99-year-old mom with dementia broke her hip. Opinions?

There’s an appropriate book titled My Mother’s Hip by Luise Margolies that you might like to read.

Jomo11: Thank goodness that your mother had surgery and is doing well.

Your mother cannot walk with a broken hip and lying in a bed for 6 weeks in pain will be devastating to her.

My mother broke her hip when she was 91 and her surgery went very well. She was able to stand within hours of surgery and is still with me at 97 years old.

The anesthesia cause some confusion for awhile but it would be heartless to leave her in pain.

I know that the OP's dilemma is resolved and that the mum has coped well with surgery, but I wanted to say to anyone else - do whatever is necessary to relieve pain.
If a surgery will lessen everyday pain then it should be undertaken, even if the procedure could lead to an acceleration of dementia. Chronic and extreme pain also leads to confusion and contributes to a deterioration of cognitive abilities, anyway, so the risk may as well be taken.
Quality of life is more important than quantity, and pain robs you of that.

Broken hip hurts immensely! Please allow her to get surgery and rehab afterwards.

That happened to my mother. We opted for surgery and the anesthesia seemed to accelerate her dementia to where she needed help with most every task. Not sure what anesthesia options you might have but general has the worst outcome. So sorry.

The recovery from anesthesia is worse with some Dementia patients. She will be in chronic pain without surgery too. I am sorry but your decision process is complicated.

Breaking a hip is a real b***h. When my wife broke hers it was the beginning of the end. She never fully recovered doctors said she was fine. Something broke in her mind. in about 3 years she was dead. All you can do is be there for her

I’m glad it worked out for you.

I guess having surgery at an advanced age depends on the patient, the injury and the doctor.

My mom was in her 90’s and had Parkinson’s disease.

She had rotator cuff issues. Also, the bone on bone knee condition. She wasn’t a candidate for knee surgery.

They did X-rays to determine the severity of her shoulder issue. Mom’s doctor said that she wouldn’t recommend surgery for her due to her age.

She ended up doing home health. Her doctor decided on palliative care since she was in her 90’s.

Mom took her share of tumbles but she had strong bones. She never broke any bones. She used a walker but never ended up in a wheelchair.

She wasn’t bed bound until she entered her end of life hospice care home.

My friend's mother had a hip replacement at age 97. She lived to 101. She didn't move around much and had dementia by the time she died, but all in all, things worked out well. I hope your mom recovers well.

Thank you all for your advice and ideas! Glad I found this group! We did go with surgery, and she came through fine. The deciding factor for us was without surgery she would be bed ridden and in pain (of course hospice would take care of that), but she is very good shape and healthy except for the dementia. She got up every morning, dressed herself, made her bed, and cleaned her room.
again, thanks and I'll keep you posted!

My husband‘s 99-year-old grandmother recently fell and broke her second hip hip. She had another incident about four years ago. She did well both times with surgery and rehab. They did have to increase her care after the second one, and have added a 24 hour aid to her Set up at assisted-living. But his grandmother does not have dementia either. I hope you get some good answers here.

I wonder the same thing! My mom can no longer communicate. The ALF recently called me thinking she had a stroke and asked if I wanted an ambulance to go to ER. Once there, the doctor asked me what I wanted them to do. He said if they ran tests and found the cause I would have to agree on treatment (surgery or whatever). He said if she’s not a surgical candidate then they won’t run any tests, so what did I want them to do? I didn’t know what to say! I simply answered I didn’t want her to be in pain with a trembling voice and tears. I think he felt terrible and ordered bloodwork. It turned out to be a UTI and antibiotics were all that was needed. But it was the moment I realized that at this late stage of the game the options are very limited when a problem arises that under normal circumstances could be treated. I’m so sorry you’re facing that!

What is there to lose here?
She cannot live with a broken hip.
She was active.

She well may not survive the surgery, but she CERTAINLY will not survive the lack of it.
I don't see the choice. We don't at this point allow people to live with broken limbs that can be mended. Were this a cancer, a kidney failure, a heart failure I would call in hospice, as these organs cannot be fixed. A broken limb can.

