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My mom’s fall and broken hip brought dementia on. Before the fall and several more afterwards, she was a normal mom. She mentally started declining after the falls.
My mom (91) was living alone but not cooking other than the microwave. She only used a cane if we went out to eat. I thought her forgetfulness was old age since it started as short term memory loss and then progressed to a lot of her long term memory. She had a couple of falls that ended with mostly bruises or scrapes so we knew she was having balance problems but wouldn’t use a walker. My husband or I were there for at least several hours a day working around the house and yard. The bad fall came in July of 2022 and broke her hip. She didn’t have a replacement just a rod into the ball that went into the thigh bone. She was never the same again. She had rehab where she wouldn’t participate and lots of times when I visited she didn’t recognize me even when I told her. She went to a SNF where she was finally diagnosed with dementia. She died in October 2 weeks before her 92nd birthday. Her dementia progressed rapidly after the last fall where she hallucinated people in her room. She ate very little even her favorite treats until she passed. I feel like she just gave up on life.
This can cause a rapid decline both mentally and physically. Sometimes it is just short term, but can also be long term. Especially in people who have dementia. They are at a higher risk.
Also, check the medications being given after surgery that can affect her nervous system, such as those for anxiety, seizures, muscle spasms or sleep aids. These can also have serious adverse effects on people with dementia.
My sister was constantly falling and I found out it was the drugs they were giving her for anxiety. There are better alternatives that don't cause these serious side effects. Often natural supplements are far better for things like sleep and anxiety.
If she does need more surgery for her hip, speak to the doctor about alternatives to anesthesia. When possible giving it less frequently.
Although it certainly appears that general anesthesia may cause confusion, the literature says otherwise. Delirium--which can be recovered from fairly easily, yes; but general anesthesia, no. I was concerned about confusion/dementia when I was preparing to have general anesthesia when I was 75, but 2 anesthesiologists strongly contradicted me. They did warn me about the possibility of delirium and what to do about it, and I wanted my healthcare POAs, but fortunately, it did not occur.
Growing up in the south my grandmother's list of irrational fears was falling and breaking a hip. She had a printed out list of friends that had broken a hip or bone and were gone within a year. My mother now has the same irrational fear and since she has been living at a senior apartment she has a list of friends that broke a bone and are now gone. So yes, it happens.
I have read that 50% of people who break a hip are gone within a year. It was true for my mother, who broke her hip, spent time in a rehab facility following surgery, and was gone in 8 months. She also suffered from cognitive issues after the hip incident. It's a lot of trauma for an aging body.
After my mother broke her hip in January 2020, her dementia moved from mild to moderate but hasn't declined any further. The anesthesia did a number on her and it took a few weeks to get it out of her system.
The biggest change was her inability to walk unsupported. She now uses a walker and has to be escorted as well because she's a fall risk.
She came out of the hospital using the walker and never progressed past that. In my opinion she had the ability to learn to use a cane but she refused and instead she hung on to the walker for dear life.
I'm just happy that at 96 she's at least able to walk to the kitchen and the bathroom and is not bedridden.
My 93-year-old husband (now with dementia) did not have a broken hip, but he DID have an extremely serious infection that started with his gallbladder and spread through his abdomen -- his belly was like a beach ball and he had to have a drain installed to try to drain off infection. They couldn't remove gallbladder because it swelled to 3 times its normal size and adhered to both his stomach and his colon. He was in hospital for nearly a month and had other issues too: cardiological, serious edema, etc. At 93 he probably shouldn't have survived but machines and antibiotics saved him -- which in retrospect might not have been the best thing at 93 years old. I am heartbroken at the thought of losing him but in a lot of ways I've already lost him. For me life is one long manifestation of grief now. After a week in the hospital he began serious sundowning and, once home, went inarguably into serious cognitive decline with onset of paranoia and the need for nearly constant home help (which will leave us bankrupt in about 2 years and probably fighting to go totally broke and enter the Medicaid line). So although he didn't have a broken bone, the sudden quick limitation in ability to move, sudden problem of serious constant pain, and need to take pretty strong meds -- those things, in my view, really jump-started the dementia. In 3 months his short-term memory (always good before) is nearly gone. And his anger at the sudden loss of power, having "strangers" be invited into his home (by ME, who am now the enemy) is always in the background, although at times he is his normal loving self. But less and less.
