Mum fell weeks ago - still so uncomfortable :(

[CaroleKing]

Mum (90+) fainted/blacked out (we don't know) a number of weeks ago, fell very heavily and smashed up her shoulder. She also hit her head and hurt her hip/side though no fracture there. As a result of all this she could barely move afterwards to begin with, it took a few weeks before she could even get out of a chair or across the ward. Shoulder fracture now 'healed' but its sore and weak.

She did get stronger and continued to improve a bit once home, but progress seems to have stalled. We hoped she would be able to get upstairs after a few more weeks -nope, so have had to fit a stairlift, as she has been sleeping in a recliner since being home.

Everything is a struggle for her and uncomfortable/painful, and I am not sure why. Weak I get, but why the pain? She's on regular paracetamol, but moving just seems to hurt, so she does the minimum (takes herself to loo, fetches food and drink from kitchen)..still needs help dressing etc. I suspect not moving might be making the pain worse. Her miscles are very wasted but her feet are swollen. Is this just what happens to elderly people after a fall?

(Dr precribed a v low dose opiate as well but she doesn't like its side effects so doesn't take it)

Very much appreciate everyone who has taken the time to reply - thank you.

I broke my shoulder and had to sleep on the sofa for many weeks as it was so painful, though it did heal eventually. My husband washed my hair for me. I was 74 at the time.

Re why she fell, i said 'we don't know' but it has been narrowed down to hypotension from too much bp medication (she's now off it all) or a recurrence of an arrythmia despite ongoing treatment for that..shes supposed to be having a cardiology investigation but not arranged yet.

And yes there is long standing mild heart failure so the swollen legs are not new but we think never lying quite flat , and moving so much less , is probably why its so much worse?

That’s why I wonder if some private physio might be more interested in exploring the pain side too.

I can see why someone opiate naive would struggle with oxycodone. It is very heavy duty. Could you/she request dihydrocodeine? It's not as strong as oxy but will feel effective to her hopefully just to make movement less painful. Then it can be gradually reduced if necessary.

And sorry you are still in pain too @endofthelinefinally - at mid-60s the various falls ive had have not really left lasting pain so I suppose I don't automatically expect it. (Though a cracked rib gave me gyp for several weeks) And mum has had bumps before even in recent years that she recovered from.

But clearly this, like your accident, is clearly in a different league 🙁

Thank you @DiscoBob - is dihydrocodeine different from just codeine.

She is terrified by the prospect of becoming constipated unfortunately which is why she went from codeine to oxycodone in the first place

She 90+, I think you have to realise she’s not going to bounce back from anything at her age and I really wouldn’t push her. Make sure she has some lovely girls helping her and accept that she’s a very old lady.

It's similar but more effective than otc codeine. She should also be prescribed laxatives alongside any opiates. Docusate and movicol together are good. She only needs a small dose just to make moving less intolerable.

Has she had OT and PT visits? Have they given exercises for her to do?

@CaroleKing my DM is still in hospital after her second fall this year, and this time I'm worried she won't be able to come home for all the same reasons you say (heart failure, probable AF, hypotension). She already has a stair-lift and an adjustable electric bed at home, but she won't be able to transfer from chair to bed to stair-lift etc without quite a bit more physio input. We are hoping they will discharge her to rehab soon, but it gets harder for people to come back from this sort of thing. I'm hundreds of miles away, and my tiny Dad is almost 90. He can't support her physically although he does everything else. It's heartbreaking.

No advice (although the bed is a very good shout and really benefited my mum). Otherwise just solidarity.

I know what you mean, some of the early days it was enough just to get up. However it is worth saying that if the pain is better controlled her energy level and tolerance may rise. Broken nights will not be helping, is she still waking in pain? If she can build even a little physio into her day, maybe after lunch and pain meds, it will help her recovery. Having someone to encourage her, be it a carer or physio, might motivate her. If what she was initially prescribed is still too much go back to physios asking for a review.

Thank you - she's on regular cosmocol already and uses glycerine suppositories too - pelvic floor issues mean constipation is a nightmare to be fair (I have inherited the issue, joy!). But the pain is really limiting her willingness to move even though she does know she should (and @LIZS I agree, and the carers are fantastic and do encourage her to do a little walk" - ie along the hall and back).

So we'll suggest that she asks tontry something else rather than simply taking paracetamol and leaving the oxycodone in the cupboard..

Even if she can't progress much strength and independence wise, she does say she wants to be able to do more - and above all, we don't want her in pain 🙁