Experience with broken pelvis?

[Anonymous]

My 85 yo mom, stage 6 dementia but otherwise pretty healthy, fell in her memory care(left her walker in another room). In tons of pain, currently at the ER, just found out she has fractured her pelvis. What does recovery look like? Is this like the broken hip that leads to the slow decline? Is it with calling for hospice evaluation? She has an advanced directive calling for comfort care only at this point and she is so uncomfortable right now, breaks my heart.

[Anonymous]

It's hard because not much can be done beyond pain management and PT. And PT with someone with stage 6 dementia can be difficult. This will likely lead her to become less mobile which is often where the decline comes from because it can lead to things like pneumonia. Can you see if you can meet with a palliative doctor at the hospital? They were a great resource for us when discussing the next steps for my dad and what the options looked like.

[Anonymous]

I am so sorry this happened to her.

[Anonymous]

This is the beginning of the end, sorry. 85 is a good long life. Make her as comfortable as possible.

[Anonymous]

This happened to my MIL, very similar story, she had dementia, was in memory care, and forgot she needed her walker. It was really rough and I'm so sorry you are going through this. She declined very quickly from the pain and lack of mobility and lost a lot of weight. The director of nursing told dh not long after it happened that she would die within a few weeks and he was so sad and shocked to hear that, because she had seemed fairly healthy before, but that was roughly what happened. I'm so sorry

[Anonymous]

Sorry op but she’s 85 with stage 6 dementia. Let her go.

[Anonymous]

Having had a fractured pelvis, I'm wondering how her pain can be handled.

[Anonymous]

It depends on the fracture and prognosis, it doesn’t mean the beginning of the end. If she is strong and can handle rehab, she can get better.She will need more caregivers while she heals

[Anonymous]

My grandmother broke her pelvis in 2020 when recovering from covid. She was probably more like Step 5 of dementia at the time. Droperidol was very helpful for sedation when she got agitated in the hospital; it's only available inpatient but it calmed her better than anything else. When she was discharged, she was on a lot of pain meds--at first opioids (be very careful about constipation) and NSAIDs and medical marijuana later on. Everything has side effects but we prioritized pain control over potential risks. The recovery was hard; my aunt arranged for an amazing in-home PT and she was eventually able to walk again and get to the toilet, albeit with a walker and a special toilet seat. She was never again able to get up from a chair or toilet without help. In some ways that made it easier to cope with her dementia because we didn't have to worry about her wandering and her agressive moments were easier to move away from. She lived about 3.5 years after the injury and a lot of it was pretty miserable. I'm very sorry, OP.

[Anonymous]

Op here. Thanks for the input and sharing your experiences.

I just have a sinking feeling this is the start of the end ….but we will see. I have a couple calls out to hospice providers and hope to square that away soon. I worry about the lack of movement and muscle wasting. She’s already fairly small/frail, having lost 15
Lbs in the last couple months from 130 115.

She will not be capable of doing rehab aside from walking.

At the same time… she never ever wanted to live the way she has been, with dementia, and left clear directives to prioritize comfort over anything else so I just hope whatever comes is not too painful.

Her aides are, for the most part, really sweet and they are doing a good job with her. As soon as she got back “home” from the hospital she relaxed so I think we will try to ya doe everything from there from now on. No more hospitals…

[Anonymous]

Anonymous wrote:It depends on the fracture and prognosis, it doesn’t mean the beginning of the end. If she is strong and can handle rehab, she can get better.She will need more caregivers while she heals

You’re right. This is the beginning of a wonderful future, with many enriching years to come.

[Anonymous]

Sorry op but she’s 85 with stage 6 dementia. Let her go.

Op here. Not planning on trying to do much to “rehab” but asking more about what to expect, might be she hospice eligible. should I hire 1:1 aide, should I cancel trips…the ER doc didn’t seem to think she was hospice eligible based on the broken pelvis and seemed to think she could heal but he’s also not aware of how compromised her cognitive function is.

[Anonymous]

Look into palliative care. See what options there are for helping her receive care- do think she will need around the clock measures. Her dementia is likely to complicate things significantly. ER doctors are not always trained about moving to this approach unfortunately.

[Anonymous]

Anonymous wrote:This is the beginning of the end, sorry. 85 is a good long life. Make her as comfortable as possible.

This was our experience. Never walked again and the dementia worsened. It was a rough 6 months to the end. So sorry.

[Anonymous]

Op here quick update, hospice evaluation happening tomorrow. Based on the way the leadership at her memory care reacted, I’m sure she will qualify. It will be good to have someone who can guide us realistically and prioritize her comfort and peace. I’m sure my mom knows that something has changed; she was crying this morning and I haven’t seen her cry in a while.