What will happen to an elderly person like this?

[countrygirl2]

We have a neighbor by MIL's old house. She is 93, very alert, no memory

problems, but she was doing something with a curtain and fell. 

Just a bit of history,  has a wonderful son that lives with her. He has a

very good job, not quite ready to retire, but works now part time from

home so he can be there with her. Neighbors help when needed.

Ok, she crushed her shoulder and broke her neck. She is in rehab right

now with a neck brace but they went to doc and he said the shoulder is

so shattered they will not operate on it. Son is trying to find another

doctor.

So what happens to someone like that if they can't or won't fix it? How

could you live, I would think the pain is horrible. I know something similar

happened to an aunt of mine, though it was her pelvis, she didn't live long.

But could you live in a condition like that? I was just wondering what others

experience was. DH and I were talking about it, also after 90 days they are

going to face some kind of care as she is in rehab right now. Medicare won't

pay unless its medically necessary, seems like they are caught between a

rock and a hard place.

Experiences in your families? 

[swamp]

Medicare will pay for 90 days as long as the goal is rehab/return home.

Then it goes to LTC and it's self pay or Medicaid.

Can you live with a crushed shoulder? Yes.  Will it hurt?  Yes. But at 93, she may not have the bone mass to repair it, or the ability to withstand the surgery.

[dannylion]

At her age, it is likely that she has osteoporosis, and the fact that her shoulder "shattered" hints that it was probably fairly significant osteoporosis.  Her bones are probably too fragile to support the hardware necessary to repair it, and the metabolic function of the bone is so compromised that it would likely not heal anyway.  They will probably immobilize her shoulder to minimize pain from movement and treat her with comfort measures.

[Value Buy]

I really hate saying this, but it is all downhill from here.
Usually very healthy elderly people decline fast after such an accident.
There health was fine, but the body physically gives up after a major injury.

[Tiny]

I'm not sure what "crushed shoulder" actually means... so bear that in mind when I relate some personal experience.

My mom (at 72) fell and broke her upper arm bone just below the "head" part that fits into her shoulder bone (we heard lots of people describe the break in different ways - some scarier than others) . The final prognosis was that surgery and a 'pin' was not a good idea (a bad outcome) so,  what happened was that they lined up the bones by immobilizing her shoulder and arm and ordered bedrest and lots of pain meds.  She stayed over night at hospital and came home the next day.  the next 10 days were pretty HORRIBLE.  They were bleak and uncomfortable (even with the pain meds - the meds made her sleepy/cranky and her immobilized shoulder/arm made resting uncomfortable and she could not do anything herself (to her frustration and anger).

The x-rays at 10 days showed the bone was knitting and in a pretty darn good position for what was trying to be fixed - thru immobilization.  The doctors were VERY positive and  optimistic at this point.   This made my mom feel better mentally and emotionally and the next 4 weeks were miserable but better (hope for the future).   Mom did NOT want to go to physical therapy when the time came - but me and my sibs made her go.  After the first week of PT when she saw how much more movement she had and with the encouragement of the therapists and her family - she toughed out the PT.   When all was said and done - the bone healed fine (no pain) but it was obvious from x-rays that it had been broken and there was an extra "bump/thickness" where the repair happened.   She did recover nearly 90% of her movement - as the doctor promised she could 'throw' a pass with a football to the grandson.    It was a long, arduous, uncomfortable, and stressful 6 months of recovery and then another 6 months or so of daily exercise/movement.  It took about a year to full recovery and for her to be back to the typical things my 70+ yo mom was use to doing.  

Best case scenario it will be many months before the older woman recovers from her neck and shoulder injury.    I suspect that while she is laid up and recovering - the biggest dangers may be infection or pneumonia.    

 

[Malarky]

I'm only 55 and in reasonably good health.  


I'm recovering from a shattered elbow and broken humerus and ulna.  Bonus, my radius bone was broken by the surgeon as part of the repair.  Six hours of surgery, bone grafts, three plates and eighteen pins later and after almost four months, I still have limited use and will probably never regain full use.  Regaining whatever use I'll get is estimated at six months to a year.  And I go to physical therapy three times a week.  

I can't imagine having this happen at 93. I can't imagine that she would tolerate the surgery and subsequent rehabilitation.  I spent 6 solid weeks on morphine just to keep the pain at a tolerable level.   

[busymom]

How long ago did her accident happen?  Sadly, as Value Buy has already mentioned, I've never heard of an elderly person past the age of about 85 surviving something like this.  Sending prayers your direction that your neighbor is the exception to the rule (as long as she isn't in massive pain).  

[dee27]

I think many of the elderly die not from the original broken bone but from secondary sources like C-Diff or pneumonia that they contract in the hospital or rehab facility.