I do want you to understand that the surgery itself may lead to hospice if she survives. Some cannot tolerate anesthesia at this age. Blood clots and poor healing and failure of major organ systems are a risk.

Get the recommendations of several doctors; her own doctor and a surgeon. Fully discuss.
Also ask her for her own wishes. I can imagine she is in quite a lot of pain now. But hopefully she will give you some idea. Be honest with her that a failure to not have surgery does mean death almost certainly, and no little pain (which can be addressed).
Your and her decision not an easy one, and I am so sorry.
I am 81. There's LOTS I won't do now, node testing, chemo, radiation, dialysis, tube feedings, etc. But I WILL do other things, such as surgical removal of a tumor, repair of a broken bone, and so on.
At this age am down to the "What-I-will-do-and-what-I-won't" stage of life.

You could do both.
That is what eventually happened with my Husband. I stopped in at the Hospice building and asked about Hospice and how I would know when he would qualify.
BUT he had already had the surgery AND...this is the biggie...he went through rehab AND participated.
If your mom can not participate in rehab there does not seem to make sense to put her through the surgery.
On average though a Hospice patient with a broken hip that is not repaired will die within the 6 month time frame.

Some things to think about.
Surgery is tough at any age but at 99 it is going to be very difficult that I think is the biggest thing to think about.

She WILL decline due to the anesthesia.
MC probably will not accept her if she is not mobile.
She WILL decline more when she is moved to Rehab, Skilled Nursing or MC. ANY move will result in a decline. As will the hospital stay for the surgery.
If she CAN NOT or WILL NOT participate in rehab there is no sense to put her through the surgery.
What is her cognition now? Does she understand the options? Have you talked previously about Health Care choices? End of Life, and "life saving measures" i.e., DNR, Feeding Tube, Intubation? If you have discussed this in the past or she has made comments those are your guide posts in making decisions. (within reason)
I hope this is now as clear as mud...😂 all serious now when making decisions you always have to weigh the Benefit VS Burden and you have to make the best decision you can with the facts that you have. If you do that then decisions are coming from the Head and not the Heart. Those are the tough decisions.

If she was going to memory care, this means even if she survives the surgery -- and recovers *some* mobility back through rehab (if she cooperates with it), then she might forget she's not stable and attempt to walk and fall again.

For surgery, she will need to cooperate with things and keep her IV in, and hope she doesn't get delirium afterwards.

To do the rehab she'll need to take the pain meds (and endure the extreme constipation from those). Someone will have to stay with her all the time to make sure she doesn't attempt to get out of bed and make sure she's eating and drinking and advocating for her. In the end there's no guarantee she'll walk again.

When my 100-yr old Aunt with advanced dementia fell & broke her hip, we decided against surgery and she went to rehab just to learn how to pivot on it. She passed away in the rehab. She continued to try to get out of bed, and wasn't eating or drinking unless a family member helped her.

In hindsight I wouldn't have put her in rehab but didn't have a way to keep her from thinking she could walk no matter where she ended up.

It is often a fall that will be the final straw for an elderly person and cause their demise.
Putting a 99 year old person through surgery that will only cause her dementia to worsen sounds rather cruel and inhumane to me.
If it were me, I would want my family to put me under hospice care where they would keep me pain free and let me live out my days around my loved ones.
But that's me. Has your mom ever discussed before her dementia what her final wishes were? If she had, that should help make your decision a little easier.
Know that even if you choose to have surgery for your mom that she will more than likely never walk again anyway, and will be completely bedridden, so I'm not sure any of that is worth putting a 99 year old women through.
I would instead just keep her pain free until she leaves this world for the next.

And on a side note, of course the doctor is suggesting surgery as all the majority of them think about is money any more, and not what is in the best interest of the patient.
Why don't you ask them if it was their mother what would they suggest and why?

I agree , it's about keeping her pain level down at this point. Putting her under will most likely worsen her dementia. Sorry about your mom, we all know how hard this is.

If they can do surgery without general anesthesia --they can use a spinal and sedation, I'd do it to keep her out of pain.