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Thread: Question about broken ankle with a 76 year old woman

  1. #1

    Question about broken ankle with a 76 year old woman

    My mother broke her ankle about 6 weeks ago and had it operated on and then was put in a nursing home. Well she has been there for 6 weeks now and I'm wondering if anybody knows what the average stay is for this type of thing as she cannot walk with crutches since she is old and does not have the balance, they say they still dont feel comfortable in sending her home yet as this week they say she can only put 50 percent weight on it. Next week they say 100 percent weight and hopefully within 2 weeks she can go home walking with a walker. Is this kind of time normal for this kind of thing anybody know? I wanted to get her out of the nursing home like a week ago as she is miserable there. Would a eight week stay in the nursing home be the norm in such a situation? She does have some neuropathy in her feet from age, but was walking ok before she fell and broke her ankle. I'm just thinking maybe they are trying to keep her there as long as they can? I dont really know a real lot about these kinds of things, but it seems like a lot of time for just a broken ankle? They claim they are nervous to send her home in a wheelchair as she does things like forgets to lock up the brakes when she transfers and they are afraid she will take a real bad fall that way? They claim she needs to keep the boot she has to wear on when she stands up for at least another three weeks? Do bones take this long to heal? I always thought it was like 6 weeks for broken bones to heal? Maybe I am just rushing things because I want her to be able to go home and and be so miserable. I hate seeing her have to be in a nursing home, I feel she is too young to be there with all those older folks in their 80's and 90's, she looks younger than she is and she is only 76, I come from a family of longevity, my grandparents lived to be nearly 100.
    Last edited by Curt Leatherbee; 05-28-2008 at 11:08 AM.
    "Life is about how you
    respond to not only the
    challenges you're dealt but
    the challenges you seek...If
    you have no goals, no
    mountains to climb, your
    soul dies".~Liz Fordred

  2. #2
    Senior Member Tom's Avatar
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    A lot of variables at work, Curt......I broke my leg and ankle in 5 places (stupid me, dunking off a picnic table ) way back in '91. Got a couple screws, pin, small plate for that, and IIRC, cast from late Feburary all the way to the end of May - a good 12 weeks. Then 3 more months with no running/jumping allowed before they removed one of the screws......that's when I blew up like a balloon weight wise, life has been pretty much downhill since....

    Old age, female = osteoporosis. Older bones heal slower no matter what. So it's certainly reasonable to expect her injury to take a long time to heal, even if its a simple, non-displaced fracture. That said......I'd get her out. Here's why - rehab makes so much difference, young or old, whatever the injury. I have some friends who've hurt themselves riding or whatever, and they've all done rehab to some extent during/after treatment, and they've all stayed in shape. I did no rehab, and gained 75 pounds.....I should've broken my other leg! That way I coulda kept exercising (crutches are a marvelous workout). As you said, she's clearly younger than her years both in person and at heart, and being miserable is reason enough IMO.

    But the NH has some good points with safety as well, although I suspect financial motives trump safety most of the time....money usually does that. Could you perhaps ask the doc about any alternatives? At-home care? Probably $$$$, but so are nursing homes.

    Good luck!

    Tom

  3. #3
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    You've got some good genes running in your family, Curt.

    How does your mom feel about it? Does she feel strong enough and capable enough to go home?

    When was her last X-ray? That should tell you how far along the healing is. I hope she gets out of there soon. It's no good being unhappy. Especially for our mama's.

  4. #4
    Hi,

    The length of stay does not sound unreasonable for an ankle fracture in an older woman. Therapists everywhere (including NH's) have safety and fall risk as their utmost concerns, as they should, because another fall could set her back that much further.

    I might try another approach. If possible, attend therapy sessions with your Mom to see for yourself how she is doing and ask to review the therapy goals as to what she needs to do before she can safetly be discharged.

    Communicate early and often with the therapists. If they know you are concerned and want her to go home, they may be able to speed up the process with some in-home services that would still be covered.

    Does she have any help at home? This will make a great difference on when she could safely return home. Also, speak with her orthopedist about the results of her xrays to be able to assess the current rate of healing.

