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How to decide if hip replacement appropriate for an elderly relative?
Old 04-06-2012, 12:42 PM   #1
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How to decide if hip replacement appropriate for an elderly relative?

I'm looking for advice on deciding on hip replacement for my 85-year-old mother.
I received an email from a sibling this morning. She lives in the same city as my mother and brother, thousands of miles from me.
My sister asked my brother and I if we should explore the possibility of my mother getting a hip replacement.
My mother is 85, physically and mentally feeble, but usually lucid.
My brother, sister, AND mother have no science education, and all medical information coming through them is invariably totally garbled. If my mother's health wasn't involved it would be humorous, some of the things they report. I know that my mother has serious physical and mental issues because I visit once a year and I'm about to visit again in a few weeks, and also I talk on the phone with her often.
We siblings been wanting my mother to move to an assisted living facility for years, mostly because of her mental confusion, and only in the past few weeks she has reportedly been more receptive to this idea, as her condition has worsened, and back and hip pain become more severe, and neighbors become more scary in her neighborhood.
There was some hope I could help her move this visit.
But now, a hip replacement? I'm just floored right now. Any suggestions on how to get started on figuring this out?
Thanks for listening, anyway.
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Old 04-06-2012, 02:01 PM   #2
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Long distance caring is very hard . Hopefully your Mom has been to an Orthopedic Physician to be evaluated for her hip problems . My Mom had both her hips done in her eighties and did fine .My Mom did not want any surgery at her age but the pain got so intense she really did not have a choice . Good Luck !
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Old 04-06-2012, 03:37 PM   #3
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Maybe some of the docs will chime in but my understanding is that when coming out of major surgery people that old with "mild cognitive disorder" often take a significant turn for the worse. I can't imagine the horror of a confused 85 YO not knowing where she is or what has happened to her and trying to deal with the rehab from a hip replacement. Also, how long does she likely have? -- are her kin long lived or is she likely to head downhill in short order anyway?
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Old 04-06-2012, 05:12 PM   #4
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Moemg - I will pass along that suggestion. I don't know who she's seen, or their qualifications. I'm not impressed with her GP, judging by things that have been missed and crises not averted, and neither is my sister, which may be why she's felt the need to bring this up.
Donheff - thanks for your input. I don't think she has typical senile dementia, but I'm no doctor and I haven't seen her for a year so who knows. Judging by her siblings she may have 5-10 years yet, maybe not, but that's so hard to predict.
I feel better just having posted this. Thanks.
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Old 04-06-2012, 05:19 PM   #5
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I recall that when my mom was in her late 80s she had a bunch of teeth removed and a bridge installed. Doesn't sound like much, but it had a big impact on her health, and it was almost a year before she was herself again.

IOW, even minor surgery can be problematic at that age.
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Old 04-06-2012, 06:04 PM   #6
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I can't address whether or not hip replacement would make sense in your Mom's case. But if you/she decides to go ahead I would urge you to find a surgeon who uses what's called the "anterior approach" as opposed to the the posterior approach used universally in the past.

My wife had both hips replaced at the same time 9 weeks ago (at age 65) with the anterior approach. Her recovery has been nothing short of miraculous. Compared to the difficult, lengthy rehab and recovery required with the posterior approach, she had no restrictions following surgery, had only three weeks of in-home physical therapy and we are now walking over a mile each day after dinner.

Given the differences in recuperation I don't know why anyone would chose to have the old surgery.
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Old 04-06-2012, 06:15 PM   #7
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BIL recently had hip replacement, but he is only 50. His doc had told him years ago to live with it and that once he couldn't stand the pain he should have it done.

I would be concerned that in your Mom's case it might do more harm than good, but if she is in severe pain she may not realistically have much of a choice.

The other thing to consider is that it is best to move into assisted living before dementia sets in - I know in my grandmother's case she waited too long and could not get in so a nursing home was the only alternative.
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Old 04-07-2012, 12:36 AM   #8
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Quote:
Originally Posted by toofrugalformycat View Post
Moemg - I will pass along that suggestion. I don't know who she's seen, or their qualifications. I'm not impressed with her GP, judging by things that have been missed and crises not averted, and neither is my sister, which may be why she's felt the need to bring this up.
Donheff - thanks for your input. I don't think she has typical senile dementia, but I'm no doctor and I haven't seen her for a year so who knows. Judging by her siblings she may have 5-10 years yet, maybe not, but that's so hard to predict.
I feel better just having posted this. Thanks.
Jane Gross' book "A Bittersweet Season" mentions a phenomenon called "emergency room psychosis". It's reported to be the disorienting/debilitating effect suffered by the elderly when they're in pain and in the hospital ER.

I have no idea whether your mother would be subject to the same from a "routine operation", but I could understand how the experience of waking up in a strange room would be very upsetting-- especially if her short-term memory is impaired.

You really need to consult with an orthopedic surgeon who specializes in geriatrics. It's also worth asking for a couple months of physical therapy to "get her ready for the surgery", in the hopes that as she strengthens her muscles then she'll stabilize the joint and be able to avoid surgery for some time.
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