A perplexing decision!

Mikeylikesit-6

Hello All. My first post. I need some thoughts on this. My wife has Osteoporosis, pretty bad arthritis, Sleep Apnea, and every organ she doesn't need has been removed. She also has "Moderately severe dementia and Anosognosia. Add to the list, She fell and broke her arm in two places. One down at the wrist, and the other up top just under the joint. The wrist healed well enough, but the shoulder break has been impossible to keep motionless and so it appears that the only fix is surgery. Or not. Her various dementia personalities make it impossible to keep it in her sling. She'll doze off sitting in her chair and wake up to a new world where everything is fine and she goes about activities until she, say, yanks the refrigerator open with her broken arm (even in its sling) and suddenly she is in terrible pain. A Tylenol will make it go away. When she complains about the pain, i remind her that she has been misusing her broken arm, and then I have to describe what happened. HOw she broke it, and all about it until she is aware of what is going on. Then she is SO sorry for putting me through all this and maybe she should go away, or maybe I should go away, thd then starts the yelling and crying and hugging and getting her to forget about it and enjoying our blessings, of which there are many. So anyway, when she is in pain she is all. for surgery. Like, sure, lets get it done. And the nagging fear of the statistics raises it's head and I fear who she might be when she comes out of whatever drug they put her to sleep with, when she wakes up. I am not anxious to be getting along with the next step until it happens. I can put up with her as she is for a long time knowing that soon enough some event is going to come along and force things to move along. I think she would get along with her present limited use of the arm if the risk included too big a chance for her cognition problems to get worse. As it is, when she wakes she thinks we have just come here after a. party and will be going home. She asks if we are the only ones here and did we say good by to everybody. Sometimes she makes me describe our living situation. is this OUR house? Where did her sister go? Does she have a doctors appointment today? She is pretty much totally dependent on me and has to learn it every day and objects to me appearing annoyed as I go around and put things back where they belong, and closing windows and searching for hours for things Lost. "I didn't have it!". The humor has left finding things in inexplicable places. So I'd sure appreciate some input on this. My daughter is coming tomorrow and we have to discuss what to do --soon.

Denise1847

I am so very sorry for what you and your DW are going through. If she has surgery, they will put it in a sling or something to keep the arm stabilized. Have you talked to the surgeon about her inability to comply with the restrictions? My DH has gone through 3 eye surgeries and a total knee replacement with conscious sedation and I didn't observe any long-term decrease in his cognition. All of the recoveries were difficult due to his AD.

I hope I have helped a little.

loveskitties

I would check with her doctor and see if an immobilizing sling could be used...one which essentially straps the arm to the body. This might keep her from using it at all.

SDianeL

Unless they can restrict the movement, I can't see how it would do any good to have the surgery. I cancelled my DH's colonoscopy because no way would he go through the prep. Please let us know if there is any solution. So sorry you are going through this.

Mikeylikesit-6

I did talk to her bone doctors, and they, almost as a group, just kind of shrugged and admitted that they didn't know what to tell me and they give us an appointment to come back in a month for another xray and hope it is starting to heal with the methods we are using but are not working. And another 40 dollar co-pay. The sling they gave her would work if she wouldn't so quickly forget what it is for and takes it off. I'm afraid it's getting worse. I give her tylenol and the pain goes away. So she forgets anything is wrong and manages to squirrel her sling around so it only covers her elbow, and uses her arm till it REALLY hurts! I feel so sorry for her. I can't imagine how confusing the world must seem to her. The only thing she has to hang on to is me and when she sees me getting upset at her for something she doesn't know she is doing she just cries. So I started taking anti depressants and am waiting to see some improvement in my behavior. Trouble is, when she is mad at me for being mad at her, she hangs onto that hurt for a lot longer than I do. Another problem is her sleep apnea. She couldn't deal with the machines so we used positional therapy (they call it) that was working till she broke her arm and then she couldnt sleep on that side any more, and she can't sleep on her right side because of her arthritis in her right hip and knee. So she sleeps on her back and I spend the night nudging her to keep her from holding her breath for too long. I got her one of those new pillows that cradle your head and support your neck in a position that opens the airways in your throat. Too hard. Too uncomfortable. I got one for me too and really like mine. I can sleep on my back for the first time in forever. I also tried a wedge for her to lay on with her upper body elevated. That helped her breathing a lot. BUT! Every time she would have to get up in the night, I had to get up with her to see that she got in the right position. Without me, she would just get back in bed, below the wedge, and use the wedge as a pillow with a throat closing angle on her head. So I took the wedge away and she was happier, but now she has started rolling over on her broken arm.

update: Doctors want a cat scan on her arm to see if she can benefit from an electric bone growth stimulator. Two weeks till that appointment.Then we'll see how she gets along with that. She couldn't accept the Cpap machine, or her pretty new teeth, or a hearing aid, or the new clothes I get her, so I'm not hopefull about an electric shoulder attachment. The bone is showing some small amount of healing. Our daughters visit went very well but when she left, the quiet house was nice. Wife thinks that there were lots of people here and every time she wakes she wonders where everyone is. Are we the only ones left? Whose house is this? How did we get here? And life goes on.

housefinch

Do you have a primary care doctor for your wife who you know well and trust? Maybe a frank conversation with that doctor about her overall health situation may be in order. Without your wife present at that conversation. I say this from a place of kindness, trying to decrease the number of procedures, appointments, copays, and surgeries your wife faces if she has little chance of following the instructions to help her arm heal. Maybe also you could discuss with the orthopedic doctor what your wife would have to do to have the bone stimulator be successful? Eg is she capable of following those instructions anyway?

I would not discuss any medical plans with her because she won’t remember the conversation from what you describe above. It sounds like those conversations are upsetting her, making her start to apologize, etc. If she starts having pain because she forgets her arm is broken, I would have a script: “I’m sorry you’re hurting, let’s get some medicine to help you feel better.” Then redirect her asap and get the pain medicine.

I’m really sorry you’re facing such a difficult and stressful situation. No one wants to see a beloved family member suffer, particularly when they don’t understand what is happening. It’s very hard to be faced with these decisions as a family member.

@M1 @Jo C. and @Marta have medical backgrounds — they may have advice