The clinical data tells us after a major broken bone; a senior has a 50% chance of dying in the next year. How or where the treatment is rendered does not impact the outcome from the fracture. A broken bone and a fracture mean the same thing. Often people think a fracture is more or less significant than a broken bone. Fractures and breaks are synonyms and indicate that there is a break in the continuity of the bone whether it is still in alignment or out alignment it is still a break or fracture.

What about when the individual with the broken bone has advanced dementia? Maybe they are not able to walk or ambulate anymore due to their dementia. Does this have an impact on the options that a decision maker has to face?

The primary issue is one of pain for the individual with the fracture. Broken bones are painful. The literature tells us that if an individual with dementia sustains a fracture 10.7% of those with surgery and 4.8% of those without surgery were able to walk after the fracture. This demonstrates the impact the fracture in those with dementia.

19.3% of those who had surgery were in hospice within 6 months. 33.8% of those who did not have surgery were in a hospice in 6 months. The story to tell is that broken bones are deadly in those with dementia. It is vital for family members to ask about hospice sooner rather than later. Often healthcare providers want to fix problems, but forget to look at the big picture of the person as a whole. If the pain is relieved, we have had success if one believes in the quality of life, palliative care, and hospice as an alternative to aggressive treatment when other significant conditions impact the anticipated outcome.

It is never to early to be an advocate for those that we love and care for. When they are not able to speak for themselves, they rely on those of us that are capable of helping them. Ask your healthcare provider the difficult questions and do not stop until you have a clear understanding of the risks and benefits of treatment and procedures.