Quality of life after severe fall??

My 91 year old FIL broke 3 ribs a few months ago. He was in hospital about 6 weeks. He was frail with a walker and largely housebound before the fall. He did manage to go home again and has recovered to pretty much how he was before. He fortunately didn’t get pneumonia which I guess made recovery more straightforward. He was delirious much of the first week or two in hospital.

I hope your FIL gets a good outcome OP, it must be in his favour that he was fit beforehand.

What the person above said… I think it’s correct to say that elderly people lose 10% of muscles per week in hospital… so if you’re in for a while the prognosis is unlikely to be good. DF broke his ankle badly at 82 while playing golf. It was a nightmare at the time but he’s recovered well. Can’t walk as far but is living independently. Getting your FIL up and moving will be vital - but not sure how possible that will be.

I wouldn't work on his expectations right now if he's feeling optimistic about recovery. While he's had very serious, lifechanging injuries, it's still important that, once he's able, he regains as much function as possible. It doesn't feel like it now, but the pain will diminish as the fractures stabilise, and he will be able to engage in some physio and assisted movement. Even if he regains the ability to cough and manage his airway effectively, he will have a better quality of life.

But if he starts to feel that things are hopeless and he has nothing to live for now, his motivation to engage with therapies will diminish and it becomes a self fulfiling prophecy.

Yes, that's what we've had to do, but it's been really hard for him, his brain is still good but he has so little physical capability, most of the people in the home are the other way round, advanced dementia but more mobile. This is another aspect of the falls causing care home admissions issue, the psychological upset of being independent one day, having a fall, going into hospital and never going home again.

Longer he’s in bed immobile the more chance of his leg muscles atrophying and being unable to mobilise again. I’d be managing your dh expectations.

50% of broken major bones result in care home admission according to my last manual handling course.

MIL fell and broke her femur years ago. Got home eventually but could do very little. Is now in care after FIL passed, she shuffles from A to B but quality of life is not great.

Ok that's good news on both fronts. The feeding tube (I assume NG) will be uncomfortable, but will give him the best chance of getting enough calories in to help the body heal.

Ribs are a horrible injury, and unfortunately there's not much that can be done to speed up healing (other than staying hydrated and fed) or to provide support to reduce pain.

My friend in her late 70's had a very bad fall and broke several vertebrae. She was in a very bad way, in lots of pain, several weeks in hospital and then discharged into a very lovely private nursing home which she funded herself. She had lots of physio and is now back at home, well recovered. The only difference is now she has a cleaner (she already had a handyman/gardener). I think the pampering nursing home stay and physio made a huge difference. (Unfortunately she had a horrific time in hospital, but that's another story.) There is always hope of recovery.

There's an 83 year old man at my gym.
He came off his bicycle aged 81 breaking 3 vertebrae. I think being already fit saved him...he's back to full mobility hence at the gym 4 days a week.

My mother aged 90 fell and broke her hip. She was pretty active until then. It has impacted her mentally and 6 months later she had a diagnosis of vascular dementia.

It feels a fall can go either way....no longer term issues or the start of decline.

Has there been any spinal cord involvement? Generally older people don't recover well from spinal cord injury - it's a major system shock and can often be a trigger for organ failure.

If there isn't an SCI, then the problem will be keeping him well whilst he's immobile from the ribs and at a big risk of infection due to diminished breathing capability. Unfortunately ribs aren't like a hip, where the medical treatment is often to replace and mobilise ASAP. Ribs just really preclude mobilisation as the pain is just so intense and difficult to manage.

Unfortunately I'd say it doesn't sound very hopeful for a long term meaningful recovery. But liaise with his hospital team about extra care. He might not be taking in enough calories and fluids due to the pain. So it would be worth asking about fortified drinks. Also specialist positioning support to improve his secretion drainage and comfort.

My 83 year old MIL who was quite active, still volunteering, weekly dance lessons had a fall and broke her hip and had a hip replacement, unfortunately googling, I found the statistics saying over 80% would die within a year. She did well after the op, but lost a lot of confidence and only did what was absolutely necessary. Physically she was good, but mentally it changed her, she died 2 years later.

MIL broke a hip last year, having done the same previously. She was initially in pain but thanks to physio became much better and stronger and was speedier on her feet than before the fall.
However as soon as she was ‘better’ she stopped the exercise and has really really slowed down. It’s a shame really.

My FIL (88) fell a few weeks ago. His mobility wasn't good to begin with and he used a walker around the house and had carers coming in. He fell at home in the bathroom, fractured a couple of ribs and was admitted to hospital. He had a total of 7 weeks in hospital, 4 weeks in rehab hospital. He did not really help himself by doing the physio offered and generally refused to get out of bed at all. He has lost so much muscle and got so frail he was discharged straight to a nursing home. He now is 100% bedridden. I agree with @LevelHed he will have the best chance of recovery for his mobility out of hospital.

You need to get him up and walking as soon as possible. The longer he lies in bed the worse it will be for him. He will lose muscles very quickly - this is not good.

Definitely life, but it is very different. DF only broke one vertebra and one rib but also suffered a small bleed on the brain. It was a neck vertebra and he had to wear a neck brace for three months while it healed. Obviously all spinal injuries are different, but the fact that your DF was fit and well should stand him in good stead and he can have treatment for the osteoporosis. My DF was frail before, used a stick to walk and had already had several cardiac episodes and a stroke but was otherwise fairly healthy for late 80s. It was many weeks before it became clear what the long erm prognosis looked like though.

My late 98 grandfather lived independently with his wife. Good health and no cognitive problems. He fell and broke his hip. He was fixed and spend couple of months in hospital. He didn’t manage to walk anymore so was discharged in wheelchair to home. Two months later he suddenly died while sitting in his wheelchair.

DM fell and broke her femur last year (mid 80s) was back to fully fit and all activity within 6 weeks.

Sadly DF fell and broke vertebrae and ribs this year and after 12 weeks in a rehab unit having daily physio has had to be discharged to a nursing home with hoisting necessary for all movements. I am now wondering whether we should have tried private physio, he is self-funding though and we need to take care not to use up too much of his money. No dementia but he is about the only one in the home without it which is sad, but he couldn't have gone back home, the house isn't suitable.