He needs a place with better anesthesiologists but there are no beds available in WA, OR, or California. I am afraid that he won't come out alive if he is not able to have surgery soon. Has anyone else experienced this, and if so, what did you do?
I am sorry for your Father's situation & your stress load.
"I am afraid that he won't come out alive if he is not able to have surgery soon".
Surgery may assist to repair or replace a broken bone.
Surgery is not a cure for old age. Surgery is not pain free, will not stop delerium, may not extend his life.
The stress on the body from a fractured hip is immense. With or without surgery. People will die without surgery. But also, people die during surgery, never wake up or die in the week/s after surgery too.
A fractured hip in the extreme aged is often called 'the beginning of the end'.
I am sorry for my bluntness. It is best to be prepared.
If your Father has no dementia, has a strong physique & healthy heart - surgery, recovery is possible. May extend life for some weeks or months.
The bigger questions is: What is kinder?
Will there be any benefit to surgery/extending life vs too burdensome/painful to bear?
My FIL is going in for his sixth surgery in so many months to keep him from having another stroke.
Despite this, and I would argue the surgeries probably contributed, he has fallen numerous times. He now has back and pelvic fractures and now won’t get up unless to do no 2 in the commode or go to a medical appointment.
The latest is a scheme to look for a tore tendon and repair that. Then around that time, a brain surgery.
Thank you all for your answers. He needed to be in a hospital with a higher level of anesthesia - there are only certain ones who will accept and have the capabilities to carry out that surgery. If you check with the hospitals here, there is an acute bed shortage of beds here on the west coast, or more accurately, there is an acute shortage of personal. The rule in all three states has been that all staff has to be vaccinated. They lost quite a few staff. All the hospitals that we talked with said they are having a tough time clearing their own emergency admissions and they are not accepting transfers. I appreciate the risk of surgery and the hesitation to continue on with that course. However, all of the surgeons felt it was indicated and possible. None of them refused him personally, it truly is a matter of bed space and staff. While I am ready to let my dad go when it is time, I'd like to give him the best life possible while he still has a good mind; and being bedridden, unable to sit up and on a high enough dose of painkillers to endure it seems like its own brand of slow torture. We did just find a hospital with the correct anesthesiologists who have agreed to take him. I will let you know how it goes.
Op, The UCSF system lost less than 200 people out of the thousands who work there, and most of those were kitchen workers and room cleaners as versus clinical workers.
Most hosps here have a vaccination rate of at least 98 percent, on par with the surrounding communities.
Anyway, your dad is bedridden, can’t sit up and on painkillers. This will no doubt get worse immediately after surgery, and will require extensive pt that he must cooperate with for any hope for a tangible benefit. Most elders of your dads age aren’t gonna put in that long painful effort.
Major surgery in a 98 year old patient, will probably kill him, even with the best anesthesiologist in the world. If by a miracle he survives, the post operation recovery and rehabilitation would be a nightmare. If he survives all of this which is unlikely, something else will kill him in less than a year, may be another hip fracture. Is it really worth to put your father through all of this? I doubt that if an honest surgeon would accept this case. I would think that surgery should be avoided, because the risks are much greater than the benefits.
At 82, my grandmother fell and broke her shoulder. The doctors stated any surgery wpuld be risky, but she needed surgery to ever use her shoulder and arm again. Because grandma needed to use her arms to push up from some chairs and for balance when walking, no surgery basically meant she would be bed bound for the rest of her life. Her children chose to decline surgery and she was indeed bed bound until she died at 85 from renal failure due to CHF.
My mother fell at age 86 and broke the prosthetic in her knee replacement free of the femur in her leg. Without surgery she would never wall normally again but surgery risked an infection the doctors felt had a 50%+ chance of requiring amputation. Her children chose PT and letting her use a walker in the house and a wheelchair outside for the rest of her days. At 89, her spinal stenosis finally got so bad she could not walk with the walker anymore. In the last weeks of her life, she became bed bound and passed peacefully in her sleep of a heart rhythm problem.
I was in my early 30s when my grandmother fell and vehemently believed she should have had surgery. She would either have a good quality of life or be in heaven with her husband and eldest son.
In my mid 50s, I chose for my mother to live a few more years with a disability rather than risk trying to cope with an amputed leg. If she was occasionally having problems remembering to use a walker or cane to help with balance issues created by the spinal stenosis, how difficult would it be to remember a lower leg was missing?
My perspective changed a lot across 25 years. I loved my grandmother every bit as much as my mother. I had been helping poviding care for grandma since I was 20, my mother lived in my house with MCI and spinal stenosis since I was 50.
It comes down to there is a point where medical interventions, like surgery, can no longer sustain the quality of life or even life itself for our loved ones. We have to accept and determine what we can do to keep them safe and as comfortable as we can for how ever long God continues to bless us with there presence. And then we have to let them go. I believe they are reunited with loved ones they have previously lost and are waiting for me to join them. It brings me some comfort and I pray you find some kind of acceptance and comfort with your father's situation.
When you say better anesthesiologists, do you mean one who doesn't say "I'm not touching this patient"? I'm not sure such a one would be better. Just less risk averse.
Your father is not only 98 but 98 with congestive heart failure. My mother was only - only! - 88 but when she broke her wrist we had a young anaesthetist bursting into her cubicle in the ER, quivering with rage and righteousness, and saying to me "I have to TELL YOU that IN MY OPINION it would be NEGLIGENT to give your mother a general anaesthetic!!!" I gathered that he had been being bullied by the surgeons, it certainly wasn't anything I'd argued about. They did a Biers block in the end...
What are the surgical team suggesting for your father? And what does your father want to do? - how is he, and what's he saying?
