My Mother broke her hip 10 mos ago. She was healing well, but fell again and rebroke it 5 mos ago at the same time she had Covid. This time she was in great pain and it did not heal well at all and needs either surgery (hip replacement) or to let it go.
The surgeon says that a hip replacement could help with the pain, but there are risks at her age that she could get an infection, problems with anaesthesia.
At 97 her vitals are very good and she has a strong Will to live. But she seems to be waffling between the decision. She will answer one way and then the next minute the other. Do I step in to make this decision? (I am the MPOA.) How do I speak with her to understand what she really wants?
I am concerned to go back to square one and put her back in the pain she was experiencing before on the chance that she might be pain free - when we had such a poor healing response this last time.
Is this a fool’s errand?
I would go pain management, and I would switch doctors.
My mother is 98, her mind is good, neither she nor I would go forward with any kind of surgery at her age,
She is not in a mental state to make any sound decisions, she will not understand, I would let it rest.
All that for the chance that she MIGHT have less pain which, considering all the factors above, is a gigantic MIGHT.
I vote for pain management over surgery.
If you choose to go ahead w full hip replacement, know that mom can likely have an epidural INSTEAD of general anesthesia, which is far less dangerous in general. That's what I had with my hip replacement. I chose some Propofol to knock me out bc I didn't want to hear sawing and scary sounds. The surgery itself took 90 minutes, left me with about a 4" scar on my leg, and they had me up and walking that same day. I had little pain from the surgery, and my rehab was lots of walking, nothing else.
I needed a lot of help from my dh bc it's very hard to move around in bed after THR. It feels like the lower body weighs 300 lbs, is the best way to describe it. I needed help getting to the bathroom, where we installed a hi riser seat with handles. You cannot bend over at ALL to pick anything up or put socks on etc. I was 55 at the time of my THR so you can't compare my outcome with that of a 97 yo with dementia. I was driving and back to work in 3 weeks, no pain at all w the new hip.
I think if this were a decision I had to make for my mother who had dementia, I'd choose to up her pain meds. There is SUCH a level of confusion w dementia and inability to follow instructions that I think it would be too much of an undertaking for the woman.
No good answer here, for sure.
Best of luck with a difficult situation
I honestly do not know how to answer you. I think that I would opt for the increase in pain meds, and I might try palliative care and hospice now. It seems she cannot answer the question. You are left with your best instinct and I would say that whatever choice you make there is no good decision here, no decision without constant risk. She is 97. That says it all. It isn't a fool's errand, but it may just be a situation with NO GOOD ANSWER. My best to you, and I am sorry for this tough decision. I would consult with her regular MD about this, not just a surgeon; cutting is what he does.
So sorry. This is a tough one.
I would just keep your mother as pain free as possible and not put her through any more medical procedures. And if need be, bring hospice on board as they will do their best to keep her pain free and comfortable.
Her mobility wasn't good before her 2 falls. A hip replacement (and the PT that will then require her full participation) will NOT regain or improve her mobility.
Address the pain and keep her as comfortable as possible. If this lands her LTC, so be it. Talk to her doc about managing pain in the long-term. I'm sorry both of you are going through this. There's no "right" solution... only a least bad option.
My MIL is 96 and I would suggest to my husband NOT to do it. It's too much. I would do whatever is possible without surgery to keep her comfortable.
At this point is she able to be active at all? If so, has she had PT?
Best of luck.
When my mom was in her 90’s her doctor said, “At your age, absolutely no surgical procedures for anything.”
Best wishes to you and your mom.