What happens next after a fall resulting in a broken femur?

My 94 yr. old mom threw herself backwards saying, 'I'm dying". (Mom is very dramatic). I had witnessed her doing that when I was visiting also. But, this time, there was no bed, sofa or chair behind her to break her fall. She fell on the floor and broke her wrist. After a 2 day ordeal, seeing orthopedic docs, she finally got her green cast. I spoke to her about it (she's got stage 5-6 Alzheimer's) and told her that if she did that again, she wouldn't have any usable arm. I told her, "No more theatrics." She smiled a guilty smile and agreed. (I am not blaming the staff. Things like this can happen in the blink of an eye while the caregiver is only feet away.) Two weeks from now I will take her back to get the cast off. She was using a cane at the time (which had nothing to do with the fall) but, I had to take the cane away and replaced it with the walker. She was mad but I wasn't giving in.
We have to do the RIGHT thing for them instead of letting them have their way when you know it's detrimental for them. They did that for us when we were kids and, unfortunately, seniors often don't make the best decisions, so they need guidance from us.
I know we aren't used to telling our parents what to do but, if it will avoid a debilitating fall, then I think it's worth a couple days of griping. Throw in a story of an elderly friend that fell with a long, painful recuperation and they might start seeing it your way. Get a Physical Therapy evaluation of the patient and home (can be ordered by their doctor). They will give recommendations and most probably the suggestion of a walker. Physically remove the cane and replace it with the walker. Then shut off your hearing aid! ;)

Sine I'm the one who started this post. I thought I should give you a progress report for my mom so far: emergency room, then 3 days in the hospital, now 8 days in rehab. They are givng her physical therapy, but she needs a lot of pain meds which makes her a zombie. I went to see her yesterday and she could barely talk to me. She's in constant pain, also having trouble with her bowels from lack of movement, doesn't have much of an appetite, and she's depressed saying this is the end. A week and a half ago she was going out to restaurants with me, living in her own apt., and a happy woman. I warned her many times that this could happen if she didn't start using a walker. So if you are reading this and either you or someone you know is refusing to use a walker or other assisted device, then heed my warning. Your whole life will change in an instant. I don't know at this point if she will ever go back to her apt. or walk.

SueC1957: I don't get it either! They would rather suffer pain of a broken bone instead of saying "You know what; I need help."

My 96 year old father broke his ankle 2+ weeks ago, had surgery (plate with 8 pins) and is now in rehab. He's complaining like crazy that he wants to come back home with me. He got a walking boot last Friday and is starting to walk again. It's totally possible to have a good recovery.

I guess I just don't "get it", how older folks WON'T comply with the precautions to prevent falling and thereby invite a fracture. Then they're surprised WHEN they fall and, of course, don't like the pain/immobility.
Maybe because I'm a nurse and I've cautioned many patients on "fall precautions", I tend to comply with them myself. I hang onto the shower frame when I step over the tub, gripping bath mats, non-skid rugs, holding hand rails, etc. You are just inviting an accident when you go against the PT recommendations.
Also, many older folks suffer from osteoporosis. Many people think they fell and broke their bone. Actually, with the thinning bones, their (porous) bone broke (gave way) and then they fell.
Some weight bearing exercises (to strengthen the bones) coupled with moderate calcium intake and observing fall precautions can prevent future fractures.

Watch out for elders NOT telling you that they've fallen. My own late mother, insisting on living alone in her own home 400 miles away from me, fell twice! I find out "on the sly" 10 months later! Her child-like response="I don't have to tell you everything." I said "no, mother, I don't need to know when you have a hangnail, but I DEFINITELY NEED TO KNOW WHEN YOU'VE FALLEN!"

#1 Hospital stay
#2 With morphine
#3 Then rehab unit of SNH

MidKid58, you've just described my 97 yr old mother. On a daily basis, several times a day, I tell mom to get close to her walker. She takes a few steps, then back to "Chasing it" as you put it. That's funny. Mom does what she wants to do.

