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My mother has hip dislocation that cannot be repaired in surgery - they don't know if she would survive it. Before this she was walking with a walker, and we are getting conflicting info from health care people about whether to get her a lift and get her into a chair or not. Anyone else with this situation? I don't want to make the situation worse, but she has been in bed for over a month and is too weak to sit up by herself, but hates having to lie there all day. Hospitalist told us that she has conditions that she doesn't even have (according to Hospice) - so we are getting a bit distrustful with medical establishment. She doesn't seem to be in much pain - just don't want to make it worse. Thanks

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I have had this myself. After 8 months in bed and major depression Inwent to an OSTEOPATHIC MANIPULATION doctor. She manually corrected my hip. In just a few minutes I could walk again! After so much time had passed my hip kept going out so I returned once a week, then twice a month and eventually from once a month to being 80%repaired.
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😠 Hospice is supposed to be about improving quality of life, I think they need a stern reminder of that! If they won't even attempt to do anything to get her up then you may have to think hard about dismissing them temporarily.
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I'm sure she feels she is just lying in bed waiting to die, and that's no way to be. I think I would ask whether she needs a x-ray to see how well the fracture has mended and armed with that information ask for an OT and PT evaluation to see how they recommend getting her out of that bed and into a wheelchair.
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Did the doctors physically manipulate the joint back into place or is it still dislocated? I understand not being a candidate for surgery because of not surviving anesthesia, same issue here with MIL. They could give her a mild sedative and anesthetic in the area to be manipulated avoiding anesthesia due to heart and get hip back into place. Problem is that after a month damage may have been done to her actual joint, eg deterioration, nerve damage, she may need to wear a hip brace for support afterwards. Going thru broken upper arm with MIL where arm meets ball of shoulder joint. She fell in store when with older SIL, normally this would involve surgery to correct it. Have to let it heal as is, immobilize arm, finally seeing some healing. Hospice sent PT to my home for balance/ walking with cane issues and now receiving OT for passive therapy for her arm to get arm muscles in shape for when she will be able to do more intensive weight bearing exercises. I have never been turned down by them when seeking therapy but then again she has an awesome nurse who advocates for her and when I asked for help it was explained eg, fall risk, shuffling instead of picking feet up, range of motion, quality of life type of arguments. They also know that I have busted my rear to get MIL to the point she is now, no more fluid in lungs or extremities, healthy meals with cheat days (gotta have pizza), medication management, physician visits (give them a copy of all blood work results for their files too), and walks to keep her moving. Your situation is much worse due to hip injury. Is there a teaching hospital nearby that their head of ortho may have a suggestion for this situation? They are usually the first ones to know of new procedures and techniques that is not available or common knowledge to the rest of the medical community. Just an idea.
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cwillie Oct 2019
Good points about the possibility of repair without general anesthesia, I knew a man who had his artificial hip repaired using nothing more than an epidural.
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I had a similar issue re my father. Even got the hospital consultant to say it was better for him to be sat in a chair, psychologically as well as physically. The nurses in the home lied - got him to take medication then wouldn’t follow through with moving him. I could write a book on the terrible issues in just that one day - Christmas Day 2017.
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Takincare Oct 2019
Too much like work don't you know
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What happened to her is that she apparently slipped in her bedroom the first time and I took her to the ER and they were able to get it back in. Told her that she had just dodged a bullet that time. Well about 14 days later, she slid off her low bed and in the process of trying to wiggle around and pull herself up, she dislocated the same hip. The leg is shorter and they said the hip replacement done years ago has failed, due to bone loss I guess. This time they took her back to the operating room and put her under - got it back in, but the hospice nurse said, when she was admitted to their facility ( for respite) that she thought it was back out. It has been a mess - the hospitalist said that she had double pneumonia ( hospice says lungs clear) and he also told us that she had a bowel blockage ( she messed her diaper very next day, so nurse said ' obviously not!')
Her physical therapist that she liked said - 'well with hospice, they will kick me out.' They do not have physical therapists working with them, but if Medicare will pay, why not call someone in? My mother did try to do all the exercises they told her before the last hospital visit.
We're just confused about everything. Guessing one reason for hospice is to get help with bathing, nurse care etc. The doctors knew I was trying to do everything by myself. She is now so weak that she cannot sit up in bed, so we were told that a lift could be brought in so she could at least sit up. Can't they bring x ray machines to your home that are portable? Thought I saw an ad on internet about it.
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People on hospice care do use lifts (I think that hospice provides them), perhaps the only way to determine whether she could tolerate it would be to try... the problem there may be that you don't have anything appropriate to transfer her in to, if she can't even sit up in bed she needs a specialized chair that would hold her upright as well as not put pressure on that hip. Perhaps a better solution is to work with what you have, can you at least crank the bed into a sitting position? Can you move the bed into a different room so she doesn't feel shut away? Her weakness is a real barrier, if you feel she could recover some strength with exercise and she would be willing to put in the effort you don't need a physical therapist, all the information you need is on the web at your fingertips.
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cetude Oct 2019
Hoyer lifts would be very painful for a person with a dislocated hip--unless she tolerates being turned.
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If you look up Medicare guidelines for hospice and dementia, it doesn’t sound like she qualifies. They are quite strict and one of them being the loss of communication. From what you’ve written, I suspect this hospice may not be on the up and up. They have to justify to Medicare reason for admitting and keeping her in hospice. If it were me, I’d discharge hospice you're using. Get her to an orthopedist and get a second opinion. Her primary doctor can order a mobile hip X-ray. This is done all the time in nursing homes. I used to be an X-ray tech and taking portable films is not difficult. It’s done all the time in the hospital and surgical setting. And yes, they can do an epidural with sedation for hip surgery, even for a hip replacement. So a general anesthetic is not necessary.
Your mom has been in bed so long she is deconditioned and I’m surprised she doesn’t have pneumonia. Which you say she does by the doctor but not by hospice. So did she have a chest X-ray to confirm it? Was it treated? Missing information on this.
she needs a medical evaluation!
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Ask for an orthopedic referral. She shouldn't have to suffer even with hospice or dementia.
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Sounds like torture. But there are many people in wheelchairs who lead productive, interesting lives. Are there any videos you can play for her of such people? Look on YouTube. Try to get her to do upper-body exercises. Post photos of people in wheelchairs who are smiling and active. Ask her what advice she would give to paraplegics and children who have had amputations. She can still have a life, even if it is not the one she would have chosen.
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ShenaD Oct 2019
I know when my hip was dislocated I couldn't sit. I could crawl while dragging legs behind me or lay in bed. That was it
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