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Original poster

Broken hip at age 95 - any experience?

47 replies

olivertwistwantsmore · 14/12/2018 22:39

Mil fell last night and broke her hip. Saw her today in hospital. She was in pain, very confused - she has dementia - and had no idea what had happened. I felt so sorry for her.

She’s having an op tomorrow to fix her hip, but does anyone have any stories about people of a similar age who have had a broken hip? Hiw did they recover? Did they regain mobility? The doctor said it is a ‘significant injury’, and I can’t imagine how they do physio for a patient with dementia...

OP posts:
toomuchfaster · 14/12/2018 22:43

Probably not what you will want to hear, but my great grandmother died under the anesthesia. She was 99.

cheesywotnots · 14/12/2018 22:46

I know of people in their 80s and 90s who had this operation, they were bedbound before and afterwards so didn't get physio. The operations were successful, I hope it goes well for her, how was she before the fall. Flowers

Original poster
olivertwistwantsmore · 14/12/2018 22:47

I’m so sorry to hear that.

The doctor said there’s a 10-30% mortality rate in the first month. She just looks so lost and sore, and she’s delirious, talking nonsense.

I don’t know. I just can’t imagine how they’re going to get her mobile again.

Ah, fuckit. The next thing we need to think about it, go to my parents 500 miles away as planned, or stay with mil while she’s in hospital...?

OP posts:
giftsonthebrain · 14/12/2018 22:48

the risk of passing within one year of breaking a hip is really high for all age groups at 95 she will be very fragile.
i don't expect the outcome will be positive.

Original poster
olivertwistwantsmore · 14/12/2018 22:49

She was up and down, cheesy, sometimes ok, sometimes very down and with very little short term memory. She uses a walking frame.

Today she could barely speak, couldn’t swallow. No idea if this is the result of the fall and shock, or the dementia too.

OP posts:
OnlyWantsOne · 14/12/2018 22:49

A NOF fracture doesn't have great prognosis I'm afraid (I work for ambulance service) especially with other coexisting chronic conditions such as dementia. Poor MIL I am sorry it's just horrid. I hope she's well looked after. Take care x

HollowTalk · 14/12/2018 22:51

Not a broken hip, but my 98 year old aunt had a broken thigh. (Waving to any relations!) She had an operation but didn't have a GA - she had Fentonyl (which has been in the news lately since it's used by some as a recreational drug and is considered 100 x stronger than heroin.) She couldn't walk afterwards but that was because of the state of her bones. She's survived it all, but she doesn't have dementia.

I hope your MIL is OK. What a horrible situation. Flowers

WillChellam · 14/12/2018 22:51

Never had one of my hip fracture patients die during anaesthetic, but a hip fracture should be considered a pre-terminal injury, the equivalent of a 20 year old being hit by a lorry, especially in a 95 year old with dementia.

I have had a handful of patients in their 90s + make good recoveries, but they were exceptional - living alone, independent and still driving. The vast majority are less mobile after their surgery a nd on average 40% of people die within a year of their hip fracture. The surgery is however generally quite effective at improving pain, and on balance is better than the alternative, which is to lie immobile in bed.

Burlea · 14/12/2018 22:52

MIL broke her hip when she was 89. She was out of bed the day after her op. 2 weeks in hospital, in a convalescent home for 4 weeks. She is now back in her bungalow and relies on her stick. She was housebound before so nothing has changed in that way.
Toilet, bed and comfy chair were raised by Social services. Grab rails by the loo and a seat in the shower.
MIL is very stubborn stopped pain killers after a week as she said they made her constipated.
I hope your MIL is going to be well.

BertrandRussell · 14/12/2018 22:54

My mother broke her hip and had a hip replacement when she was 92. She recovered-but she was a very robust character - and the medics were surprised that she did so well.

I think you need to stay.

Spartak · 14/12/2018 22:54

I'm a physio and I've recently been working in trauma and orthopaedics.

We have to adapt what we do if someone has dementia a bit but the treatment is mostly the same. She'll be out of bed within 24 hours of the operation. It's helpful if you can fill in a "This is Me" form so that the staff know bit more about her. They should be able to give you one or you could probably find it online - sorry I'm on my mobile with limited signal or if find the link. It's helpful if she's scared and confused to be able to talk to her about things she's familiar with and to know how she likes her tea and that she doesn't like bananas or whatever etc.

Lots of people in her position do get back to functional walking although it's slow process and she may need a zimmer frame for a while.

Spartak · 14/12/2018 22:59

She may be reluctant to eat if she's feeling in pain and confused too.

It's worth making stuff she has a stash of favourite foods - cakes, biscuits, chocolates and fruit are normally best received - in case the hospital food is minging. The same with drinks if she likes lemonade or squash as choice will be limited on the ward.

svengoren10 · 14/12/2018 23:01

Another physio here! I work both in the emergency department in a major trauma centre for the south west of England and out in the community seeing patients post-discharge home from hospital. Safe to say I have seen thousands of post hip fracture patients over the years. Statistics long-term aren't great but they take into account that most patients already have complex needs/pre-existing problems.

