An 84-year-old, frail, elderly woman with psychological issues was hospitalized for hypotension that triggered because of her medications. She was put in rehabilitation for almost a month, moreover, was later hospitalized for congestive heart failure.
- 84 year old white female with osteoporosis, lumbar compression fractures, chronic pain
- Giant Cell Arteritis (GCA)/Polymayalgia rheumatica (PMR) treated with steroids since 2001
- Depression since death of spouse 2001
- Colo-vesicular fistula since 10/02
- DM, HTN
- CHF, COPD
- PAF, hypothyroidism
Over the next few months, the patient was hospitalized repeatedly. She experienced functional decline and a decrease in her overall sense of satisfaction with life. She also complained of an increase in lower back pain which was managed by short-acting morphine. The occasional exacerbations in CHF were managed with diuretics, at home. Although she was able to stay out of the hospital for a few months, she had poor functional status and compromised quality of life because of her medical issues.
The patient also suffered from trauma caused by abruptly sitting down on the commode. This caused excruciating pain in her lower back the next day. She was hospitalised for pain control. However, no new fractures were found. Her functional status worsened because of the pain.
Here physical status continued to worsen and she was considered for a minimally invasive spinal surgery (vertebroplasty). While the procedure showed improvements in pain, there were no functional benefits.
After weeks of unsuccessful attempts at physical rehabilitation, she was discharged to a nursing home where she continued to deal with physical problems.
References
Osteoporosis Impact in an Older Adult Patient https://www.hopkinsmedicine.org/gec/studies/osteoporosis.html