They’ve concluded that he’s inoperable because of age or conditions. I doubt you would get different results in other states.
If you don’t want to put him on hospice, you don’t have to. But pain management often comes easier for those on it now that so many utter losers have been addicted to stolen opioids.
You realize that even if there were beds available( and I'm not clear as to why they're not)at a preferred hospital, that at your fathers age he still might not "come out alive." He's 98 years old. How much longer do you want him to live? Often times at your fathers age a fall is what will be what finally takes them, so you need to prepare yourself for that. I would get a second opinion about whether or not your father actually needs surgery,(as surgery itself is very hard on an elderly person along with the major side effects of the anesthesia)and instead perhaps even start looking into getting hospice on board, so he can just be comfortable until it's his time to go. I wish you peace in whatever decision is made. God bless you.
Why hasn't surgery been scheduled? Most sizeable hospitals would have surgery facilities., especially in 3 states. And what's wrong with the anesthesiologists? Aren't any to your liking? Who and how was the assessment made that his hip was fractured?
If there are "no beds available in WA, OR or CA, something's amiss with that assessment.
"I am afraid that he won't come out alive if he is not able to have surgery soon".
Surgery may assist to repair or replace a broken bone.
Surgery is not a cure for old age. Surgery is not pain free, will not stop delerium, may not extend his life.
The stress on the body from a fractured hip is immense. With or without surgery. People will die without surgery. But also, people die during surgery, never wake up or die in the week/s after surgery too.
A fractured hip in the extreme aged is often called 'the beginning of the end'.
I am sorry for my bluntness. It is best to be prepared.
If your Father has no dementia, has a strong physique & healthy heart - surgery, recovery is possible. May extend life for some weeks or months.
The bigger questions is:
What is kinder?
Will there be any benefit to surgery/extending life vs too burdensome/painful to bear?
Despite this, and I would argue the surgeries probably contributed, he has fallen numerous times. He now has back and pelvic fractures and now won’t get up unless to do no 2 in the commode or go to a medical appointment.
The latest is a scheme to look for a tore tendon and repair that. Then around that time, a brain surgery.
For what?
I appreciate the risk of surgery and the hesitation to continue on with that course. However, all of the surgeons felt it was indicated and possible. None of them refused him personally, it truly is a matter of bed space and staff. While I am ready to let my dad go when it is time, I'd like to give him the best life possible while he still has a good mind; and being bedridden, unable to sit up and on a high enough dose of painkillers to endure it seems like its own brand of slow torture.
We did just find a hospital with the correct anesthesiologists who have agreed to take him. I will let you know how it goes.
Most hosps here have a vaccination rate of at least 98 percent, on par with the surrounding communities.
Anyway, your dad is bedridden, can’t sit up and on painkillers. This will no doubt get worse immediately after surgery, and will require extensive pt that he must cooperate with for any hope for a tangible benefit. Most elders of your dads age aren’t gonna put in that long painful effort.
My mother fell at age 86 and broke the prosthetic in her knee replacement free of the femur in her leg. Without surgery she would never wall normally again but surgery risked an infection the doctors felt had a 50%+ chance of requiring amputation. Her children chose PT and letting her use a walker in the house and a wheelchair outside for the rest of her days. At 89, her spinal stenosis finally got so bad she could not walk with the walker anymore. In the last weeks of her life, she became bed bound and passed peacefully in her sleep of a heart rhythm problem.
I was in my early 30s when my grandmother fell and vehemently believed she should have had surgery. She would either have a good quality of life or be in heaven with her husband and eldest son.
In my mid 50s, I chose for my mother to live a few more years with a disability rather than risk trying to cope with an amputed leg. If she was occasionally having problems remembering to use a walker or cane to help with balance issues created by the spinal stenosis, how difficult would it be to remember a lower leg was missing?
My perspective changed a lot across 25 years. I loved my grandmother every bit as much as my mother. I had been helping poviding care for grandma since I was 20, my mother lived in my house with MCI and spinal stenosis since I was 50.
It comes down to there is a point where medical interventions, like surgery, can no longer sustain the quality of life or even life itself for our loved ones. We have to accept and determine what we can do to keep them safe and as comfortable as we can for how ever long God continues to bless us with there presence. And then we have to let them go. I believe they are reunited with loved ones they have previously lost and are waiting for me to join them. It brings me some comfort and I pray you find some kind of acceptance and comfort with your father's situation.
Your father is not only 98 but 98 with congestive heart failure. My mother was only - only! - 88 but when she broke her wrist we had a young anaesthetist bursting into her cubicle in the ER, quivering with rage and righteousness, and saying to me "I have to TELL YOU that IN MY OPINION it would be NEGLIGENT to give your mother a general anaesthetic!!!" I gathered that he had been being bullied by the surgeons, it certainly wasn't anything I'd argued about. They did a Biers block in the end...
What are the surgical team suggesting for your father? And what does your father want to do? - how is he, and what's he saying?
What's his physical condition like generally?
That the surgery is too risky? That cardiology won't approve him for surgery?
Sit down with the surgeon and ask what s/he'd do if this was their parent.
If you don’t want to put him on hospice, you don’t have to. But pain management often comes easier for those on it now that so many utter losers have been addicted to stolen opioids.
I would get a second opinion about whether or not your father actually needs surgery,(as surgery itself is very hard on an elderly person along with the major side effects of the anesthesia)and instead perhaps even start looking into getting hospice on board, so he can just be comfortable until it's his time to go.
I wish you peace in whatever decision is made.
God bless you.
If there are "no beds available in WA, OR or CA, something's amiss with that assessment.