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I have been his full time care giver since my mom passed 6 years ago. His Alzheimer's/dementia was in a moderate stage most of this time but since the broken hip and surgery then rehab (about 3 weeks) his mental status has declined incredibly. This once vibrant , social , talkative individual able to watch and understand movies or conversations now barely speaks and when he does its that of a child. He's been home now for 2 weeks and its gotten a little better. The health care individuals all tell me this is normal and say he might get it back or he might not. His hip has healed perfectly, in fact he's already completely off the pain meds. Unfortunately this incident has left him incontinent , which was not a problem before. Just was hoping for some feed back on similar situations.
thank you.

His mind is filled with anger,
You can imagine why.
Everyone he see's is a stranger,
Every memory is a lie.
Familiar is an unknown word,
Remember is one too.
Except ,at times when a song is heard,
But even those become few.
Attention fades in an instant,
Because his brain won't allow.
He is somewhat like an infant,
Except he will never learn how.
You'll forever try to reach him,
Hoping that each day is the day.
Yet his light will continue to dim,
Until it eventually fades away .

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Linda, thanks for sharing the really positive news on your father's physical recovery. While his ability to communicate is still recovering (hopefully), perhaps you could use something like flash cards or a collection of pictures for various everyday needs to help him communicate.

When my father was intubated and couldn't talk, he experienced a great deal of frustration trying to communicate. So I made up boards with commonly needed items and help - in large letters, so all he had to do was point to the board. There was only a mild issue of cognition impairment though, arising from the meds being administered. Still, he could point to water (or use a picture of water) when he needed to have his lips moistened. Photos might trigger some parts of your father's memory more easily than words.
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thank-you soooo much for all your input . Since I first wrote dad's hip has healed unbelievably. He'll try to walk without his walker if I let him. He gets up and down with little strain. And yes medicare did send a nurse 3 times and his p.t. just finished her 4th visit , he still has a 4th visit with his o.t. They are all pleased and amazed at his progress. However his memory and ability to communicate as he did prior to his fall has only improved slightly. I am trying to find a day care facility to bring him to a couple times a week so he can socialize with others. He has always been a very social person and at home unfortunately it is mostly him and I. With me he seems to want to apologize constantly and no matter what ways i try to keep him entertained he gets frustrated. But it has only been 5 weeks so I'm thinking positive and hoping some of his mental state still will return. Yet I know, with him having been diagnosed with Alzheimer's almost 9 years ago, this stage of the disease was eminent. Thank you all again for all your helpful advise.
Linda
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Passive movement is better than no movement at all. You can hire machines that will keep his legs moving. These must be prescribed by his surgeon. Visits from occupational and physical therapists would set him on the right track.

In these circumstances, urinary incontinence is often a psychological problem related to regression. It can be surpassed with gentle humour and such aids as plastic urinals into which he can pee without having to get up.


Good luck. :)
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Another thing that buoyed my father's spirits - friends and family sent cards. My cousin sent a card every week. Many of the cards had cute photos of animals - those seemed to be the ones that delighted him the most.
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Medical professionals have told us that hip fractures result in a different level of healing and possible complication because of the immobility caused by that type of fracture - i.e., no longer being able to walk as freely as before. It's a new mindset.

In some ways, it's like cessation of driving. The mobility and freedom once enjoyed is no longer there. It's a new and unwelcome dimension of limited mobility and aging.

So compensate by trying to create mobility. You can leverage that mobility by driving him (getting him out of the house for a change of pace), then go for shorts walks at the destination. Combine mental with physical therapy.

Visit scenic places, go out to eat. Take him to lovely parks and spend some nice time sitting on a bench or just gazing at a scenic site. Nature is a marvelous healer and touches us on a most basic level.

If you can, get neighbors, family and/or church friends to stop by to keep his social life stimulative. If they have pets, ask them to bring their pets. Pet interaction is a marvelous therapy.

If you can help recreate his mobility, that's a good step forward. But do it slowly and safely.

