

There have been several broken hips in Mom's unit and each one of them was different. One did not have surgery, never walked again, ended up with an infection, and only lived for a few months afterwards. One had surgery, did very well. She came back to the facility for PT and eventually walked again. She is still there, ambulatory, with only a minor downward decline from the entire ordeal. Yet another one did have surgery but never walked again and had a major cognitive decline despite therapy. Most of the ones in Mom's unit either did not go to rehab or went and came back to the facility in short order. As Meg said, most rehab hospitals are not prepared to deal with dementia. They expect a patient who can and will cooperate... and has the short term memory to remember what they are taught. They are definitely not adapt at dealing with the behavioral issues of dementia. If you can get her back to where she now knows with therapy daily or several times a week she will probably do better. That way she only has the surgery, pain, and hospitalization to deal with and not a second change of living space.

She will not understand what is happening to her. When she wakes up she will be in pain and not know why. She is going to try to get up and walk. She is going to try to do the things she did before. It is going to take a lot of patience to get her through this but it is doable Hang in there.

I am glad your Dad is doing well. Dad was the same way when Mom was in the hospital for 10 days. He ask about her a few times but was satisfied with my answers. As long as I was not upset he was ok. Delusions were a big problem with Dad as well. He was always waking up and heading out to do something. I do know, with dementia, they have a difficult time separating dreams and reality... it's all real to them. They also tend to have more dreams that are more vivid. Plus night is the worst time (sundowning) for most dementia patients so if something is going to happen then that is probably the appropriate time

I do hope your Mom does well and your Dad continues to do well. Again, it is good to hear from you

Love, deb

 
Old 09-23-2011, 07:44 PM   #4
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Re: Mom broke her hip and had surgery

Sarah,

Basically anyone with moderate/late dementia will have trouble coping with surgery or a simple hospitalization with IVs or tubings. Anesthesia is not the only reason. Actually anesthesia is the only problem that lies with the doctor and the procedures. The rest of the whole thing lies with the patient's lack of co-operation. Basically they just don't understand what is going on. They would pull out all the tubes and etc. They would not co-operate with therapy or rehab. No way they can cope so sometimes this is risky. Since your Mom had the operation already, I sure hope it was successful and that she could at least recover from it like some of the patients that Deb mentioned.

However, if she does not do well, don't be surprised. It is not the family's fault because it is hard to know what to do. A surgery to stop the pain is one good idea but no surgery also leaves the patient in agony even if the person does not decline. It is a hard decision.

Since the patients with dementia cannot cope, they would consider the surgery as a traumatic experience. Naturally due to such trauma, the cognition level would drop a bit. Even if they recover, the trauma often makes the dementia decline a bit.

But there is nothing wrong with the decision. The family did the best. Sometimes it is hard to tell if the quality of life goes with surgery or no operaton. Prolonging one's life in pain may not be a good idea, but again who can predict the future?

My FIL had hernia operation in 2007 after he was diagnosed with Alzheimer's. Because of his loss of memory, he often forgot to be cautious with his scar, so he had a second hernia op. after he broke the scar by sitting down forcefully and forgot that he needed to be careful. Now with stage 7, he can no longer have any surgery.

I am glad your Dad is doing better than your Mom. Sure hope your Mom can cope with the surgery!

Take care,
Nina

Last edited by ninamarc; 09-23-2011 at 07:51 PM.

 
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