Tuesday, January 18, 2011

Broken Hip: 97-year-old's Fall, Surgery, Rehab, Amazing Recovery Chronicled--Part 2

Rehab--Attitude and Reality
A broken hip makes one helpless.  Can't move, can't get up and do what you and I take for granted daily.  Excellent doctor, successful surgery, excellent rehab facility. Yet as R lay flat on her back in a hospital bed after admission to the rehab center, we realized there would be "down days" and physically-challenging work ahead.
The importance of attitude loomed front and center.  First concern--whether a proud, successfully independent 97-year-old woman would have the will to endure, and recover from, almost complete dependency accompanied by the pain remaining after surgery and accompanying the physical therapy.
Control and Empowering: We couldn't control much, but wanted R to feel empowered, not like a helpless little old lady.  She'd never considered herself that way, that would be so undermining. To this end, we immediately requested that the staff call her by her first name, never "honey" or "sweety" (or any other too familiar or what she might consider a diminishing pet name so commonly used in care facilities).
Next, we asked R to give us orders--where to put things, what things she wanted us to bring her from home, what we could do to make the room more user friendly for her etc. etc. That gave her a smidge of control. Within a week, she also tried to control what little she could.  "Pick the dead leaves off that plant, she would instruct.  "I don't want to look at dead leaves," she'd emphasize." "I don't want clutter in this room," she'd say. We complied with any "orders".  Her mind worked well, we wouldn't interfere unless asked.
Adjustment: The first week in an institutional setting is similar to a child's going to school for the first time: unfamiliar routines, new people, different food, expectations, surprising disappointments. When we don't feel good, we're weak, we lack energy and we're not mobile. We may not feel much like adjusting.  We may be cranky or worse.  Understandable, isn't it?  Here's where focusing on the big picture helps.
What's the goal? keeping the goal always in mind, helps dilute the disappointments, insults, temporary setbacks--equally applicable to help aging parents and their children.  The goal in R's case was to be able to walk again, have independence and not be confined to a wheelchair. But R had an intermediate goal because of her surgeon's instructions to the rehab center: "no weight on the left leg for 90 days," then an X'ray to be certain the hip was healed, before regular walking could be added to her physical therapy routine.
Patience: Unbeknownst to us, until she told us she had passed the half-way mark of 45 days, R was mentally crossing off the days until her return to the surgeon and X'ray--90 days.    ....to be continued

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