If his vocabulary has reverted to childlike, start there as a basis, gradually expanding the conversations to more adult level. But still treat him as the adult he is.

Keep the activities simple. You might also try playing dominoes; if he can recognize the number patterns he can match 2 dominoes together. Even if he can't, it may help stimulate his mind just to think about placing two dominoes together.

Chinese checkers is another game to play - even if he doesn't understand the strategy, just moving the marbles around could be helpful in recreating spatial cognizance.

Use music as relaxation before and inbetween games - make sure he has adequate downtime for his mind, body and soul to rest and recuperate.

If you have out of town family, set times when you can call and he can talk to them, but forewarn them about his verbal limitations. What you really want to do is create a routine that he can remember while integrating some social activity.

My father fractured his left hip at age 93 and right hip at age 94. He had a rough winter from 2013 to 2014 because it was so intensely cold that we were limited in how much we could safely do outside (even though I packed the car with blankets and emergency gear). The advent of warmer weather brought a welcome change and renewal of spirit.

He now walks almost 1000 feet when the weather is nice. We just got a snazzy rollator which multiplies his distance walking because he can just sit down and rest when he wants to. It's a bright snazzy color - upbeat and cheerful (unlike the drab grayish walkers which are so bland and ugly).

Assuming you live together, that will make planning easier. Try to establish a routine as that will be easier for him to handle. And repetition is easier to deal with than constant change.

Perhaps a trip out someplace in the morning, followed by rest, then lunch, then perhaps a short trip in the afternoon, depending on his strength. For now though it's likely that one outing a day will be enough, especially if he's walking. And make sure that wherever he walks, it's on solid, safe ground.
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Keep him moving! Take him on walks in the yard, neighborhood or at a store or mall. It is very important to keep walking after hip surgery. In addition to helping the hip heal properly it also helps to decrease the fear of falling that often develops after a fall with injury.
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Mom broke her hip March 30th. Surgery the 31st. Between the hospital, rehab, a re-admission into the hospital and then continued rehab, she was away for 2-1/2 months. She also declined cognitively. I've had her back for three weeks. She's much better. She was also incontinent. In my opinion, that's mostly because of her nursing home/rehab stay. They put people who are wheelchair bound in diapers for their convenience. Mom is fine now. I started by making sure she went to the bathroom every two hours with my help. (She can only walk with her walker and a gait belt supervised because of other problems.) If I forget, she reminds me. She's continent during the day. Incontinent at night. The Depends briefs are miracles. (I cut them off with surgical scissors...blunt on one end. Makes it easier.)

From what I learned, a broken hip is much more than just a broken hip. The fracture and surgery is much more serious than one would imagine. Your dad's cognitive abilities may return. Mom's did. His incontinence may cure itself with a little help from you. Mom's did. Mom also speaks like a child (did before, really).

Mom watches TV, visits with occasional visitors (mostly listens to US visit), talks about our two kitties; folds my and Tom's underwear; matches Tom's socks; folds her own clothes; puts on make-up and combs her hair on special days; goes to Adult Daycare once a week.

Are you taking advantage of any home health care that's available to you thru Medicare? Hopefully, the nursing home set you up before his discharge. If he hasn't been out 30 days and they didn't? Call and ask if they can do so. A nurse will come once or twice a week; an occupational and physical therapist will come each twice a week; a personal care assistant will come once or twice a week to bathe him. All of his will help him build his strength and unfog his mind.

I wish you well. Hope something I've said here is helpful.
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Check out the online Alzheimers Store. It has things you can buy that will occupy him.
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Your poem tell much....one thing in life that is inevitable is death.
I hear the word "normal" a lot yet after my entire life as a R.N. working with death & "DO NO HARM" as my guide, yet I still don't know what NORMAL means?? We are all so individual & there is no normal that I know of.

I also care for my husband who suffers from Solvent Dementia. I walk the walk.
God bless & guide your way....
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Anesthetics are really hard on an old brain, and recovery is slow, over months. You just keep him going with cards, scrabble, crosswords or trivia games.
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