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Question about an unhealing broken bone, CHF and hospice care
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Question about an unhealing broken bone, CHF and hospice care

My aunt is 85 and has not walked in over 7 years (due to never getting knee replacement surgery).  Her health history includes:  January 2008 - mild stroke, July 2010 - hospitalized and diagnosed with Congestive Heart Failure, September 2010 - fell out of wheelchair and broke femur.  Because of the CHF, she was not a candidate for surgery so the femur couldn't be set.  It is now March 2011, she has been bedridden since September, receiving x-rays every two weeks, and as of last week the orthopedist reports that the bone has not healed at all, and in fact, it looks worse than the original break.  My aunt doesn't appear to be in pain anymore (logically that would indicate that the bone has healed at least SOME), and outwardly she seems fine.  She is legally blind (macular degeneration), but she can feed herself, brush her teeth if someone holds a bowl under her mouth, and carry on a conversation.  Recently, however, hospice came in and evaluated her and approved her for hospice care.  This means they expect her to live nine months or less, they said.  The orthopedist also said that elderly people often die from broken bones such as this.  My question is why?  Other than the broken bone that refuses to heal, and the CHF which seems to be controlled now with medication, why do they think she is near end of life?  Isn't it possible that she can live in this condition for another ten years?  Please help me understand the connection between the unhealing broken bone and possible death.  Thank you so much.
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144586_tn?1284669764
The important question is who has authority over her health care?

Has she signed a document authorizing you to act on her behalf?

There are "missing pieces" to this story. Missing pieces regarding her medical situation and treatment.

My guit feeling is that I am not a happy camper with her care to date. Nor do I beloieve her caretakers have been truthful or forthcoming regarding decisions about her care.

You need her to provide written (or witnessed verbal, preferably by an attorney) authorization for you to interface with physicians on her behalf and participate in discussions regarding her prognosis.
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Avatar_f_tn
Thank you for your concern.  Her husband, my 91 year-old uncle has authority over her care.  She has been receiving excellent care, actually.  I am like a daughter to them and together my uncle and I have worked diligently to see that she receives the best care possible.  Her caregivers regularly comment, in fact, telling her that none of the other patients have supportive family that visits her every day of the week, weekends and holidays included.  My uncle is there with her 10 hours a day, every day.  I don't know what "missing pieces" you are looking for, or why you don't believe there has been dishonesty regarding her care.  That's puzzling.  At any rate, it seems that regardless of how diligent we have been, and continue to be, the professionals lean toward the fact that she is at end of life.  The orthopedic surgeon told me that "often times elderly people die from breaks such as this," and someone from hospice told me that patients are approved for hospice when hospice believes they could live nine months or less.  To my uncle and me, she appears to just have a broken leg that refuses to heal.  The rest of her problems seem minimal, and are managed with medication.  So he asked me to look on the internet and see if I can learn WHY the professionals believe that an unhealing broken bone can ultimately lead to death for her.  The orthopedic surgeon said "because of complications that result from it," but he did not go into what those complications might be.  So that is why I am here ... seeking answers.  Thanks for taking the time to respond.
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144586_tn?1284669764
There is a philosophical issue to be addressed.

Clearly, someone who recommended a hospice believed that it is time for her to die a "death with dignity". It's called medical arrogance.  Hubris is another descriptive adjective I can think of.

I have seen enough elderly people who were effective terminated by physicians who believe "their time has come" to state that this is not a myth.

That is the nonsense I got from a number of the top chancre mechanics in a "top" geriatric facility when my "little camper" was 99 years old and had a stroke and couldn't talk.

At age 103 she told me "I've never been happier!"

A year later she was talking and smiling and she is 106 years old and going strong.
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