Older mother with significant osteoporosis, what to expect

March 11, 2012 8:19 PM

Mother, 80 years old, with significant osteoporosis -- what should we expect?

My mother is 80 years old with significant osteoporosis. She's lost inches of height and is very frail and slow and bent over. She's had at least one fracture in her spine. She's been given all kinds of treatments but nothing has helped. She has chronic back pain treated with Tylenol. Other than the severe bone loss she has no significant health problems. She lives in a one-bedroom unit that is part of a tiered retirement community. She still goes out about three times a week (e.g. church, movies, concert) with transportation provided by friends or the retirement place. She is mentally sharp.

What can we (her children) expect over the next months and years? Quality of life? Pain management? Life expectancy?

If any of you have gone through this with your mother (or father, but more common with older women), what should I know? (I tried to google, but it didn't really help me understand.)

posted by ClaudiaCenter to Health & Fitness (7 answers total)

Best answer: When you are old, broken bones can be a much more serious deal. Once an old person breaks a bone, the time in the hospital can be a risk (hospital-acquired pneumonia, UTI with a catheter, other infections circulating in the hospital), if the fracture is serious enough to consider surgery that has a whole host of risks, and she is likely to need more and more care (i.e. going to short term rehab, increase in care level to assisted living or nursing home). So, if only considering osteoporosis in terms of life expectancy, the life expectancy is going to depend mainly on how often and how hard she falls.

Osteoporosis means that your mother is very susceptible to fractures, and thus your main aim should be to help her avoid situations in which she might be injured. I'm an ER doc (IANYD) and the classic examples I see are things like "I went out to get the newspaper on an icy day." "I got up to go to the bathroom in the dark and I tripped over or bumped into something." "I slipped in the bathroom." "I was supposed to be using my cane/walker but I didn't use it and I fell."

I have a biased perspective towards these kinds of acute care issues, but if it were my mother I would take measures to try to minimize the likelihood of these things causing a fall, i.e.:
- Ensure assistive devices (cane/walker) are in place if needed, and being used
- Have apartment fitted out with things like side rails in the shower and toilet area, if it isn't already
- Make sure she has very stable shoes with a good tread
- No throw rugs
- Nothing obstructing the way to the bathroom, nothing left on the floor

You particularly want her to avoid the more serious fractures like spine fractures or hip fractures. Compression fractures may be inevitable, I would just say be very careful with narcotic medications for pain because they can worsen the situation by causing wooziness/confusion and then falls. I hope this is useful information. You can MeMail me with any other Qs if you like.
posted by treehorn+bunny at 9:28 PM on March 11, 2012 [5 favorites]

My mentally sharp elderly cousin broke her pelvis right before Thanksgiving and was given Oxycontin in the hospital. Her daughter told me this completely addled her until she was given a less strong (but just as effective) painkiller.
posted by brujita at 11:10 PM on March 11, 2012

I think this happened to my great aunt as well, but no one changed her meds. The vivacious, urbane woman with whom I spent a Thanksgiving became one who was no longer all there. We also found out that one of her caregivers had been both stealing from and neglecting her.
posted by brujita at 11:18 PM on March 11, 2012

Is she able to exercise at all? I ask because my mother was told she had quite severe bone loss in her 60s and she has apparently completely reversed it and has normal bone density about 10 years later. She joined Curves and does some other exercise classes as the mood strikes her. She had gotten "frail" looking and lost an inch or two of height but now she looks much better.

Her exercise is just walking the dog (not often), going to the gym about 3 days a week and random classes she does for a while and gets bored with like Yoga or Pilates. She swims a lot too, very slowly and not very far but she does it just about every day.
posted by fshgrl at 11:34 PM on March 11, 2012 [1 favorite]

Response by poster: Thank you, everyone. She does do some exercise classes held at the center (and has been doing classes for some years, though no change in the bones). Thank goodness she moved last year from her own home (think stairs, ice, snow) to the retirement center which is brightly lit with flat surfaces, elevator, etc. The apartment is fitted with railings and clean, I don't think there are any throw rugs but I'll check. I'll check with my sister about her shoes. It sounds like the outings -- which are critical to her participation in the community -- are times when she might be at risk of falling. The people who take her places (my aunt, church friend, etc.) are very kind and know about the bones, and I'm sure they take care with her, and my mother goes very slowly. I'll remind her to always go slowly, but she doesn't really need reminding on that. She doesn't use a walker yet, but when she does we'll encourage her using it.
posted by ClaudiaCenter at 8:53 AM on March 12, 2012

I don't know what type of exercise classes she does, but she probably wants to look into resistance-based and weight-based training if the current classes she's doing are not addressing the issue. I am not saying run into the gym and do 500lbs deadlifts, with seniors/disabled it starts with things like doing "squats" by lowering oneself slowly into a chair and getting up, lifting one's arms above one's head, doing push-ups against a wall. You also want to monitor her diet to make sure she's getting enough protein, etc. The elderly can make good fitness progress, even into a very old age, but it takes commitment and a smart trainer who is able to adjust the programs and movements accordingly to fit their needs.
posted by Anonymous at 9:56 AM on March 12, 2012

Hopefully her doctor already has her taking calcium but it not, Caltrate with vitamin D or a generic version of it really helped my mom. I'd also go for a multivitamin. Make sure her body has everything it needs for bone health.
The shower is one of the easiest places to fall so shower chairs give a little extra peace of mind. If your mom has enough trouble eventually to need a walker, get one that has a seat so she can sit when she gets tired. You can also sit and push them with your feet though you're going backwards. My grandmother really liked hers.
posted by stray thoughts at 11:36 AM on March 12, 2012