79-year-old husband with advanced Alzheimer's in memory care, on hospice broke his hip. What now?

My dear husband passed away last night. His sisters and my daughter were with us every second, through his last breath. Most of the people dearest to him were able to say good bye either in person or on the phone. The facility staff and even a couple of the residents were sweet and caring. Hospice was invaluable.

I am so grateful for all of you who have listened to me through this and given me the benefit of your experience, comfort and strength. You’ve set me back on course when I was veering and encouraged me when I was feeling defeated. Most important, you helped me to prepare for his decline and set up my life without my provider and protector. I made a few mistakes along the way but, oh, they would have been so much worse without you!

I have some questions about my husband’s last couple of days as well as his actual passing and I know I can come to you when I’m ready to ask them.

Thank you with all of my broken heart.

What are the doctors telling you Peasuep? I think your goal now is to keep him as comfortable as possible for whatever time he has left, I would rely on them helping me to understand what is necessary for that.
(I want to add that I know how hard it is to choose do nothing, even when you know there is nothing else you can do)

Well on Hospice if you do decide that he should have surgery Hospice will discharge him while he is under the care of the doctor.
With advanced dementia he probably will not do well with anesthesia.
(Do his doctors even think he is a candidate for surgery given his medical history?)
With advanced dementia he probably will not be able to participate in rehab.
He probably, even with surgery to repair the fracture not walk again.
He will be at higher risk for pressure wounds.

Once he has surgery (if this is your decision) he can then qualify for Hospice.

Without surgery he will probably survive not much more than 6 to 9 months. Honestly with surgery it would probably be about the same since he would be very limited in his activities and would probably be in wheelchair or bed. (due to the fact that he probably would not do well in rehab)

I said for years when I had to make tough decisions for my Husband I was ruled by 2 major organs.
My head
My heart.
I could only hope that my head would rule on the important decisions like the one you have to make.
I can tell you in your situation I would opt NOT to have the surgery done.

Two years ago my almost 101-yr old Aunt with advanced dementia got out of bed at night and broke her hip. As her MPoA I was not in favor of a surgery but her in-home, hands-on long time caregiver nieces wanted to bring her back to the house and continue to care for her. The problem was as she was in the rehab facility she was still attempting to get out of bed. It would be no different back at home. I finally decided to not put her through the surgery. PT was going to work with her to get her to be able to pivot on that hip so she would be able to stand and transfer from bed to chair, etc. I was actually in the process of having her assessed for MC or LTC when she passed away in rehab, cause unknown but possibly from a clot that can be a risk related to large bone breaks. My Aunt did not seem to be in pain unless she attempted to stand and walk (which she wasn't able to do well prior, hence her falling when unsupported). She was not going to die imminently from any other health issue. She probably would have gone back home where she'd continue to fall. If I were in your situation I would not have the surgery (because there are risks with the anesthesia, risks from infections, risks that he won't keep the IVs in, etc) and he probably wouldn't cooperate with the rehab. I take it that without the surgery he will be bedbound. I agree that comfort and pain control is what now needs to be the priority, not his mobility. Is he even considered a candidate for the surgery with heart failure? FYI my Aunt's surgeon told me bluntly that they only like to take on patients with best chances of good outcomes because it impacts their own ratings. I wish you clarity, wisdom and peace in your heart no matter what you decide for him.

Oh honey I am sorry for your loss. Something to be aware of: if he was on hospice and his hospice was through Original Medicare coverage, it has a bereavement counseling benefit for his immediate family. You don’t need to sign up right away. But it’s there for you to utilize even if it’s 5 weeks from now. It’s billed to his Medicare even tho he has passed. It’s usually outsourced to a licensed SW or therapist who does this as a part of their regular practice.

I don’t know how Medicare Advantage Plan work for bereavement counseling.

Dear Psue (((((((hugs))))) my deepest condolences on your loss. I think your hubby was a special man as he earned such devotion from you. So glad he was surrounded by family when he passed. May he truly rest in peace. Loo after yourself as you go through these next days and weeks dealing with the necessities. Grief counselling can be very helpful when/if you are ready for it. Do come here for support as you need it. My heart is breaking for you.💔

So sorry for your loss .
Your husband is at peace now.
I’m sure he would say that you did a great job , your best in such a heartbreaking journey . He was grateful for your love and care , even if he could not tell you so . Cherish good memories.
((((Hugs)))

I'm so sorry to hear of your husband's passing, though glad those who were near and dear got to be with him and say their goodbyes.

Peasuep, May The Lord give you grieving mercies, strength and comfort during this new season in life.

Peasuep: My deepest condolences , I am so sorry! 😥 My thoughts and prayers 🙏 are with you.