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My Mother broke her hip 10 mos ago. She was healing well, but fell again and rebroke it 5 mos ago at the same time she had Covid. This time she was in great pain and it did not heal well at all and needs either surgery (hip replacement) or to let it go.
The surgeon says that a hip replacement could help with the pain, but there are risks at her age that she could get an infection, problems with anaesthesia.
At 97 her vitals are very good and she has a strong Will to live. But she seems to be waffling between the decision. She will answer one way and then the next minute the other. Do I step in to make this decision? (I am the MPOA.) How do I speak with her to understand what she really wants?
I am concerned to go back to square one and put her back in the pain she was experiencing before on the chance that she might be pain free - when we had such a poor healing response this last time.
Is this a fool’s errand?

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I am sorry that your mom is in pain. I would be very concerned about her having surgery at her age.

When my mom was in her 90’s her doctor said, “At your age, absolutely no surgical procedures for anything.”

Best wishes to you and your mom.
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I don’t think the surgery is in your mother’s best interest. I doubt she would be walking again with this surgery. I also think at 97 keeping her comfortable and pain free is the priority. These surgeons just want to make their money.
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My 97 year old aunt broke 2 bones in her lower leg when dropped by caretaker a few months ago. Doctor wouldn't operate because she wouldn't survive the operation. She's healing just fine. Her goal is to be 100.
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From what you describe, you’re the one most competent to make the decision. After the hip replacement, there’d be rehab. Would she be able to withstand that? Ask what would be involved. Also the possible delirium after the anesthesia needs to be considered. And then if the anesthesia causes more cognitive decline and she doesn’t understand what’s happened, you’d have to deal with that. It’s a tough decision. I’d be inclined against surgery at age 97 because you don’t know what you’d be dealing with afterward, but at least you know now.
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This is a terrible decision to have to make. Terrible. On the one hand you are left with increasing pain meds and increasing falls. On the other, the dangers of anesthesia alone can send her reeling from partial loss of faculties to full dementia.
I honestly do not know how to answer you. I think that I would opt for the increase in pain meds, and I might try palliative care and hospice now. It seems she cannot answer the question. You are left with your best instinct and I would say that whatever choice you make there is no good decision here, no decision without constant risk. She is 97. That says it all. It isn't a fool's errand, but it may just be a situation with NO GOOD ANSWER. My best to you, and I am sorry for this tough decision. I would consult with her regular MD about this, not just a surgeon; cutting is what he does.
So sorry. This is a tough one.
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I think there's a doctor's ego at work here if he's even suggesting that kind of surgery on a 97-year-old. Just the anesthesia will likely accelerate the cognitive decline, which will lead to her being unable to do the physical therapy properly, which will lead to her becoming wheelchair-bound.

All that for the chance that she MIGHT have less pain which, considering all the factors above, is a gigantic MIGHT.

I vote for pain management over surgery.
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I think moderate cognitive decline makes her unable to make this decision.

My MIL is 96 and I would suggest to my husband NOT to do it. It's too much. I would do whatever is possible without surgery to keep her comfortable.

At this point is she able to be active at all? If so, has she had PT?

Best of luck.
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No doctor should encourage anyone your mothers age to have surgery as they are more than well aware of the many risks. Most notably is the effect that anesthesia has on the elderly, especially an orthopedic surgery. It's been proven to cause dementia like symptoms and dementia itself that sometimes go away but more often does not.
I would just keep your mother as pain free as possible and not put her through any more medical procedures. And if need be, bring hospice on board as they will do their best to keep her pain free and comfortable.
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I would take heed from the slow healing she experienced before, anything that’s happened previously has an increased chance of recurring, especially considering her age
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Good Grief, operate on a 97 yo person who has dementia? Makes no sense to me.

I would go pain management, and I would switch doctors.

My mother is 98, her mind is good, neither she nor I would go forward with any kind of surgery at her age,

She is not in a mental state to make any sound decisions, she will not understand, I would let it rest.
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