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In the meantime we are trying to get her into an inpatient rehab facility until they operate. She is too weak and unsteady to use a walker. She can’t hop, the physical therapists at the hospital realized that. Even after the operation I fear she will be confined to a wheelchair. I do have some modifications at my home I can do to help her some but if she doesn’t get out of the wheelchair I fear she will lose her mobility. If she becomes bedridden I don’t think I will be able to care for her. What are reasonable expectations? Outcomes? What should I ask the therapists. Perhaps I am only seeing the worst case scenario. Any thoughts.

Not to be the bearer of bad news but if she has dementia and is operated on, the anesthesia typically makes the dementia decline dramatically. My friend scored a 14 prior to his surgery and 2 months afterward scored a 6.
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Reply to Barb53
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There is a lot to discover with your mom's condition, but for now, you should be researching and visiting rehab/nursing home facilities. When your mom has her surgery and then requires rehab, you will know what facility or facilities you prefer. Why? Of course you want her to be at the best facility AND because if she goes to a really good one. The physical therapists will help her reach her best level and when your mom is near ready to return home, they will visit the home to identify any adaptations needed. Also very important to understand is that many of the better facilities have wait lists for long-term care. Here is where your homework can help, because iff low and behold she can't safely return home, she can stay in this facility while you apply for long-term care. They can't boot her out and she will have a bed in a better facility.
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Reply to lynina2
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Having worked in rehab facilities for years, I can say the outcome depends primarily on her state of mind. Can she follow directions? Does she try to help herself or is she completely dependent on staff? Does she show an interest in getting out of bed?

Ask the therapists if they are working on transfers from bed to chair, toilet etc. Ask if you can attend the PT and/or OT session. A reasonable goal would be for her to transfer from bed to wheelchair (and back) with minimal assistance of one person, probably you.
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Reply to Bigsister7
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I have known numerous people (including my mom with Parkinson's Disease and my mother in law with severe dementia) who fell and fractured either their hip or leg. My mom was 79 when she fractured her hip. She recovered fairly well. She did have to use a walker, mostly because of her Parkinson's disease and only used a wheel chair in the last stages of her Parkinson's. My mother-in-law was in her early 80's when she fell in her kitchen and broke her upper thigh and her wrist. The surgeon had to wait several days for doing surgery, partially because they wanted to repair both brakes at the same time. She's a brittle diabetic, so surgery and healing gets complicated. She was in rehab at a nursing care facility for several months. After her recovery, there was some rehab at her home. She was able to get back to driving (which, she probably shouldn't be doing, but I'm not in charge of that), she still shops at Costco, and tries to maintain much of her "earlier life." For the most part, she rarely ever uses her cane (although her doctor recommends it), and she gave up the walker ASAP.

Modern medicine is truly amazing. PT is crucial and keeping a positive outlook helps tremendously.

You're doing a good job by asking questions and being an advocate/voice for your mom. I pray that she has very loving, compassionate care givers in the days and months ahead—that was my mom's biggest support in her recovery. We loved and appreciated every one of her care staff. The PT's were amazing!
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Reply to busymom
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speak to the hospital social worker. The social worker can look at the doctors notes and arrange a stay at a rehab facility. Depending upon whether or not the “goals” of rehab are met, take it from there. You might be surprised that rehab can get her strong enough, or train other muscles to compensate. She might be able to transfer from chair to bed independently after rehab! Stay positive and take one day at a time.
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Reply to Rattled
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I think we can get a narrow wheelchair if need be but I worry about using her arms to roll. She’s not very coordinated. We will cross that bridge when we get there. She is going to Rehab for pt till surgery then back to rehab after surgery for pt. So we will cross that bridge when the time comes. Thank you all.
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Reply to Choupette
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rocketjcat Sep 18, 2018
I would say most of the people at moms NH who are in wheelchairs and who can navigate themselves do so by scooting their feet, with the footrests removed. Or even a combo of one foot rest, scoot with the other foot and use arms. Don’t worry...the PTs will figure out how to make her most mobile.
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At first it always seems difficult and like things may never change. After my Mom fell 3 times, all requiring hospital stays and surgery, she did eventually recover enough to get around using a cane or walker later. The key here was steady PT and time.
It will take time but with continued PT it can get back to normal. They can do the PT after she is discharged from the hospital in a rehab facility. Medicare paid for that and she was in about 2 months. Then when she was discharged able to get around a bit PT came to her home for several weeks. I wish you both the best!
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Reply to Katie22
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Choupette you have a lot on your mind and it is best not to worry about a situation which may never arise. Secondly
no one can predict the outcome of Your Moms Operation and all You can do is Pray and hope all will be well.
Good Luck to Your Mom and to You Choupette.
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Reply to Johnjoe
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Ask if PT can come during this wait-before-surgery period to teach her some exercises for the other leg, arms etc, and to keep muscle tone in the whole body, not just lie around in bed.

After surgery, make sure she has frequent PT and encourage / facilitate her doing her exercises in between sessions.

Recently a 67-year-old friend of mine endured 4 months of nursing home in a similar situation with a badly-broken leg ... and quickly learned that staff need to be TOLD and re-TOLD to let the patient do everything that the patient CAN do. Learned helplessness was really a problem even with this highly-motivated patient.

9 months out, recovery appears to be total.
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Reply to maggiebea
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Choupette Sep 18, 2018
Yes she was very helpless when she first moved in. Gave her the “job” of loading unloading the dishwasher. It was interesting, kinda like playing hide and seek looking for certain items. And she is NOT highly motivated.
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well, a lot depends on WHERE the break it, how much down time she;ll need, how compliant and invested she is in getting well.

Having a patient who can help themselves a lot makes you job a ton easier. She needs to be invested in getting well.

What's her overall mental state? I know people who bounce back from broken hips, knee replacements, whatever, with amazing results. And also ones that simply malinger over any illness.

They say "plan for the worst, expect the best." Plan that she'll be able to come home AND plan for backup thay she may have to move to ALF.

Most regular homes are NOT designed to accommodate wheelchairs, and Hoyer lifts--and a patient in a wheelchair is a wholes different animal.

How mobile was mom before the broken leg? That would be indication of how she may rehab.

Good luck wiht this. The unknown is hard. I can handle anything if I have all the facts!

BTW, I also cannot "hop"....most older folks don't. What a funny criteria.
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Reply to Midkid58
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Choupette Sep 18, 2018
Mom was not very mobile before the break. Unsteady on her feet. Walked with a cane and sat a lot and watched tv. Her aides helped when they came kept her engaged and she did well. Before aides she zoned out. If she goes to NH full time afraid she will get lost in the shuffle and go back to zoning out. She has no private finances so If she goes to NH no aides.
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Sorry this is happening. It must be very scary for both of you. Just one thought that might help...I’d she does eventually need to use a wheelchair, that doesn’t mean she will be bedridden. Transferring from bed to wheelchair can be taught by the PTs and a full life can still be had from a wheelchair. Not that you shouldn’t try to encourage her walking, but if your house can be adapted so a wheelchair can navigate through it, it’s not the end of the world.
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Reply to rocketjcat
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I hope you get some answers and ideas. I'm afraid I don't know much about this. My LO had multiple fractures as she kept falling, but, none that required surgery. She did fracture her spine and ended up in a wheelchair. It was more due to dementia than her arthritis and spine fracture though. She did well with one person assist to and from her wheelchair and was actually more mobile in her wheelchair, than on foot, but, that was in a LTC and not a private home. They have wide halls, large doorways, handicap showers, etc. Doing that in a home is tough, I would imagine.
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Reply to Sunnygirl1
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