Maybe bad physical trauma in general can do this? I know someone else whose sharp-as-a-tack elderly mother went quickly into decline, acceptance and death after breaking a hip...30 years ago my husband's situation would have killed him fairly quickly (probably with palliative care), but these days we save people too long and too often with technology and force them to be "alive" in a nightmare state in which everything they value about themselves is gone. The breakdown of our bodies is the way Nature lets us DIE. Beyond a point it's crazy to force damaged people into years of nightmarish survival just because we CAN do it. If my husband could, for a week, be transported back into lucidity and have it explained that treatment would keep him alive in a state of dementia -- I KNOW he would say "No treatment, get hospice." That is certainly what I would choose for myself. The mother of my friend, on the night she broke her hip (and was learning that at her age they wouldn't replace the hip but could only put her in a sort of cast) instantly said "No treatment, palliative care only." In a year she was dead, and her children all supported her decision. PS. When I was a kid (born in 1950) it was common, when an elderly woman broke her hip to say, "Well, she'll be heading toward death." It was accepted that such an injury was one gateway to the inevitable, and no one seemed to think it was inappropriate.
You need to see an elder lawyer to have your assets split. Your husband split going to his care. Once its gone, you can try for Medicaid in home care or place him with on Medicaid. You can place him now and spend down his half and apply for Medicaid. At that point ur the Community Spouse and remain in the home, have a car and get enough or all of your monthly income (Social Security and Pension is applicable) to pay your expenses. I am giving just the basics, an elder lawyer can tell u more.
quick mental + physical decline after a broken hip? yes. this happened to my LO.
butttt, extremely luckily, after some weeks/months, the mental sharpness came back!! however, my LO is intellectually extreeeeemely active ALWAYS, and even after the fall/operation (even during the stay in hospital for the operation!!) -- my LO continued their intellectual work.
and i also continued pushing my LO. --mentally. my LO has bad hearing. in order to try to save the hearing as much as i could, i not only forced my LO to wear hearing aids (it was very hard to succeed with this mission). i also did daily hearing exercises with my LO. we would read texts together out loud, and toast with water ("cheers!"). (my LO needs to be encouraged to drink water).
during the hip hospital stay, i appeared with my computer next to my LO. i said, "don't think you can just break a hip to try to get away from your hearing exercises."
we laughed. and we did continue the hearing exercises, while my LO lay in bed about to be operated.
--physically. it was very hard after the operation. took a lot of PT to be able to walk again. but incredibly, after some weeks, my LO really, really improved. and some months later, really ok.
---------------- by the way, my LO is the happiest human being i know on this planet. just amazing. also now in older age.
Yes that was the beginning of the end for my wife. While they fixed her hip she was never the same again. Her condition continues to deteriorate. She is now bed ridden and can not walk or stand. She has progressing dementia. It was about a year after the break before she became bed ridden but once that happened it went down hill fast.
Yes, my MIL passed away about a month after hip replacement surgery. She was 94 and in terrible shape, lived in a senior facility (not a SNF or AL, just a senior citizen apt bldg w/few if any help other than private paid helpers). She was having trouble getting up out of her recliner type chair. It was some type of slippery fake leather (bad option). So she put pillows on the seat to raise up the seat level to make it easier for her to get up. But those pillows on the slippery surface was the root cause of her "fall" and hip break, she just slid off the recliner onto the floor that was enough to break her hip. Now we know, but it would have been good if there was a "safety review" of her studio apt and a different/safer chair for her. These simple things (who knew) -- slippery furniture/chairs, terrible slippers they might wear, small throw rugs on the floor, on and on -- are highly dangerous for frail older folks. My mom, insisted on wearing flip flops due to bunions and would fall over and over and over, terrible footwear.
But the trauma of the surgery for my MIL was too much for her; too much for her heart. Not blaming the doctors, not sure what would or could have been done with a fractured hip at her age and if no surgery at her advanced age would have been best?
Definitely with my husband. I really thought we were going down a road to the end when he broke his hip. However, with my close scrutiny I was able to identify medicine changes that were not necessary. I then had to be very pushy to get his rehab doctor to listen.... even having a geriatric pharmacy consultant intervene when I wasn't taken serious. I had to get his psychiatrist and neurologist involved to be sure their prescriptions were being followed. The rehab doctor even told me that he had found that Parkinson's patients were obsessed with their medicines and they did not need to be! Rehab doctor's expertise do not always include pharmacy or geriatric issues which require even more attention to their medication doses. Without proper medication management, rehab is hampered. My husband was not able to participate in their rehab to the level necessary because he was over medicated. Without my close attention to details in his care he would not have improved as he did. I feel so many times, older people are written off when they arrive to an ER or Rehab because the providers do not even try to understand who they were before the crisis and all they see is a patient on a stretcher with little hope for improvement. Older folks can take longer to recover from anesthesia and providers often do not take that in consideration. I know that there will be a time in the future that no amount of advocacy on my part will change the outcome, and I pray I will recognize it when it comes. Until then I will continue to speak up because we have been through so many issues when, because I knew him best, I knew his prior abilities and could see more potential.