Your MIL prognosis will all depend on her level of function and past medical history prior to the injury. If she was fairly fit and welll and independent, then she should make a reasonable recovery. I appreciate she has dementia but there are ways and means to deliver physiotherapy to a patient with dementia. Good luck and wishing her well

Spartak · 14/12/2018 23:01

Photos of family, pets, favourite places are also helpful for providing a bit of reassurance at times. If they are in an album, I used to sit and talk about the pictures with my patients if they were having a bad day.
Hospitals can be a bit scary with dementia and having something familiar to look at was comforting for lots of people.

Original poster
olivertwistwantsmore · 14/12/2018 23:02

That’s a great idea, Spartak. Thanks. I’ll ask at the hospital tomorrow.

Will Chellam, thank you. That’s what the doctor said today - even if she was at the end of her days they’d still operate, because if you don’t it’s no life for the patient. Are you a surgeon? A nurse out on Dvt stockings on her today and it was so painful for her, it was horrible.

I’m in awe of all hospital staff. Mil is in a bay by herself, and all staff are lovely. We’ve been able to ask anything and they have been very good at giving info.

Burlea and Bertrand, I’m glad your parents were strong and bolshy! :)

OP posts:
Original poster
olivertwistwantsmore · 14/12/2018 23:05

Ah, you lot, thank you so much. You’ve made me cry. Thank you for all your help and stories. I really appreciate it.

My mil and I have not always seen eye to eye, but my dh are I are all she has, and I want to do the best for her to help her and make things as easy as possible, to minimise her suffering.

The doctor said they have signed a DNR - can they do that without family agreement? I do agree with them; I was just taken aback.

OP posts:
WillChellam · 14/12/2018 23:08

Yes, I'm an orthopaedic surgeon.

If the Ted stockings are too painful they could try calf pumps.

Also, don't let her surgery get postponed, kick up a fuss and mention the national hip fracture guidelines and best practice state the surgery should be done either on the day of admission, or day after for the best outcome provided there isn't an overwhelmingly convincing medical need to delay.

NanooCov · 14/12/2018 23:09

DH's grandma of around the same age broke her hip in a fall about 6 months ago. She was discharged home and had home help 4 times a day and MIL was pretty much with her most of the rest of the time. She was scared to do the physio as she was petrified she would fall again. Fell again shortly after being discharged home and was readmitted. Ultimately has ended up in a care home and is doing ok though very frail and hasn't regained mobility sadly. She was already beginning to suffer with a bit of dementia but actually the activities at the home (they are amazing) seem to be helping her stay engaged and alert.

Hope your MIL is as comfortable as can be and has a good recovery.

svengoren10 · 14/12/2018 23:10

Yes afraid so, not unusual for a DNAR to be done without family/patients consent, although where possible it is normally discussed. The chances of resuscitation being successful in a 95 year old it very slim, it's a traumatic process and distressing for all involved. It is likely to cause damage to the rib cage and potentially organs in the process so it's quite often decided that it wouldn't be in the patients best interests.

Violetroselily · 14/12/2018 23:15

Best wishes to your MIL Flowers I hope she isn't too uncomfortable for long

To the HCPs - what is so significant about this injury that makes it life threatening? Please excuse my ignorance

wigglybeezer · 14/12/2018 23:18

I'm afraid my Granny died at the same age, in hospital after having the op, her mother also died at 95 after breaking her hip but that was in the days before replacement joints, sorry x

Original poster
olivertwistwantsmore · 14/12/2018 23:19

I agree about the futility of a dnr; I was just surprised that we weren’t consulted.

Thank you, WillChellam. She was prepped at 11 today but then the surgeons ran out of time. She’s first on the list tomorrow. She’s had ted (I thought they were tit stockings - that’s what the nurse sounded like they were saying) stockings on since 11am today - will that be ok?

Thank you so much for the helpful medical info. Really appreciate it.

OP posts:
WillChellam · 14/12/2018 23:20

Yes they can unilaterally take a dnar decision, likewise they don't need your permission to proceed with surgery, both decisions are made as a 'best interests' decision, which, can only be overridden by a court order, or, if someone had a lasting power of attorney for medical decisions. Best practice is definitely to speak to the family to inform them of the decision and reasons for making it, and, very good that they've done it now proactively rather than later as an afterthought.

Even if an LPA objected, you still cannot comped a doctor to provide a treatment that they think is unwarranted. Our professions guidelines are to help the family seek a second opinion if there is a disagreement.

Don't forget, CPR is not there to save a persons life, its there to bring a dead person back to life. For a medically fit young person the success rate is about 30%. For an elderly person all you'd succeed in doing is depriving them of dignity in their final moments and probably breaking all their ribs, puncturing lungs and generally causing a lot of suffering.

WillChellam · 14/12/2018 23:29

The Ted's will be fine.

@violetroselily - the femur is the largest bone in the body and one of the strongest - the fact that an elderly person has broken it (usually after a minor fall from a bed, chair or standing) indicates they are already extremely frail, have osteoporosis and normal many more medical problems.

The issue is, if you leave someone in bed, their heart and lungs get weaker within days making them prone to pneumonia, heart attacks, strokes, in addition severe pressure sores can develop rapidly. Surgery (as mentioned above by several other people) aims to get patients out of bed the next day and minimise those risks, but a lot of patients font have the physiological reserves to heal and recover from the injury and surgery - problem is, there's no test to pick which patients will, and which won't.

Orchardgreen · 14/12/2018 23:29

Will
I wouldn’t use my real name on here if I were you.