Absolutely find the proper way to help Mom walk with the walker!! My mother went from using a cane to needing a walker 24/7 after hip replacement. She healed well enough, but her "balance" never came back as she simply refused to do the PT exercises--so the walker is now the way she goes. Or her wheelchair if she wants the attention. She walks completely curved over into a C-shape and I know it's very painful, but after her PT at home was over, I asked the PT if she could stand up straight and he said "She absolutely can. But she won't. I've dealt with your mom. She won't comply, don't expect her to." Well, he was right and nothing anyone could say to get her to walk with the walker so she wasn't "chasing it" instead of using it for balance. She does try to impress us by trying to walk w/o it, but it's a sad sight. She's now a towering 4'7" tall--from the "highest point" lost 5" just due to neglecting to do a few exercises a day.
Oh--and we WERE educated. Mother does what she wants. Period.

My 94 yr old mother has finished recuperation and rehab from a fractured pelvis that happened in early March. It was very painful for her and it was a little hard to keep her spirits up at first since she assumed she would never be able to regain her former capabilities. She is now fully functional and we feel like she is better prepared for maintaining her independence that before. For us the key was having her primary care doctor prescribe home health care and therapy. Just having the nurses and therapist visit her in her home and tell her that there is no reason why she couldn't return to normal gave her the motivation to do what she needed to do. There were definitely some silver linings from the event. We have become experts in setting her home up to help prevent future falls - in particular, in the bathroom. With guidance from the OT we have made sure that kitchen items are placed better for her access. The PT has resulted in more upper body strength that she had previously - this will help her for the rest of her life. They taught her how to get up from chairs safely and a hundred other practical tips.

RayLinStevens - I laughed when I read your note about the height of the walker. After my mother fell we pulled my fathers old walker out of the closet and put a tray on it so that she could carry items with her when she used it. The first thing the PT did was to lower the walker as much as possible and to take the tray off so that her arms weren't hunched up right below her shoulder while she was walking behind the tray! My DH and I just looked at each other and exchanged a look that said "How could we have been so stupid not to have seen that???". That was our wakeup call that we couldn't rely on our intuition and knowledge - we needed to educate ourselves on the whole subject.

Thank You 97yroldmom - I need to get the in-house PT for my DH again. Balance - what a lovely word. We also need help getting up from the sofa and backing up.

RE: the original question: Here in Mississippi, we have sort of "half-way" houses for the elderly to recuperate. I can't think what they're called, but it's sort of a short-term nursing home.

I have been blessed that both my Dad and now my DH have not fought the idea of a walker. I remember having to tell my Dad that his independence depended on him being mobile - not falling - this meant graduating to a walker.

For my DH, I also increased the height of the walker as he is not "stooped" and I wanted to keep it that way. Too many walkers are kept too low and the person using them winds up in a bent-over position all the time. I had the blessings of the Physical Therapist and he admitted that too often they are kept 'shorter' than necessary.

These are very encouraging posts! First, she'll get that sense of practice and accomplishment, and better methods to use. Second, she'll get really focused attention from several people and that may be really good for her spirits. My mom lights up when certain people fuss over her at dr's offices and I'm reminded that she lives these days with so much less human interaction. Stay bright, brdlvr, this may work out nicely for her and you. And I'm sorry she had to go through that.

Jeanne reminded me of my own aunt who broke her leg in her 80s. I remember going to the rehab to visit her. Her leg was up in traction. She was there all alone. No children to help her.
She had colon cancer at the time which she eventually died from but she made a full recovery with the leg. I can't remember which bone. She was amazing with a great attitude.
After your mom is all better and back at home try to get her to keep up her exercises and at least once a year ask her dr to order her home pt to keep her strong. Usually you just have to say she needs a little help with her balance which is always true. My aunt gets it once a quarter and I know it helps her.

Two of my aunts broke a bone in their late 80s. They went through some therapy and got on with their lives. These breaks were both in the arms and I imagine the leg bones would require a lot more PT. But it seems it is possible for old bones to heal. As 97 says, if she is conscientious with the PT she could wind up stronger!

Getting into or out of a chair (or toilet or bed) seems to be a risk action, whether with cane, walker, or no device. I hope the PT will teach good techniques with whatever device mother will use.

Pretty much what you said happens. She will need therapy and it will include a walker. Not to say she won't go back to the cane. If she works hard she might actually be stronger than she was before. I hope she doesn't have osteoporosis.
Now she will be focused on regaining her strength. Hopefully her attitude will pick up when she sees that she can and will make progress if she stays focused on her goals.
Encourage her to take full advantage of rehab.
I hope she feels better soon.