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Mom, 99, dementia living in memory care self pay nearly depleted. Currently on hospice fell and fractured hip. In great pain. ER gave choice to admit and have pins inserted or do nothing and send her on to SKN after rehab. The surgery will revoke hospice but I was told it could resume. Chose pin surgery. Any advice on how to proceed?

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Opt for the surgery if in pain. Some surgeons refuse to operate on patients that old
but I have two experiences. My Aunt was given 4months to live with her cancer
when she fell and broke her hip . She had the surgery and came thru quite well and
lived another 12 months with out any real pain.
My client broke her hip at age 99 and had surgery. She just had her 107th birthday and has been doing well.
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GAinPA: I cannot fathom your poor mother enduring the broken hip. Perhaps it would be best to proceed with the surgery.
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My father was an active. 90 yr old when he fell and broke his hip. He had surgery and had 5 bad post op days ie hallucinations ,constipation and impacted badly from pain meds , weak etc but he got thru it abd was doing ok in rehab for 6 weeks but not walking well but strong…he ended up getting a uti thru catheter and it went to his heart and he became septic w mrsa endocarditis ….he was touch abd go but stopped eating abd drinking …had bedsore. ,catheter and needed 8 weeks of IV antibiotics abd a feeding tube for possibly recovering ….he was in physucal and mental anguish abd the thought of him suffering abd fighting thru this terrible infection w tubes made me terrified …so I chose hospice abd I bekueve that hastened his death ie overmedicated and died inn3 days ..he was inpatient hospice …3 yrs later my decision still tortures me
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Hospice services are paid by Medicare beyond one week. As far as hospice facilities, I don’t know what is covered.
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I have had hip pin surgery myself and have now resumed normal activities. When your mother's tteatment and re-hab for the hip are completed, you can re-assess for hospice care.
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Contact Hospice and ask them
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Please allow her to have her hip repaired. She will have pain with the surgery which can be managed afterwards and should heal. The pain of living with a broken hip until she passes is not one I would relish.
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Horrible to live with the pain of a broken hip, so if the Dr thinks she can survive surgery then She should have it fixed.

After Rehab, they will find her a safe place to live.
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You made the right choice. A broken hip pain is terrible. Glad to see you were able to use a spinal block. Wish we were informed of that choice when my dad broke his hip.
He was in terrible pain until he had his surgery.
Hospice keeping her pain free but not having the surgery would have meant her being so medicated you probably would have lost any ability to communicate.
As well as being bedridden.
You made the right choice.
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ArtistDaughter Dec 2021
I wasn't given that choice for my mom either when she broke her hip and I didn't know enough to ask about it.
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GAinPA, that's great news.

Prayers sent for a good recovery of mobility and no pain.
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I have to agree that you made the right move. I myself had full hip REPLACEMENT surgery with a spinal block and no general anesthesia. How can anyone, in good conscience, allow an elder to live with a broken hip who's in great pain when surgery is available without general anesthesia? My father was 91 when he fractured his hip and had the same exact surgery as your mom, but he did have general anesthesia and survived. I hadn't had my HRS at that time and wasn't aware of the spinal block that he could've had instead, or else I would have insisted on it.

Good luck to both you and mom
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Wow. At 99 and in active Hospice she chose to have this surgery.

That's somebody who really, really wants to keep living. I hope she can return to a close level to where she was before.
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elderadvocate20 Dec 2021
My thoughts exactly. Why she was on hospice? Was it only to assist with payments? How long has she been on hospice and what was her terminal diagnosis?
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Update: spinal block was successful and stabilization of hip fracture went well. No general anesthesia no intubation.

Next possible step: Transfer to skilled nursing (along with resumed hospice) for rehab on same campus as memory unit building.
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JoAnn29 Dec 2021
This is good. Thanks for update.
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It sounds like you've already made your choice for her by electing to have the pins inserted, and that hospice has told you that after she has it she can resume under hospice care, so not exactly sure what your question is, as you answered it yourself.
Yes she can go off hospice care to get surgery and yes she can go back on it after she's had it.
I'm just not clear why you would put a 99 year old through surgery who is near death, when hospice can keep her comfortable and pain free until she leaves this world. And if need be you can have her transferred to the hospice facility for her final days, and all that would be covered 100% under moms Medicare.
Just be aware that putting an elderly person under anesthesia for surgery often makes any mental decline much worse as well, so again I'm not sure I'm following your reasoning for opting for that at your moms age.
As hard as it is to let a loved one go, there does come a time when you have to just say enough is enough and not opt to put them through anything that will cause perhaps more pain, confusion and really not prolong the inevitable anyway, just to make you feel better about things. I think you should now do what's in the best interests of your mom.
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GAinPA Dec 2021
I have been advised that allowing my mom to be sent to skilled
nursing with an untreated hip fracture would be a long, painful bedridden ordeal. Up to the fall, she was able to walk. Hospice was started when she went through a period of anxiety and was refusing care and food. She responded well with the meds and the extra attention.
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