[wvugurl26]

Or MRSA. It can be very nasty in older patients with weakened immune systems.

[chiver78]

Mar 28, 2017 20:03:46 GMT -5 wvugurl26 said:

Or MRSA. It can be very nasty in older patients with weakened immune systems.

this. if she has to spend any length of time in a hospital or rehab, I fear for her long term prognosis. those places are germ factories.

I recently caught up with a former coworker who somehow managed to contract a particularly aggressive strain of necrotizing fasciitis (thank you, autocorrect....) that nearly killed him. I would guess he is in his early 50s, and he had been a pretty solid healthy guy beforehand. he was given last rites twice, and lost one leg as an "I doubt this will save him, but we can try" and he somehow pulled through. he said at one point, the virus (?) was moving at 1cm/hr. yikes.

[Tennesseer]

Ugh.

[daisy]

Mar 28, 2017 14:37:42 GMT -5 Tiny said:

I'm not sure what "crushed shoulder" actually means... so bear that in mind when I relate some personal experience.

My mom (at 72) fell and broke her upper arm bone just below the "head" part that fits into her shoulder bone (we heard lots of people describe the break in different ways - some scarier than others) . The final prognosis was that surgery and a 'pin' was not a good idea (a bad outcome) so,  what happened was that they lined up the bones by immobilizing her shoulder and arm and ordered bedrest and lots of pain meds.  She stayed over night at hospital and came home the next day.  the next 10 days were pretty HORRIBLE.  They were bleak and uncomfortable (even with the pain meds - the meds made her sleepy/cranky and her immobilized shoulder/arm made resting uncomfortable and she could not do anything herself (to her frustration and anger).

The x-rays at 10 days showed the bone was knitting and in a pretty darn good position for what was trying to be fixed - thru immobilization.  The doctors were VERY positive and  optimistic at this point.   This made my mom feel better mentally and emotionally and the next 4 weeks were miserable but better (hope for the future).   Mom did NOT want to go to physical therapy when the time came - but me and my sibs made her go.  After the first week of PT when she saw how much more movement she had and with the encouragement of the therapists and her family - she toughed out the PT.   When all was said and done - the bone healed fine (no pain) but it was obvious from x-rays that it had been broken and there was an extra "bump/thickness" where the repair happened.   She did recover nearly 90% of her movement - as the doctor promised she could 'throw' a pass with a football to the grandson.    It was a long, arduous, uncomfortable, and stressful 6 months of recovery and then another 6 months or so of daily exercise/movement.  It took about a year to full recovery and for her to be back to the typical things my 70+ yo mom was use to doing.  

Best case scenario it will be many months before the older woman recovers from her neck and shoulder injury.    I suspect that while she is laid up and recovering - the biggest dangers may be infection or pneumonia.    

 

Oh my gosh, reading this was like seeing a replay of my mom's injury.  This amazing woman was still teaching full time and tutoring as well as working another PT job.  She fell down the back stairs of her house - 7 steps I think, and broke her Radius and Ulna at 74.  She had surgery including a pin below the elbow and was in excruciating pain for the ~4 days they kept her in the hospital.  We convinced her to go to rehab (she hated it beyond words) and she boogied as quickly as she could, still in considerable pain.  She was skeptical of PT, but couldn't turn her wrist or carry anything with it, so it was a certainly a requirement.  PT was amazing - she has regained probably the same % of use with her arm - I noticed the other day that she used her other hand to 'help' in doing a task, but she's not in any pain any longer and is back to being Superwoman! It's been probably 8 months though of recovery and she's thankfully downsized her job(s) to a more manageable level.  

Now to convince her to downsize and move out of her 3 story house with 6 different sets of stairs!

[Lizard Queen]

My mom just got out of hospital/rehab a couple weeks ago.  Medicare paid 100% for 20 days.  Then there was $160/day copay, which comes to nearly $5000/month.

[The Fonz]

Mar 29, 2017 9:35:23 GMT -5 Lizard Queen said:

My mom just got out of hospital/rehab a couple weeks ago.  Medicare paid 100% for 20 days.  Then there was $160/day copay, which comes to nearly $5000/month.

That is entirely accurate. As a medical Social Worker I see this all the time. Most common occurrence is that after 20 days she goes home even though she is not ready to do so and a family member helps take care of her.

What I often see happen is that the patient runs out of money, has to sell their home to pay for home care and then goes on Medicaid after that money runs out. This cycle is so common it is the norm. She can't just give away her home and assets to qualify for Medicaid, and in Washington State the state will seek reimbursement from the estate after she dies for Medicaid expenses.