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Dad broke his right hip this past Friday. He just got out of surgery last night. Dad is very confused and he fell out of his hospital bed! He's ok from the fall but why he is so confused? What happens after surgery? Dad is 74 years old.

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I think a lot depends on the state of mind and the individual.  My father suffered broken hips twice, once on each side.    Rehab followed, then in-home PT, OT, nursing, and eventually Dad was walking normally again.   

Both falls were preceded though by syncopal episodes.   He passed out then fell.    He was 94 at the first fall; I can't remember now if the second fall was the following year or 2 years later.  

He was a strong and determined person though and wouldn't let a fall keep him from being as active as he could.   And that kind of attitude is very important.

One thing I did was alert his friends, who visited him regularly and sent cards (a LOT of cards).   They helped provide orientation and support.   Some of the neighbors rallied and helped him at home, taking over the lawn mowing and snow shoveling.  

I think that support made a tremendous difference in his physical and mental ability to recover.  

AK, I don't know why your father is very confused, but I would first attribute it to the anesthesia, and second to the new surroundings and change in mobility status.    Suddenly he doesn't have the strength or stance he used to have; his world is probably "turned upside down", and that's unsettling.

Can you rally his friends?  church goers?   family?   If they can't come, they can send cards.  That might not change his confusion but it will provide always needed support.
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My mom broke her hip on Jan 2. She is much older (90) than your dad but is in remarkably good shape. She stayed in the hospital 1 week, then spent about 10 days in a nursing home to receive physical therapy. She was released to al when she could transfer from wheelchair to toilet by herself. After 2 days in al she returned to the hospital with pheumonia and a severe uti. While in the hospital and the nh she would try to get out of bed. The hospital was not allowed to put the bed rails up unless I specifically asked so I asked and made sure they knew at every shift change.

She was super confused throughout the entire process. Didn’t even remember that she had grandchildren. She has now been in al for a few weeks and is much less confused, recognizes everyone, is interested in grooming, and has rational conversations.

So sorry you both are going through this. I hope this gives you some help.
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My husband (in his 80s) broke his hip last fall, and very fortunately didn't suffer any confusion after the surgery, but it's very common--anesthesia, other meds, strange surroundings. The confusion will most likely go away once meds are out of his system and he's back in familiar surroundings. We had to fight our insurance company to get my husband into rehab, where he remained 3 weeks, but the rehab stay was very worthwhile since the plan was for him to return home where I'm his primary caregiver, with home health aides several mornings a week. Medicare will cover in-home physical therapy, plus nursing and other therapies if needed and prescribed, if the person is considered "home bound." Definitely have your Dad take advantage of that. An OT can help with advising on needed home modifications or other things to make life easier post-surgery. For example, for about 6 weeks after surgery the person has to be on "hip precautions," which they should explain to you in the hospital. We ended up getting a commode for my husband to use temporarily as the height of that could be raised so he could keep within the precautions (our toilet, even with an added riser seat, was too low).
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My mother was a tough old broad who pulled her own teeth. She was 92 when she broke her hip. I can't remember if she had surgery or not. She was in the hospital, then Rehab. She wasn't supposed to go back to her house immediately because she lived alone. So, she went to my daughter's house. She was a complete B*TCH to my daughter. She only calmed down when she was told, cooperate or go back to rehab. In 6 weeks, she was back in her own house. Later on, she said, she acted the way she did because she reasoned if she was hard to get along with we would let her go back home. She couldn't or wouldn't get that she was incapable of walking alone long enough to be by herself.
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My mother had the beginnings of vascular dementia and was not able to focus enough to the PT after her hip surgery. She was very focused on going home but could not understand that would not be possible if she didn't do the PT.
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The anesthesia can take a while to clear the brain. This may be leading to his confusion.
There is also a "condition" called Hospital Delirium this does not just effect people with dementia but anyone that may be "frail" and I would say anyone that broke their hip and under went surgery would fall into that group. Not to mention he is round strangers, strange noises, strange lighting and being awakened often as well as his body is now trying to heal and that can take a LOT of energy.
He should begin to return to normal BUT he may not return to the baseline prior to his break. Time will tell.
And he will have to transition again when he goes to Rehab so there may be a slight set back again.
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Give it a few days, at least, and see.

It's an extremely violent operation. Not painful for the patient at the time, of course - God forbid! - but the repair necessarily involves exerting enormous forces on large bones. You can't "gently" saw the top off a human femur or hammer pins into it! So the body goes through a lot while it's actually happening.

Then there is the anaesthesia, which can take time to wear off.

And there is the pain relief, which has different effects on different individuals.

Your father is young, so unless there are other factors I would expect his surgical team to want him out of bed and mobile as soon as possible - which means very soon, probably is already happening (it's the 25th today).

How did he do it, do you know?

Getting answers to your questions can, unfortunately, be the most frustrating part of the whole exercise; but with your father's permission it should pay to be polite, patient but persistent - you'll eventually catch a surgeon you can wring information out of. Have you written down a list of what you want to know?
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My mother moved in with me after breaking a hip and almost a month in rehab. At first she said and did some wacky things and I feared it might be the beginning of dementia. (My favorite was one night as she walked into her bedroom she said, "This is my room! No one can drive their car in here!")
Anyway she has improved quite a bit since then, and while she has some memory and "thinking" issues, they seem to me to be more like normal age-related decline.
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My friend's mom never recovered from the anesthesia, with her dementia spiraling down after a knee replacement. It's a thing that does happen, but as noted by others, many also recover from it.
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while he is young, it may depend on his mental state prior to fall. What were the circumstances of his fall and had he exhibited any mental confusion prior. Also does he have any underlying illness. If he was fine before, I would expect this to resolve. It could related to pain and/or the meds he is taking for the pain. If it does it resolve, or if he does not return to baseline, he should be evaluated by a neurologist.
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