need prayers and info, please

  1. I need both prayers and info re: a broken hip that hubby's aunt got when she tried to put down the throw rug in her kitchen and got tangled up in it instead. My hubby's family is just his 3 Aunties: the oldest is 87, HOH and retarded; then comes Hazel, 85, legally blind but living independant til this fall; and then the youngest, 76, who's had a mild stroke but won't tell her sisters (and she doesn't handle stress since the stroke.
    Anyway, Hazel fell Monday about 7:30AM, and laid in the E.D. til a bed opened at 2PM. We waited at the hospital til 9PM when the doc finally told us she'd go to surgery the next day. I dropped the other 2 aunts off at their home, then rushed home and went to work that night.
    She finally had surgery at 4PM Tues., they put in a plate and 7 screws and she can weight bear for transfer only for 6-8 weeks, then start gait training. So she will need to spent a good 2-4 months in a nursing home for rehab, etc.
    The problem we are having is that she is confused and has even been quite combative off and on and I been spending most of my time at the hospital trying to help re-orient her. We thought it was the meds (she's been confused when she's had her gall bladder removed and for cataract surgery in the past); but now I'm not so sure-- she's still confused this AM in spite of not having had anything since 1 mg MSO4 at 5PM last evening. How much pain is she in? (I'm a CV-ICU nurse, I know nothing about hips and bones!) Beings she is already confused, will switching her from the hospital to a SNF make it worse? And the literature we were given about hip fractures said that the research shows a 10-27% mortality rate within 3 months post injury!!!! Is this true? Isn't that really high? It also said that half of those who fracture their hips end up using canes or walkers to get around afterwards. We had hoped that Hazel would be able to return to her own place; but after reading that, I'm really depressed and wondering if there is any chance that she will be able to do that. And did she have a stroke along the way, or is this just a reaction to everything that has happened to her?
    We are really close to these 3 Aunties and I'm afraid that if one goes, we may start to lose the other 2! I love these ladies dearly, and am very worried about Hazel. Any prayers and/or info would be greatly appreciated.

  2. 47 Comments

  3. by   RNforLongTime
    I am a cardiac nurse and I do believe that the elderly are highly susceptible to death after a broken hip. So, I'll send you some hugs and prayers and pray that everything turns out ok!
  4. by   CEN35

    you have my prayers.....hope it helps!

  5. by   aimeee
    I wouldn't fret too much about the confusion at this point. Having worked on a SNF wing I can tell you that with those elderly folks sometimes that post op confusion can linger for a good week, even when their labs look like their renal and hepatic function is just fine. Being blind makes it even more difficult for her to sort things out, I'm sure. Don't be surprised if the confusion worsens for a few days when she moves to the SNF. That is typical too. As she gets used to the new sounds, smells, voices, routines, she should improve.

    Only time will tell what function she regains in her hip. Even if she does need a cane or walker, I would not think that would rule out her going home to live. Its probably a good idea though to use this time while she is in rehab to check out alternative living arrangements. With their advanced age and disabilities there is a very real possibility that your aunties may not be able to continue much longer in their present situation. It is so much better to make plans while you have some time to really check things out thoroughly and aren't pressured for immediate decisions.

    I haven't worked with folks who are immediate post op so I don't know about the pain level at this point. By the time they go to rehab it varies a great deal from individual to individual. Some have lots, some have very little.

    T's and P's headed your way Jenny for your dear Hazel.
  6. by   live4today
    Hello Jenny P...

    I'm so sorry to learn of your husband's aunt's injuries. My heart and prayers are with her, the other two aunties, your husband and you.

    I have worked many years as a post-op surgical nurse, and ortho post op as well. It is true that many elderly patients do not live long following hip fractures, but there are also plenty who do. My grandmother lived 20 years longer than they thought she would after her hip fracture. She died at the age of 95!

    No one knows their time or circumstance of death, so leave it all in God's most capable hands, and pray your auntie up real good. If it's her time, she'll travel to a better more peaceful place leaving her pain behind. If it's not her time to travel that road towards heaven, she'll be around until it is.

    Any patient who has a bone injury is always in a great deal of pain that often pain medication does not touch, especially hip fractured patients in pain. As long as they keep her medicated, she may not always be pain-free, but she'll at least be too groggy and sleep through it all. Bless her heart! Keep us posted! (((HUGS))) and :kiss to her and you, too.

