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My mother (will be 85 in November) fell in the NH and broke her hip Friday morning they repaired it that evening. They did not put her to sleep but did a spinal because of her COPD, CHF etc.... She was totally crazy in the hospital but I thought once she got back to the nursing home she would be better. She is not talking hardly at all, stares into space even stares at me like she does not see me. They say it could be the meds. She is on pain meds but she does seem to be in a great deal of pain when they ask her to give them a number it is always high. I am not sure how much intervention I take. They are doing rehab on her but she is VERY weak, but she was weak before she fell. This is just difficult to watch and not know what to do. Do you ask that they back off her pain meds and let her hurt or do you just let nature take its course. She has been in the nursing home for 14 months now. Her mind was declining some before she fell but she still went and played bingo and got out some. She was still delusional but the Depakote they put her on had helped that some. She was under hospice care up until 2 days before she fell they had taken her off because she had not declined but had just stayed the same not better but the same.... I am just torn as to what to do. I am an only child so I do not have siblings to consult. Everyone I talk to that takes care of her has different advice. One says let her stay on the meds one says back off of them and see how her mental state gets. Anyone been through this and can offer advice ?

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It could be the pain meds but having just broken her hip 7 days ago I would think taking her off the pain meds would be premature at this point.

We all know what falling and breaking a hip does to an elderly person. It's a very traumatic experience. Being hospitalized messes with the mind and body as well. Being in the hospital is a 24/7 experience, too much stimulation, pain, being away from familiar surroundings and familiar routines. She may not bounce all the way back but once the pain meds are discontinued (if in fact they ever are) she may become more lucid. There's just no way to know right now. But your mom's at the very beginning of this process. She needs physical therapy and time to heal, time to rest....Give it a little more time and see if she improves.
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It is only a week since Mom fell, broke her hip, had major surgery, probably had a concussion and was relocated. She is on fairly powerful pain medication and she needs it at least for another week or two. She probably does not understand the pain scale and intensive PT is totally exhausting. is she exhibiting non verbal signs of pain? Moaning, grimacing especially when moved, fear when the nurses or PT approach? It would be expected for her not to feel like eating, her body had a huge shock plus all the medication she has recieved. The pain meds will also make her constipated. Are they taking care of that. Any upheaval such as she has been through will make the dementia worse at the very least temporarily. At her age she will take a lot longer to recover than someone younger so be patient. An 85 year old can recover from major surgery, but with CHF and COPD the odds are not in her favor.. The only advice I can really offer is to keep her pain free as far as possible. Encourage eating and especially drinking but don't obscess over it. Visit often but don't expect too much just hold her hand and sit quietly, it is too much effort to talk. Keep the TV off but if she enjoys music play something soothing and quiet. Take her a very light weight soft lap robe or shawl. Being covered with something soft and warm is very comforting. A small vase of her favorite flowers or a plant is also helpful. There is nothing else you can do. i see no need to change anything right now. it is possible you may need to reenroll her in hospice but give her a couple of weeks. My personal rule of thumb is not to do anything different as long as she is not getting worse. the major danger to her now is getting pneumonia so it is important to get her up and keep moving. Blessings
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The pain meds will make her loopy, but you wean slowly and carefully. My MIL fell and hit her head and had a good size brain bleed. She is 86. PT is hard work and she will need some pain meds to get through it and make progress. I'm 62 and it took 4 months to get through a knee replacement. Take one day at a time.
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Its possible she had a concussion. I would talk to the doctor about your concerns. That could have caused some of the change you are seeing. Do you know if after the fall she had nausea or headache. I know what you mean about quality of life... I see that in my mother in law. You are being good to your mother. Take care of yourself!
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Rehab is going to work with her 6 days a weeks a little at a time each time. I even wonder if something happened in her headthat made her fall,but they did a CT scan at the hospital cause she had a pretty large lump on the back of her head. You know the thing is I really can handle her dying I think better than this....this is just pitiful and sad. This is not any quality of life. I will go over her meds with them. I go see her everyday during the week and I do not go on weekends if i don't have to. I work full time i did stay with her at the hospital,but i had to go back to work. Last night was the first good nights sleep I have had since this happened. My mom and i have had a hard time for most of my life,but now she is just a sad sick woman and i just feel bad for her.
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Awwww sorry you are going through this. Often the elderly have osteoporosis and the hip can actually break before a fall. We prevent that by making sure our vitamin D lab levels are within range, having calcium and bone density screenings. Because of her COPD she may have been on prednisone which weakens the bones.
Your mother was not in good shape to begin with from what you say, so this will set her back. Sometimes nursing homes use hospice because insurance covers it and they can get extra care. I think it is worthwhile to try a round of rehab and see how she responds. The fall, the change in surroundings and her pain level can make her loopy. Also make sure there are no interactions with the medicine that someone missed. It is probably a combination of all that has happened and the meds. Give it some time, go with your heart. and ask questions. Go to rehab with her and see what they do for her. My friends father was placed on hospice 2 years ago! They take him off/put him back on. Hang in there!
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It seems the experience of a break and going into the hospital often worsens dementia. I did this dramatically with my grandmother and mother too. I'm sorry you are going through this it is a very hard time to face without siblings for support. One thing I noticed is that often times many new meds are added when they are in the hospital and they stay on them once out. So the first step would be for you to find out ALL the new meds that she is on - it might not be the pain med that is the problem. Then you can research each one and work with her doctors if they are willing to do trial removals of each new one if it is safe. Now it's also possible her problems are not due to new meds, but it's sure worth a try to be sure.
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