My mother-in-law had been staying with us for a few weeks after a long year in and out of the hospital. She has a compression fracture in her back and had a hip replacement this year due to a hip fracture. Last night she fell on the way to the bathroom and broke her femur right above the knee (Distal Femur Fracture). They will be doing surgery to repair once she is stable, but she is currently in the ICU with a pulmonary embolism and infection of some sort.
What does recovery look like for an injury this significant? She is already weak and was barely able to get around by herself and now this.
It does sound as if she already has some health challenges. How old is she?
By any chance was she taking Fosamax?
I can only relate my experiences, if that helps. My father fractured his hip, first one, then the other the next year. I don't remember the dates now but I believe he was 94 for the first fracture, then 95 for the second. He had surgery, I found a very good rehab center, called out the troops from his church, visited him regularly (like every other day), and he healed well, eventually walking w/o assistance after each surgery.
He also stopped taking Fosamax, which he had taken before the first fall.
He was a strong person, walked until a few months before he died at 99.5. He did have co-morbidities but he wouldn't allow them to affect his outlook.
Your MIL may have a harder time if she's already weak, so you may have to give her more support. You don't mention how old she is. I would get the family together and discuss how and when you can visit so that she's not alone, doesn't get depressed, but also has ample time to rest up.
One of my cousins came to visit and brought a large, maybe 3.5' by 2.5', card holder, plus push pins. We put all his cards on the board and placed it close to his bed so he could see them regularly. Knowing that that many people were rooting for him helped him heal.
And I would begin right now looking for, interviewing and touring rehab facilities. If you need suggestions on this, just ask. Many of us have been through the rehab facility routine, sometimes many times.
Those kinds of people with strong wills fare better than those w/o that tenacity. For someone who's had some real challenges, as your MIL seems to have had, you often have to extend yourself and provide the extra support that's needed.
Another thing you can do is review the household situation and consider what might be needed for her return home, assuming she'll be coming home to stay with you after discharge from rehab.
E.g., do you have grab bars along the walls, or furniture that she can fall into if she becomes weak or loses her balance? Grab bars in the bathroom? No throw rugs? Walker or rollator? Another thing to consider is a hospital bed.
Before my father was discharged from rehab after the first fracture, the PT and OT insisted on coming to the house to do an evaluation, and made suggestions on what to move, what to get, etc. These evals can really make a difference.
Do some research on foods that aid healing as well as contribute to stronger bones; it may be too late for that, but it doesn't hurt to eat good foods anyway.
Something you can get for her to use after in facility rehab is a little hand/foot pedaled "bike", like this:
https://www.target.com/p/wakeman-fitness-folding-pedal-exerciser-with-electronic-display/-/A-52269725?ref=tgt_adv_XS000000&AFID=google_pla_df&fndsrc=tgtao&CPNG=PLA_Sports%2BShopping&adgroup=SC_Sports&LID=700000001170770pgs&network=g&device=c&location=9016939&ds_rl=1246978&ds_rl=1248099&gclid=EAIaIQobChMIwbzU8IeS7AIVEfDACh2VPgR6EAQYBCABEgIt3_D_BwE&gclsrc=aw.ds
Rehabs have larger, more stable ones, but the lightweight one can be used at home. It'll help her exercise and build strength in her arms and legs. Dad put on a favorite CD, then worked out right in his chair.
I hope your MIL is able to get past the current complications, have her surgery, and heal well once in rehab.
Good luck and best wishes to you and your family.
The latest "test" results prompted new doc to recommend that drug. I was able to get TWO previous test results from the old provider and despite it being 10+ years, my numbers either haven't changed OR became better, without taking that stuff.
Knowing about it and how it needs to be taken, it also allowed me to decline it for a cat who had ideopathic hypercalcemia (unknown cause, we tested the known ones.) I was actually able to cure him by eliminating DRY food (I offered both canned and dry to my cats. After that, I eliminated dry food for all of them, and managed to clear up some "intestinal" issues too! Given that it should be taken first thing in the morning, with a full glass of water, and you remain upright for at least 1/2 hour, how do you accomplish THAT with a cat??? Esp one who is VERY hard to handle, never got the memo on "scruffing" and would probably have scratched my face off before we were done!! (scruffing here is generally just grasping the scruff area and it sort of makes them immobile, just not him!)
