Hip Replacement--or not?

Suppose your mother falls and breaks her hip, and she's in her 90s.  She's frail and thin.

Suppose she has mild dementia and can't always make her own decisions.  In a painful crisis, she may not be lucid enough to choose.

The doctor rules out surgery to repair the hip with pins because of osteoporosis.  She gives you two options: 

1) Give your mother a hip replacement--a serious surgery that she may not survive.

2)  Just put her into a skilled nursing facility (SNF) and drug her to the point where she doesn't feel the pain of being turned over or moved.  The survival rate after a broken hip is about a year in any case.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3597289/

What do you do?  What do you do if you and your siblings are divided on this question?

Here's an article that gives you all some background for the decision.  Thank you to reporter Lisa Esposito and U.S. News & World Report (and to my friend Dana for finding the article).

http://health.usnews.com/health-news/patient-advice/articles/2015/04/08/getting-a-hip-replacement-in-your-90s

Dr. Alexander Miric, an orthopedic surgeon at Kaiser Permanente in Los Angeles, stresses the seriousness of option two:
"...the mortality of broken hip without surgery is extremely, extremely high.”

Another sentence in the piece jumped out at me, a point made by Dr. Sharat Kusuma, director of adult reconstruction at Grant Medical Center in Columbus, Ohio:
"...Alzheimer’s-type dementia would rule out a patient" [for hip replacement].  

Catch 22:  Dementia cannot be definitively identified as Alzheimer's Disease until autopsy shows the tangles of plaque in the brain.  They thought my mother had Lewy Body Dementia, but it turned out to be ALZ.

Note to self: do not break your hip in your 90s if you get there.

Gracious Aging

Living into the 90s and experiencing ups and downs as health declines and fails is quite a trial.

I'd like to report, however, that I have one friend who is negotiating these ups and downs with relative good cheer.  

She's 99% ready to leave this earth but also very patient with the day-to-day indignities.  I'm amazed that she is not angry or sad.

Most younger people look at the problems of extreme old age and hope their lives will end earlier.

Perhaps because I spent four years accompanying my mother on this journey, I myself view being in an assisted living residence with equanimity.  It's a peaceful life surrounded by others without the kinds of worries and pressures that plague earlier years.  (A skilled nursing facility, on the other hand, is not good news.  It's more of a warehouse where people are pieces of meat, showered roughly, wheeled in and out of meals whether or not their false teeth may be in their mouths.)

What seems unendurable today--such as wearing Depends--can become just another event later if one lives in a cheerful place with kind caregivers.

When I was in my twenties, in the 1970s, I was close to my grandmother and observed her dealing with cataract surgery.  It seemed awful to me to have a surgeon cutting into one's eyes.

Today my perspective has changed.  I'm 67 and starting to feel the effects of growing old.

I didn't feel old when I got my Medicare card, or when I started collecting Social Security or began noticing increasing wrinkles and gray hair.   

Yesterday, however, when I sat in my ophthalmologist's office and scheduled a cataract surgery, it happened.  I'm where my grandmother was, and now I know I am old.