Dementia 87 yo broken pelvis crying and being tired

[Sunflowervase]

My grandmother is 87 and has been in a care home for 2 years. She has dementia but is otherwise healthy. She cant remember anything that happens - her memory is about 2 minutes at this point but she does remember who the people who visit are. She doesnt remember much of her past shes forgotten my grandfather etc. she has no idea where she is or why she is there.

she had a fall a few weeks ago and has a small break in her pelvis. She is very stiff walking and says her hip hurts but if you ask her when shes sitting down shes says she has no pain.

BUT she is now distressed all of the time, she looks on the verge of tears her eyes are red and shes wanting constant hugs . She keeps repeatinf “ oh god” “oh dear” over and over but cant tell you why.

the last few days she keeps sayong she has rhe flu but cant really say why she just says “i dont feel right at all” but cant really elaborate.

the home says she hasnt been sleeping well shes just waking up and sitting on the bed and refusing to lie down and she keeps ringing the bell but when they get there she cant remember why, she only eats small amounts now.

when i go she is telling me shes ill but the home say her vitals are fine and just give her paracetamol.

im not sure what to do - i woke up thinking i should go spend the day with her but im not sure if that will make things worse as she gets so upset seeing me go!

any advice would be great theres mo other family to visit her so its only me to deal with anything.

I wouldn’t do anything to stress her any further.

Has a GP been to visit her?

Her pain medication may need to be reviewed . I know she is saying she's not in pain but her level of agitation would suggest otherwise

Agree it sounds like she needs checked over. Could be a UTI, or a virus, or a number of other things.

Visit her, if you can. If she gets upset seeing you go, it sounds like she really enjoys having you there.

You can ask for a doctor to review her.

It is tough having a loved one in a care home.

Is the care home only giving paracetamol or as an addition to other medication? A fracture of the pelvis is likely to cause significant pain for many weeks 😞 Please ask the home to arrange for an urgent check of your grandmother by the OOH GP today, she may not be able to verbally articulate that she is in pain but clearly something appears to be making her uncomfortable. Also just because the home is reporting her 'vitals are fine' does not mean she is not in pain, they need to request medical assessment and review of medication as soon as possible.

I suspect she is in a lot of pain even if she can't identify/verbalise it. I have a small pelvic fracture at the moment and it has been excruciating, I've also been in tears. Only codeine and naproxen work, paracetamol doesn't touch it. She may need stronger painkillers.

Your poor grandmother She's obviously feeling uncomfortable at best and in kain at worst. She needs to see a doctor.

Oh and lying down in bed was one of the most uncomfortable positions for the first couple of weeks so it makes sense that she is trying to sit up. I kept waking up with the pain.

If they have run tests for UTIs and they're negative then something else is going on. Have they given laxatives? Severe constipation, even impaction, is common after this type of fracture. If she is generally incontinent, it is hard to tell but spurs of bone can press into the bladder or bowel. Doesn't the home have a GP who could see her?

My first thought before I even read any of the responses is that she’s in pain but not able to articulate it.

I’m surprised that only a few weeks after breaking her pelvis the only pain relief she’s being given is paracetamol. Is that correct? I think that needs to be looked at as a matter of urgency.

Thanks for your replies. She fell at the home they checked her over and said she seemed fine but a couple of days later she was complaining of pain in her groin and so they got the gp to see her and the gp called an ambulance - the gp also reported the home to a safeguarding team who looked into it and decided the home hadnt done anything wrong. She had the pelvis fracture and a broken toe.

The hospital gave her cocodamol but i dont think that has continued now shes home - i can check today.

She is extremely tired when i go she wants to sleep in my arms which i do but no amount of sleep seems to help. She just says she wants to sleep with me there and she says now she doesnt want to wake up. Its just really heart breaking. I dont think a gp has seen her since shes been saying shes ill so i dont think they would have done any testing for a uti etc.

the home isnt the best in fact i hate it but my dad put her there and he had power of attorney etc but he lives abroad. so i dont think I can change it - i certianly dont have the money to move her anywhere myself.

She had an xray in the hospital would this have picked up on any problems like this wicked? They didnt seem too concerned once they had ruled out a head injury tbh!

That doesn’t sound right. A broken pelvis is quite hard to miss as one leg will appear longer than the other. Your poor grandmother. Please advocate for her for urinalysis, pharmacist to review all medication and take it from there.

I'm glad she has you to look after her, OP. But it must be very hard for you. It sounds like the home should be doing more.

the home isnt the best in fact i hate it but my dad put her there and he had power of attorney etc but he lives abroad. so i dont think I can change it - i certianly dont have the money to move her anywhere myself.

Can you call your DF and say you have concerns that your DM is not getting the best of care? Give him the example of the broken pelvis and toe.
Truthfully, these things happen in the care home all the time (DM broke her hip) as the residents are frail and quite often the floor they fall on to is not deep pile carpet, for obvious reasons. However, there is something in your posts which suggests there is little empathy or love for your DM in the home, and they are not especially kind and reassuring.
While your DF is the only person who can act for her, you can still phone a few places locally to see how much they are and if they have spaces? Moving her sounds awfully difficult but in practice it could be a whole lot easier than you think.
Have you had an annual review meeting recently with your DM's SW team and the home? You could start by calling your duty SW team at the Council and see if they will support you.

Also ,@Sunflowervase are you POA for your DF?

Mum5 i have told him but he just doesnt care sadly. I dont think we have ever had a review?

Mum5 no we rarely see each other he has lived abroad for the last 15 years and he has a wife and step daughter there so i dont have much to do with him.

Ok, that's rotten, @Sunflowervase

You are at a crossroads.
Do you think DM has enough will to live and you feel you should escalate a battle plan and move her? Or, do you feel the kindest route is to make the best of the situation you have, and not move DM?

Depending on your answer there are different routes. However, both will involve you contacting the SW team and probably both will involve them making touch with your DF.

A review - or a least in my part of the UK- is something that takes place once a year with care home, the social worker and a family member. A short meeting where you discuss the well being and onward plan of DM. It might have lapsed in your case because your DF holds POA and is disinterested.

It sounds like she is in pain. When I broke my pelvis (inferior pubic ramis, the most common break) the pain was excruciating. I was on percocet for a month. Lying down was the worst, because I could not lie on either side, and it was impossible to turn over. After I got home from the hospital, my poor spouse waited on me hand and foot.

MIL has Alzheimer’s and cannot articulate pain, hunger, cold etc she just feels ‘not right’. My first guess would be pain or thirst. Your poor gm