NEVER will that stuff (or the other brands) cross my lips! Best you can do for osteoporosis is get walking, exercise, etc., and eat right (I added D3 daily for myself.)
PE are also life changing, she will probably have a challenge for a while, like months, with being short of breath and needing some medication to help her get through.
I hope that your experience is better than mine, but her age and that she has blood clots and infection sounds very trying to her system. May God's will be done in her life.
My husband broke his femur. Pain is around 3 months. 6 months for recovery.
However, I can only speak for my husband. With him, he was up walking the next day in the hospital. He refused any rehab and was driving within a week.
He went to physical therapy a while. Overall, he did well.
The nurses at the hospital said most patients at the hospital with a broken femur take 2 weeks before they get out of the bed.
Like I said, it just all depends on the person and different factors.
Hope all goes well for your MIL.
The problem I see is the Dementia. Being in and out of hospitals and rehabs may cause further decline. People suffering from a Dementia don't do well with change. Then throw in C19 and they are also isolated.
No one can really tell you how things will turn out. If she is weak and with the other two problems, not sure if they can operate. Anesthesia is not good for a Dementia patient either.
Assuming she recovers from the pulmonary issue, being a willing participant in the exercise regime will be very important. You may also talk to the doctor about adding a daily shot of Forteo to improve bone density. My mom had several compression fractures, kyphoplasty to stabilize a few of those in the spine, and then used Forteo for 2 yrs. She now is back in the normal range of bone density. In fact hers is better than mine now and she's 96. She has had no other compression fractures since starting the Forteo - took it from Dec 2016 to Dec 2018.
She will definitely need to go to rehab when she leaves the hospital with regular visits and observation by family to see what is really going on while she's there. It is not out of the ordinary for rehab to note she is exercising several hours a day although she is just in the PT/OT room sitting in a wheelchair. If you don't see real participation, if you can take her to your house do it and have doctor order in home therapy. Big difference in getting someone back on their feet. If finances allow, you can hire help so that you/hubby are not 100% tied to her care. Without getting her up/moving again, my opinion would be a bedridden person with those problems could not last in our world. Best wishes to all of you.
First things first, If she has sepsis and a pulmonary embolism, those diagnoses must be addressed first. Expect her to have IV's, anticoagulants for the embolism, some respiratory treatments, supplemental oxygen therapy, and lots of monitors. She will be closely monitored (1:1 care or 2 patients to 1 RN care) until her infection and embolism are not putting her life at risk. Though it sounds cruel, expect that they may have her leg in traction for the fracture and not "fix it" with surgery until her other problems resolve.
When she is more stable, as in moves from ICU to a regular hospital bed, an orthopedic surgeon can do more permanent work on the leg fracture. Depending on the injury, she may have metal on the outside of her leg with "pins" called an external fixator or a long incision with metal rod inside her leg and screws called an internal fixator. She will get pain medication and will need to stay off the leg - probably in the hospital, or more likely in a rehab facility, until the break heals. Expect her to stay in a rehab facility until she is walking well enough per physical therapy to return home. Please do not consider having her do physical therapy at home; she will get more work in a rehab facility than at home.
She is only 70, but in very poor health. Congestive heart failure, Chronic Kidney Disease, severe rhumetoid arthritis, osteoporosis, just to list a few.
I wanted to update you that there is still no improvement, she had continued to decline. Refusing to eat or drink. Her cognitive thinking has declined as well. We are thankful this hospital is allowing one visitor a day, so my husband is able to visit. Her breathing is getting worse, they have her on 35 liters per minute of oxygen and was only in 5 here at home. Her oxygen levels drop when she tried to talk. Her hemoglobin levels keep dropping, they did a blood transfusion. They have her on morphine for the pain of the femur break. She is no where near stable enough for surgery.
She has DNR and DNI on file, along with a Advanced Directive requesting no feeding tube. They do have her in IV fluids.
We are afraid she gave up once she found out the recovery time of the femur - doctor said 10-12 weeks I a rehab facility. She has never handled rehab well and doesn’t put much effort in at all.
Im not sure what is ahead of us...
Do you work fulltime? Does your H/ Be very careful what you go along with at this next juncture. If she wants to come home (obviously to your place), and your H thinks that is the best, just which person will be doing the caregiving?
Do you know what you will be getting yourself into?
All I can is to BEWARE. So many in your position will agree and come to deeply regret it.