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Delirium and even death following physical trauma not unusual for elders

Carol Bradley Bursack, Minding Our Elders columnist

Dear Carol: My mother, who was in her early 80s, was doing well, except for arthritis and high blood pressure. Then she fell and broke her hip. After surgery, she seemed not just foggy but completely irrational. The doctor said that this wasn't unusual for someone her age considering what she'd been through and that she'd get better.

Mom spent several days in the hospital and was then moved to a nursing home to recover and receive physical therapy. The staff was terrific with Mom. When I asked them if Mom would recover mentally, they were non-committal. They didn't want to say that she wouldn't but they seemed less sure than the doctor. As the weeks went by she didn't improve mentally, though she was doing fairly well physically. Then, five weeks after the surgery, she suddenly died. It's hard to accept. How common is this? — Terri

Dear Terri: You have my deepest sympathy for all that your mother and you went through. Sadly, your mother's situation is not uncommon. Her body experienced enormous physical trauma when she broke her hip. Even elders who seem to recover from this type of injury have an increased risk of death for as long as a year afterward.

The mental effects your mother experienced are likely delirium. There are a significant number of elders who experience delirium after hospitalization, even without surgery, which has been blamed on the noisy, cold and often confusing atmosphere of hospitals. Those who are not at risk of dementia generally recover from delirium, however, if the person is on the edge of developing dementia, this experience may tip them over the edge into dementia.

When physical trauma such as a broken hip is the reason for hospitalization, there is extra cause for concern. Difficult as it is for those of us who are left wondering about the sudden death of our loved one, the human body can only withstand so much. Aging bodies can withstand less.

I witnessed this with my neighbor, Joe, for whom I'd become the primary caregiver. After breaking his hip, Joe needed nursing home care. He seemed to be doing well physically and mentally, though emotionally he was not. He couldn't accept his new limitations. Joe died within six weeks of his fall. Like your mother, his death was sudden. I'd been with him less than two hours before he died and there were no warning signs. My feeling was that he simply gave up. Perhaps he didn't want me to make him hang on. We don't really know what people have under their control.

I hope that you have support from your family, your spiritual home, and even a grief counselor if you feel the need for professional help. You did all that you could for your mother. She is still with you in spirit, so keep her close by bringing her to mind as you go about your day. She'd want you to get on with your life.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carolbursack@msn.com.

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