I have seen so much of what you are saying first hand. My MIL broke her hip at 96 and rehab wanted to send her home after only working on standing and sitting. It took a few days to get speech back after the anesthesia. It wasn’t until her room mate said she was walking to the bathroom at night on her own that they started working on walking. To me they had wrote her off.
Back in late 2013, my father, the 91, suffered a fractured hip from a fall at his home and never recovered. He was put on Morphine for severe pain and passed away 5 months later. Before this unfortunate happened, Dad used his cane to get around with his wife, my stepmother although he did not go out anymore.
Yes and not just elderly. My husband with Parkinson’s fractured his hip over 2 years ago and since then had two additional surgeries and never walks without walker again, despite 2 years of physio. This man who was the most active even after PD diagnosis in 2015, did not see many changes, exercised 2 hours a day. Now, simple walk with walker 10 minutes leaves him breathless and sweating profusely. And tired and almost unable to move with pain in back, neck. And about 40 other symptoms, countless drs, specialists with no real solution.
Yes. My dad died 10 months after surgery to repair a broken hip and he never walked again afterwards. Hip issues often signal the beginning of the end for elders, unfortunately. His mind was in some delirium in the hospital and during rehab, which pain meds exacerbated greatly. Although he did not suffer from dementia as your mom is.
Dementia itself is progressive and every illness or health issue seems to set them back until it reaches the point where they can no longer bounce back. That was the case w my mother who did have dementia and never was able to get ahead of her health problems after she turned 92. She lived until she 95 and CHF wound up taking her life.
Its tough to watch all this, I know. May God grant you both some relief from all the suffering involved.
Yes. My grandfather died 6 months after breaking his hip. He was 93. Until he broke the hip, he was living alone, dressing himself, preparing little meals, walking down to the coffee shop to meet his friends, stopped by the newsstand to buy the paper and his pack of cigarettes (yup - he smoked a pack a day), and walked with a cane. Looking back, it was a blessing that his end came quickly after living such a long life on his own terms.
As a nurse I have seen it happen VERY often. The truth is that the downfall can come quickly on the heels of ANY what we call "insult" that is big enough and bad enough to tax the body of an elder more than its aging systems can adjust to.
In fact I am 80, and still walk, garden, and am generally quite active. The one thing that I notice a whole lot is the lack of balance I was used to. I always tease that I WILL go down, and when I DO go down, something will break--likely the hip. And then I top it with "beginning of the end". It seems that from there you go to confusion, UTIs, pneumonia and etc so easily.
You are definitely not alone and your observations are correct.
This rang a bell with my own intentions. I began having hip pain in my 60s (skiing, and I also now need a knee replacement) and when my PcP saw the X-Rays he said "Get it done NOW." This was because (he explained) that kind of operation gets harder and harder to recover from as we age. I had an anterior hip replacement at age 63 and it was wonderful -- I was walking half a mile in a week. BUT -- I'm not so sure it would be that easy now. I was about to get the knee replacement (I'm now 73) when my husband (age 93) got terribly sick and, although he recovered physically, he's now heading into full dementia. So the knee replacement has been put off indefinitely. One thing (among the thousands) that I worry about is that by the time he's gone I either won't be able to afford the knee replacement or it will have the "old age effect" people are describing in this thread.
So I echo your prognostications for yourself. These large events -- skeletal, etc. -- are VERY hard on people over a certain age. I've seen a number of cases in which they have kicked off dementia or just opened the door for the collection of things that will kill you. It has been the case for my husband and I believe it will be so for me. So -- if you are not really elderly and some joint isn't working that well -- get it replaced NOW. If you ARE really elderly and you fall and break something...wheel your chair over by mine and we'll wait for death together, between our morphine doses. Maybe we can talk about how our gardens used to be, if we can remember what "gardens" are. At some late point the correct answer to "when shall we schedule your hip replacement" may be "Never."
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
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You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
This can cause a rapid decline both mentally and physically. Sometimes it is just short term, but can also be long term. Especially in people who have dementia. They are at a higher risk.
Also, check the medications being given after surgery that can affect her nervous system, such as those for anxiety, seizures, muscle spasms or sleep aids. These can also have serious adverse effects on people with dementia.
My sister was constantly falling and I found out it was the drugs they were giving her for anxiety. There are better alternatives that don't cause these serious side effects. Often natural supplements are far better for things like sleep and anxiety.
If she does need more surgery for her hip, speak to the doctor about alternatives to anesthesia. When possible giving it less frequently.
