From the hip

My father has fallen and broken a hip. Until now, family members have always mentioned the broken hip in one of those hypothetically speaking "what if" scenarios (that only seemed to happen to other people’s families). It has normally been a conversational topic only after previous falls left us feeling blessed/thankful the dreaded hip fracture had somehow been avoided, yet again. No more.

It was at night, he was agitated, the bathroom was too far away. (A few steps may as well be 500 meters to someone with dementia, awaking from a sound sleep). Plus, dementia units never seem to have enough staff on at night to assist patients whose bodies and minds have abandoned the lessons of long-ago toilet-training. To Alzheimer's patients at a certain stage in the disease process, any hints and signs of impending bodily functions get lost among the muddle of random synapses firing away. Then, suddenly, a sense of urgency propels them toward the facilities faster than indifferent muscles can carry them.

Strangely, now that the dreaded hip fracture has occurred, I wonder what all the sturm und drang was about. In the past, whenever I heard people talking about an elderly or disabled person falling and breaking a hip, it was almost a foregone conclusion he or she would be a) thereafter bedridden and helpless, b) dead soon or c) better off dead. Looking back, the underlying belief seemed to be an older person breaking a hip would be comparable to a racehorse breaking a leg and therefore, needing to be (euphemistically speaking) “put down.”

No one will ever really know the exact scenario of my father's fall. It happened at night, he was alone. By the next day, staff decided his agitation, bruising and crying out warranted an investigation, so he was transported to a small hospital near his nursing home. Although the orthopedic surgeon is coming from a large regional hospital, the small country hospital where he is a patient and will have the surgery lacks an Intensive Care Unit and intubation capabilities. This means family agreed-upon orders can be honored. No resuscitation.

His surgery is tomorrow. He is in quite a lot of pain and does not understand what is happening; I feel helpless for him. I can only wonder at his short and long-term prognosis and quality of life. What would he want? It is too late to ask. He just grips my hand, holding on so tightly my fingers turn white and numb.