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SandwichAEM Asked April 19, 2024

Is there a pain injection available for a 95-year-old with a broken hip when surgery is not an option? Will she ever heal?

My mom has a long list of health conditions why doc said she was not a candidate for hip replacement surgery (alzheimer's, COPD, AFIB, Osteoporosis, Chronic Kidney Disease and Chronic Anemia and Diverticulitis) this last one put her in the hospital last year and from being so long in a hospital bed, despite PT she can't walk since July 2023. She is also incontinent and always forgets she has a diaper, 3 weeks ago, she woke up one morning and tried to get up and fell of the bed, broke her hip. She is at home with me through "Home Health" so I have a nurse come weekly, a PT to exercise her other leg and arms, but she's and in a lot of pain despite oral meds and I would like to know if there's a pain injection/numbing injection that she could get, while she recovers, I also wonder will she recover?

MidwestOT Apr 19, 2024
I also think she would qualify for hospice but if not, request palliative care and they will manage her pain. You don’t need a doctor’s order to request a hospice evaluation at which time you will find out if she qualifies or not. Such a terrible situation and I hope your mom gets relief soon. I’m a little surprised that one of the home health practitioners hasn’t discussed these options with you.

sp196902 Apr 19, 2024
That PT sounds more like torture. Even though they are working the opposite leg it seems that would still cause some movement in the broken hip. If she can't get the hip repaired maybe it's time to stop the PT. Personally i would risk the hip repair rather than be in pain for God knows how long.

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Grandma1954 Apr 19, 2024
Hospice.
She will not walk
Any PT will be painful
Almost any movement will be painful
Even if the fracture heals somewhat there will be chronic pain.
I think I have read statistics that a hip fracture that is NOT repaired the life expectance is about 6 months or so.
Given that and the other health problems she would no doubt be Hospice eligible.
You will get all the equipment that you need and supplies you need. As well as a Nurse weekly, more often if needed. A CNA 2 to 3 times a week and if you want a Volunteer that can come and visit with mom.
The goal of Hospice would be to manage her pain and keep her as comfortable as possible.

funkygrandma59 Apr 19, 2024
Perhaps it's time to bring hospice on board, as they will have access to much stronger medications to hopefully keep your mom out of pain.
I don't believe there are any easy answers here, but keeping your mom as pain free as possible should be top priority.
Please call hospice.

Geaton777 Apr 19, 2024
Does her healthcare network have a Pain Clinic, like through the ortho department? That's how it is where I live. They can make non-surgical suggestions but IDK what it would be in your Mom's case...maybe an epidural steroid injection? Those aren't fun to get but ask her orthopedist about it. Your poor Mom... and poor you...

AlvaDeer Apr 19, 2024
I don't see how surgery is not the ONLY option, Sandwich, and that even if it kills her or makes the dementia worse.
I don't see her long surviving the extreme pain of a broken hip. And it would mean heavy medication or constant agony. A torture, really.

We recently had someone mid 90s and someone I think 100 do fine with broken hip surgery. Not replacement, you understand, but repair. I understand this would be VERY risky with the COPD to say nothing of the perfect storm of other conditions, but I think you are now at the place where the only issue is PAIN.

I myself would discuss with a surgeon. Either you are looking at surgery KNOWING the risks or you are looking at hospice and very heavy medications which are in themselves a risk.

This falls under not everything can be fixed and I over and over again say here that a fall often spells the beginning of the end.

I am so very sorry. I hope you will update us on the decision. This has to be a dreadful choice.

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