The biggest change was her inability to walk unsupported. She now uses a walker and has to be escorted as well because she's a fall risk.
She came out of the hospital using the walker and never progressed past that. In my opinion she had the ability to learn to use a cane but she refused and instead she hung on to the walker for dear life.
I'm just happy that at 96 she's at least able to walk to the kitchen and the bathroom and is not bedridden.
Maybe bad physical trauma in general can do this? I know someone else whose sharp-as-a-tack elderly mother went quickly into decline, acceptance and death after breaking a hip...30 years ago my husband's situation would have killed him fairly quickly (probably with palliative care), but these days we save people too long and too often with technology and force them to be "alive" in a nightmare state in which everything they value about themselves is gone. The breakdown of our bodies is the way Nature lets us DIE. Beyond a point it's crazy to force damaged people into years of nightmarish survival just because we CAN do it. If my husband could, for a week, be transported back into lucidity and have it explained that treatment would keep him alive in a state of dementia -- I KNOW he would say "No treatment, get hospice." That is certainly what I would choose for myself. The mother of my friend, on the night she broke her hip (and was learning that at her age they wouldn't replace the hip but could only put her in a sort of cast) instantly said "No treatment, palliative care only." In a year she was dead, and her children all supported her decision.
PS. When I was a kid (born in 1950) it was common, when an elderly woman broke her hip to say, "Well, she'll be heading toward death." It was accepted that such an injury was one gateway to the inevitable, and no one seemed to think it was inappropriate.
oh boy, i see almost all of us are saying "yes".
i'll try to answer, too:
quick mental + physical decline after a broken hip?
yes. this happened to my LO.
butttt, extremely luckily, after some weeks/months, the mental sharpness came back!! however, my LO is intellectually extreeeeemely active ALWAYS, and even after the fall/operation (even during the stay in hospital for the operation!!) -- my LO continued their intellectual work.
and i also continued pushing my LO.
--mentally. my LO has bad hearing. in order to try to save the hearing as much as i could, i not only forced my LO to wear hearing aids (it was very hard to succeed with this mission). i also did daily hearing exercises with my LO. we would read texts together out loud, and toast with water ("cheers!"). (my LO needs to be encouraged to drink water).
during the hip hospital stay, i appeared with my computer next to my LO. i said, "don't think you can just break a hip to try to get away from your hearing exercises."
we laughed. and we did continue the hearing exercises, while my LO lay in bed about to be operated.
--physically. it was very hard after the operation. took a lot of PT to be able to walk again. but incredibly, after some weeks, my LO really, really improved. and some months later, really ok.
----------------
by the way, my LO is the happiest human being i know on this planet. just amazing. also now in older age.
❤️🙂
But the trauma of the surgery for my MIL was too much for her; too much for her heart. Not blaming the doctors, not sure what would or could have been done with a fractured hip at her age and if no surgery at her advanced age would have been best?
So sorry you are dealing with this.
My husband with Parkinson’s fractured his hip over 2 years ago and since then had two additional surgeries and never walks without walker again, despite 2 years of physio.
This man who was the most active even after PD diagnosis in 2015, did not see many changes, exercised 2 hours a day.
Now, simple walk with walker 10 minutes leaves him breathless and sweating profusely.
And tired and almost unable to move with pain in back, neck.
And about 40 other symptoms, countless drs, specialists with no real solution.
Dementia itself is progressive and every illness or health issue seems to set them back until it reaches the point where they can no longer bounce back. That was the case w my mother who did have dementia and never was able to get ahead of her health problems after she turned 92. She lived until she 95 and CHF wound up taking her life.
Its tough to watch all this, I know. May God grant you both some relief from all the suffering involved.
In fact I am 80, and still walk, garden, and am generally quite active. The one thing that I notice a whole lot is the lack of balance I was used to. I always tease that I WILL go down, and when I DO go down, something will break--likely the hip. And then I top it with "beginning of the end". It seems that from there you go to confusion, UTIs, pneumonia and etc so easily.
You are definitely not alone and your observations are correct.
So I echo your prognostications for yourself. These large events -- skeletal, etc. -- are VERY hard on people over a certain age. I've seen a number of cases in which they have kicked off dementia or just opened the door for the collection of things that will kill you. It has been the case for my husband and I believe it will be so for me. So -- if you are not really elderly and some joint isn't working that well -- get it replaced NOW. If you ARE really elderly and you fall and break something...wheel your chair over by mine and we'll wait for death together, between our morphine doses. Maybe we can talk about how our gardens used to be, if we can remember what "gardens" are. At some late point the correct answer to "when shall we schedule your hip replacement" may be "Never."