    AAD

  5. #5
    Curtis, I landed in a nh for right at a month after I broke my foot/ankle/lower leg in a fall. I'd had surgery, was deemed too "dis" to return home and too "dis" for as local phys rehab hospital so I was carted off the the nh for "rehab".

    What is her ortho saying about how she is progressing? How often is she seeing her ortho? It is ultimately up to her when she leaves. A nh cannot keep her there against her will.

    She has a home to return to and her house is likely accessible given you are her son. She can always leave the nh and have p/t at home. You may wish to talk to her orthopod about that. The doctor can order at home therapy to help her help herself.

    What kind of p/t and o/t is your Mom getting? How many hours a day? How many days a week?

    Are they teaching her to use a chair if her balance is as you've described? Does anyone know why her balance is so bad? What do they think will change next week about her balance that isn't changing now?

    I'm with Dave on the x-rays. When did she last get films?

    When she returns home is it possible for her to have an emergency call button? Sometimes that can offer peace of mind should she fall again.

    I know I'm asking many questions, but I'm hoping it helps to focus what's happening with your Mom and her care. Her length of stay sounds excessive to me, but I'm not her doc and each person is different in terms of healing.

    I hope the two of you find what can work for her at home. Nursing homes are no place to be if at all avoidable.

    to you both.

  6. #6
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    Curt, I agree there are a lot of variables going on here. My grandmother broke her hip just short of her 85th birthday and the rest of the family was doing a "they never recover at that age" thing. Nothing could be further from the truth. My grandmother was an active woman who had walked a lot prior to her fall. She must have had some osteoporosis as I remember her with a slight hunch in her posture, but she still healed up and went back to a life of independence. She had great genes too, living to 102 and lucid the whole time. I HATE nursing homes, so I would want her out of there ASAP too.

  7. #7
    Thanks for the good words everyone. I guess I just need to face the fact she will be there a couple more weeks, its already been 5 or 6 at this point, its been a long haul. As of next week they say she can put 100 percent of her weight on the foot while wearing the boot, this week she has only been allowed to put 50 percent of her weight on her right foot but is walking every day up and down the halls of the nursing home using a walker. So I guess she is progressing as well as can be expected. The nursing home really is not that bad, I've seen worse. The people seem nice there too. It has just been a really long recovery. They feel its a bad move to send her home in a wheelchair as they feel she will have problems and be a safety risk, I think they are probabley right. This way too with waiting to send her home until she is walking we can avoid having to make modifications to her house such as a shower bench and grab bars, although both these things might be a good idea anyhow, would not be that hard to do.
    "Life is about how you
    respond to not only the
    challenges you're dealt but
    the challenges you seek...If
    you have no goals, no
    mountains to climb, your
    soul dies".~Liz Fordred

  8. #8
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    My fear for your mom is that she does not use the wheelchair in a safe manner, and might never learn to lock the brakes. I had the same problem with Dad. Gosh! All those newbie wheelchair users in the nursing home made me nuts when I visited him!

    Have patience. Once the broken ankle heals properly, she should do fine in her own home.

  9. #9
    Super Moderator Sue Pendleton's Avatar
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    Quote Originally Posted by Eileen
    Curt, I agree there are a lot of variables going on here. My grandmother broke her hip just short of her 85th birthday and the rest of the family was doing a "they never recover at that age" thing. Nothing could be further from the truth. My grandmother was an active woman who had walked a lot prior to her fall. She must have had some osteoporosis as I remember her with a slight hunch in her posture, but she still healed up and went back to a life of independence. She had great genes too, living to 102 and lucid the whole time. I HATE nursing homes, so I would want her out of there ASAP too.
    My Grams fractured her one ankle into a lot of little pieces at 81. Her doc said she'd never walk again. Months later, the nursing home lasted about 3 days, the doc saw her dragging her walker behind her heading to the store. He pulled up to ask why she was dragging it and she came back with something like "but you told me to always use my walker from now on." The doc took it off her hands and Grams 'allowed' one son to rototill her garden the next several years. Depends on a lot of things Curt.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  10. #10
    Senior Member skippy13's Avatar
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    Curt, The shower bench and the grab bars in the shower would be a really good idea. Most accidents happen in the bath when trying to get in and out. I think every single bathroom should be so equipped no matter how old the person is. Good wishes to your Ma...

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