February 25, 2014


Dad had a fall on Sunday. The resulting injuries are horrific. The top of his femur smashed through his pelvis, shattering it. Picture a plate dropped onto a tile floor. That is my dad's pelvis.

I've seen the images from the CAT scan, and they made me sick to my stomach.

Doctors can do nothing to fix it. The injury is so severe, and his bones are in such poor condition, they have no way to surgically repair the pelvis. And even if they could, with his poor health it is unlikely he would survive the operation.

IF we can keep him in bed for eight weeks, he MIGHT eventually be able to sit in a wheelchair. He would never walk.

However, our hospice team says they have yet to see anyone in dad's condition live more than a few days after sustaining such a significant injury. We expect his decline to accelerate at a far more rapid pace now.

Because he is not a surgical candidate, the hospital will discharge him today. As I write, we have nowhere for him to go. He can't return to the memory care unit where he has been for close to a year. They are an assisted living facility; he now requires skilled nursing.

One issue we are facing is that the only way dad will remain in bed is if he is restrained. He has already been trying to get up. And, he has repeatedly attempted to remove his IV and catheter. The hospital has been using soft restraints.

There are regulations about what kind of facility can restrain patients. Hospice does not believe they are able to do so in one of their facilities. We are looking into that. We could hire a 24/7 nurse to sit with him and keep him in bed if he was moved to a hospice facility, which would be our preference.

If he were to try to stand, the results would be catastrophic. His femur would push the shards of bone and either sever a blood vessel or puncture an organ. And he would die a very painful death.

His dementia complicates matters a great deal. He doesn't remember he is injured. He's not feeling pain, because it is well managed, and so keeping him still is extremely difficult. He is being given medication to lessen his anxiety, and he follows instructions when given. But if he were not restrained he would have to be monitored every moment of every day.

We are the the midst of an epic nightmare.

This incident has been the final straw for me. I've been holding it together for so long. But now I, too, feel broken. Just in a different way. I have lost my fighting spirit. All the emotions I have been keeping under control have come flooding out. They are running rampant.

On top of all this, I've been recovering from a concussion and am now sick with a fever, body aches and a sore throat. So I can't even be with dad today. All I can do is stay in touch with mom over the phone. I feel helpless.

This pretty much sums up where I am:

Update: Dad has been transferred to a local hospice facility. This is considered a short-term solution, until we can locate a skilled nursing facility. Hospice is not allowed to use bed rails or restraints, but will have a nurse by his bedside around the clock.

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