He’s in his early 80s, lives alone, and is having increasing problems with one of his shoulders. His doc prescribed physical therapy a few month ago in lieu of surgery, and he’s been doing it, but his shoulder is still bad. He’s now thinking he might want the surgery.
Problem is, he’s not especially mobile even in the best of circumstances; he suffers from a lifetime of physical labor that now takes its toll on his body. He can’t walk long distances - if he wants to visit his across-the-street neighbor, he drives. He suffers from neuropathy in his hands and feet, and can’t tightly grasp things.
He had rotator cuff surgery on his other shoulder several years ago, and remembers how hard it was then. But at that point, my mother was still around and could help him with day-to-day activities like getting dressed and going to the bathroom.
We’re obviously going to go to the doc and talk this through with him, but I wanted to put it out to the teeming masses. I’ve heard the surgery has improved in the past few years and might not be quite as bad. Is that true?
Also curious if folks can recommend ideas to getting him through this. Someone mentioned he could recover in a nursing home, but I think he’d rather not get the surgery if he had to spend 6 weeks in a nursing home afterwards. I know home health is an option, but I’m not sure we can really pay for 24/7 care for many many weeks (but we could for a little bit).
One major concern I’ve become aware of in recent years it the permanent brain damage from anesthesia in the elderly that can easily happen. To see someone go from fairly normal to near kumquat after surgery is painful.
Is this worth the risk? Definitely should be extensively discussed.
If it was my dad, I’d have a talk with him and let him decide what he wants to do. I think it’d much depend on how bad the torn rotor cuff is affecting him - and then choose the lesser of the 2 evils.
I went on a whitewater rafting trip and tore mine a few years ago - and tore an achilles tendon as well, so I’m familiar with the therapy and recovery. The surgeon told me that the shoulder is the 2nd most painful joint in the body (the knee being the most). For me, the choice was a no-brainer and all eventually got almost back to normal.
My brother had a completely torn rotor cuff and so he couldn’t lift his arm at all - to comb his hair or to hold a coffee cup. He let it go so long that they couldn’t repair it - and they took a ligament from someplace in his back. He got over it okay. I think he was about 65 or so at the time.
If your dad’s arm is just hanging by his side or he’s unable to lift his arm, he might opt to get it fixed before the muscles atrophy. If it’s something he can live with - well - that’s up to him. Quality of life is worth a lot.
What I’m mainly trying to find is ideas for care during his recovery; living alone without the use of one arm is going to be extremely difficult, if not impossible. He won’t be able to dress or cook, at least for a while.
I’m going to explore options with the doc, but looking for any other ideas/advice.
Is there anybody who can stay with him – be an actual caregiver – after the surgery?
If not, is it possible for him to have a paid home health aide/companion to help with light chores? Or a neighbor, perhaps?
I have a friend who’s wheelchair bound. She hires out an aide once a week to do her grocery shopping, laundry, and light chores. She also has a home health aide who does a weekly check. Perhaps something like that?
The other thing I’d look at is something like Meals On Wheels so he’s assured one actual hot meal a day.
Meals on Wheels is a no-go; he’s had them before, hates them with a passion.
The issue is that I don’t think “light chores” is what we’re looking at. Perhaps someone more familiar with rotator cuff surgery can chime in, but I’m under the impression that he will not be able dress or undress or make food or really anything, at least for a while.
My siblings and I can help out, but we all work full time and we can’t be there 24/7.
We certainly can bring in aids; I’m hoping to find some resources to help $$ wise. 24/7 care even for a few weeks is pretty pricey.
Surely he’s not the only person in the world looking at this kind of surgery who lives alone. How do folks handle it?
I had a spinal fusion - back surgery - some years ago… and I lived alone. A friend brought me home from the hospital when I was released and I stayed on the couch for the next couple of months. I could (carefully) get up and go to the bathroom but couldn’t stay upright for very long.
I’d go to the kitchen, get out a pan and a empty a can of Campbell’s soup and put it on the burner. Then I laid down on the floor and waited until I heard it sizzle, etc.
Rotor cuff surgery rehab is a breeze in comparison to that! So you’ve got an immobilized arm? Big deal. Can you put on your shirt with one hand? Takes longer but there’s not a lot that you can’t do with one arm.
After my rotor cuff surgery, a neighbor would come over and dump a bag of salt into the water softener and drop off some groceries but I was on my own otherwise.
The rehab people will give him a rubber strap to pull and instructions to ‘exercise’ by walking his fingers up a wall - to extend the range of motion. You don’t really need somebody standing by, watching him do it. In other words, he won’t be totally helpless with one arm in recovering from surgery.
I want to reiterate that even pre-surgery, he’s in his 80s and not very mobile. He has trouble with clothing when he has both arms; he’s not going to be able to put on a shirt with one arm. He can walk small distances but not, say, across the street and back. I do think he will be mostly helpless for a time after surgery.
I’m hoping to find an answer for him, since he is in a lot of pain and would like this fixed. It may be that a stay in a nursing home after the surgery is the only answer, assuming his insurance covers it. But I’d at least like to exhaust all other options before that one.
The goal at his age should be “functional”, not “perfect”. Stick with the PT and exercises. Do them regularly and fully. It takes substantial time and effort to strengthen the shoulder muscles that have weakened with age and inactivity. This won’t repair a rotator tear, but it will stabilize the shoulder and make it both more functional and less painful, in large part by improving blood flow in the area.
My mom went through the exact scenario you describe for your father, except she was in her early 70’s. My wife is a PT and gave her that advice, along with equipment and a written exercise plan. Mom decided surgery was the easier, more expedient option. She regretted that decision for about a year.
Hectorik’s observations clearly come from someone who has not had rotator cuff surgery. In addition to helping “nurse” my mom and, earlier, my dad through it, I have had the same surgery. I was in my early 40’s and tore the cuff pulling heavy bushes out of the ground. I have had surgeries on my knee, elbow and hip. Shoulder surgery was far and away the most painful and had a longer recovery timethan the other 3 combined. Figure 6 weeks in an immobilizer, 3-4 months before he’s able to use the shoulder without constant pain and about a year before he’s back to 100%. And in people over 60, a significant number of tears do not heal even after surgery so it could be a lot of pain for naught.
In my opinion, surgery should be the absolute last option for a person of that age.