    "Earth has no sorrow that Heaven cannot heal." -- Scriptural lesson learned very young in life...
  7. by   kids
    I have also see pain cause confusion, agitation and combative behavior in some normally very sweet, cognizent elderly, rather than less MS maybe she needs more...please also remember that pain is grossly under rated/stated by the elderly and a confused person may not recognize that what they are feeling is pain and can't confirm or deny it accurately.

  8. by   NurseDennie
    I second everything that Nurse Williams said! I have had a bit of time in ortho and my grandmother had to have three hips replaced. (My grandma outlived the first hip replacement, which was at age 86 and she died at 93). Nurse Williams is right - the pain level postop is HIGH. My grandmother who was a very, very quiet woman and not at all one to demonstrate pain was unable to keep from crying out when getting OOB the first few times.

    She also was confused and it was very, very difficult for us to watch her go through the pain, when she really didn't understand the why's and wherefores.

    We'll keep her and your family in our prayers - it's so hard to have somebody in hospital!


  9. by   kaycee
    My grandmother was 83 when she had a hip replacement. She got very confused while in the hospital. She went to a nursing home for rehab and the confusion improved. She was able to go home and did well. The biggest hurtle was to get her to wear pants(which she never wore in her life) and flat shoes.(she always wore heels which is why she fell). She lived until she was 93.
    Good luck and many hugs and prayers for you and you Aunties.:kiss
  10. by   hoolahan
    See lots of hip pts do well after surgery, at home. I also agree the post-op recovery from anesthesia can really linger in the elderly. But, if it doesn't clear, definitely ask for a neuro consult before she goes to rehab.

    I agree with what aimee said entirely about going home. I think she may do fine, maybe you need to hire a live-in 24/7 caregiver. Talk with the social worker at the hospital and get the names of some [i]reputable]/i] agencies that provide this service in your area. I have plenty of folks who stay at home with these live-ins. If you are blessed to have a god one, and so far many of them have been great, it is a God-send. Most folks recover better at home, and may decline from depression in a nsg home. But she must have the reahb before it can be considered. PT can continue at home if more is needed.

    Also agree with Renee. It's in God's hands. Take comfort in the fact that she had such caring and devoted people in her life to see to her needs such as yourself. You are doing the best that you can for her, and I am sure she loves you for it. Plan what you can, and then try to take it one day at a time. We'll be here for you.
  11. by   Jenny P
    Thanks, everyone, for your thoughts, prayers, and words of encouragement. I really appreciate all of it right now. I was at the hospital again today-- her sisters were there from 11AM til 7PM; I was there from 4PM til 10:30PM. I would have stayed longer but our weather is very icky tonight and supposed to get much worse through the night, so I thought that I should get home instead of trying to stay awake while driving on ice. Besides, I was given orders to call the younger Aunt and let her know I made it home okay; and you don't mess with orders from elderly family members around here!
    We were told that Hazel will be going to the rehab center tomorrow noon (I'm assuming weather permitting). Get this: she had the foley removed and has had to be straight cathed twice so far; and has only been up in the chair once that we are aware of (although the nurse says she was up in the chair before the other 2 Aunts got there). She's had Tylenol 650 mg PO since 5 PM yesterday. She is still confused.
  12. by   aus nurse
    Jenny, these wise people have given you good advice. We have a lot of post-op hips here and many do very well. Confusion is very common in the elderly, especially with long anaesthetics. They often come good in a short period of time. And yes, pain is a big factor with hip surgery.
    Keep your chin up hun, sending my thoughts winging over the ocean.
  13. by   semstr
    Hi Jen,

    Hugs and prayers from here too.
    I am sure her mind gets clearer, when she is in surroundings she knows.

    Take care, Renee
  14. by   Jenny P
    Well, Hazel didn't go to the rehab center today. Her Hgb was 8.2 so she needed 2 units of RBC's, got the foley re-inserted since she couldn't void, and remains confused. On top of that, when my dtr. was there this evening, she got mad at my dtr. for telling her to keep her arm straight (for the antecubital IV for blood) and told her to DROP DEAD! (this from a lady who rarely says even a "Darn!") She is postive that she spent last night in a gunny sack in a van and we're telling her lies. I was there all day and gave her sisters the day off, which they really appreciated. They are getting worn out also.
    Thanks for all of your thoughts and prayers, and also thanks for the information. I do appreciate all of your kind words and encouragement.