Dementia, Broken Hip, and next steps

scgrits

Hello,
First time posting. My mother is 95 and was lving independently with caregiver assistance until she broke her hip a few weeks ago. She has been through a lot since 2018 - kidney timor ablation; treatment for APL (acute promyelocytic leukemia), a small stroke, and now this. She is in rehab connected to the retirement village she lives in. Her memory issues are prominent. She is able to use the wheelchair. She is working on walking with assit. and walker but not far -yet. She has a keen sense of humor. My brother takes her to play pool even from the WC. She is a sharp shooter! She can read w/out glasses and I cannot! She has a UTI which I now suspect she had prior to the fall given the symptoms and with dementia she may not remember when she last went to the bathroom. I don't know that she will be able to walk or gain enough strength to get out of the bed on her own or do basic toileting. I think the rehab team is already thinking she needs to go to skilled nursing. This makes me so very sad and kind of angry as I don't think she will be as engaged in activities there as she might be in AL or Memory Care. I am being told to be in AL or MC she has to be able to be more mobile. We can pay for 24 hour care on top of AL/MC if need. I will keep advocating for her. We want her safe and importantly engaged. She still has much to share. I'm beginning to feel depressed and realizing I'm most likely facing a long good-bye. She has always wanted to live to be 100 but I don't want her to suffer or be miserable. Thank you!

harshedbuzz

Hi and welcome.

This is a pretty common scenario where a PWD is turfed permanently to a SNF after a broken hip. This happened to my aunt when she fell in AL. I think her disease had progressed and triggered the fall. She seemed about stage 5 at the time but the fall and surgery left her in stage 7.

One of my friend's mom fell in the early stages of dementia and was able to return to her IL cottage although it took real determination on her part to rehabilitate herself as the CCRC wanted to move her and bring in a new resident.

My other aunt moved to a CCRC that allowed wheelchairs so long as the user was relatively independent within the MC unit. She'd had TKR and had a stroke post-operatively, so the wheelchair was new to her but she did fine. They were a great facility that was very flexible with residents. Her dementia was moderate at the time of her move there, but she was pleasant and cooperative, so they often included her in the AL activities and outings as they felt it was a better fit for her. She'd sleep, get dressed and have breakfast in MC and then move to AL for crafts, lunch and dinner for a couple years before she needed to be in MC all day. Would your mom's facility agree to something like that? Or could you find a place that would accept her into their MC as a wheelchair user? Some places look for mobility rather than ambulation.

HB

scgrits

@harshedbuzz Thank you. She is able to use the wheelchair but not strong enough to get in and out of it without help so this presents an issue with AL and MC. They expect the client to be able to do more for themselves. It's all federal guiddelines! I did get to talk with someone who knows SN well and it was a little encouraging in case we need to go this route.

towhee

We had a similar situation. We moved my LO to skilled nursing after their rehab time ran out and continued PT privately and family worked with my LO also. After about 3 weeks they could have moved back to MC, but we decided to keep them in skilled nursing as the bed could go lower to the floor and assistive devices for standing were available if needed and we foresaw having to move them back to skilled care in a year or so anyway. Whether the facility involves them in activities is to some extent dependent on how much the family pushes. Hope things work out for you.

RoseGwen

Wow she sounds like a very strong lady! It's possible that if she keeps doing PT she'll at least be able to transfer to her wheelchair well enough for them to take her. But I agree with you that if you think she'll do best in memory care, keep advocating for her to get the right placement regardless. Maybe some nursing care places put emphasis on activities as well. I hope you find the right place. I love that she wants to live to 100. She appears to be determined, so she might surprise you and gain her strength back. I hope she does.