Shoulder dislocation in elderly patient

[doones_1]

Hi, I'm new to nursing, only been a nurse since March,

I work in a LTC where an elderly patient has a dislocated shoulder that no one knows how happened;

is this common? Can this just happen?

The resident is in her 90's, totally contracted, dementia....but nothing is being done to fix her shoulder

[VivaLasViejas, ASN, RN]

Yes, it's possible for shoulder joints to become dislocated without a lot of provocation in a 90-something with orthopedic problems. But how certain is it that "nobody knows how it happened"? This incident needs to be investigated thoroughly.......not only does abuse need to be ruled out, but the dislocation could have occurred due to incorrect transfer techniques, and staff may need some retraining.

As for fixing the shoulder: This is probably not something that can be fixed, but there's no reason for the resident to be in pain. I hope she is being medicated adequately and her comfort assured with good positioning!

[doones_1]

thanks for the reply, there has been an investigation done - preliminary findings are that when dressing some CNA's put sweatshirts on her that they get her arms in then have to lift up to get it over her head....we think this possibly put her shoulder out of joint.

We've taken all the non front/back closure items out of her wardrobe and even taken some home to alter.

I just don't have enough expierience to know if this can happen or not

thanks!

[scmrn]

I think I know where you work. Cari___n?

[CoffeeRTC, BSN, RN]

Yes, I've seen this happen. Abuse must always be ruled out first.

We've had this happen with a CNA removing a very tight sweater, how they got in on in the morning, I don't know??

We've also had a res come up with a femur fracture...just woke up one day with a lot of pain. Turn out after multiple scans..she had alot of other minor fractures and her bones were like swiss cheese.

[jonamb]

Spontaneous fractures, unfortunately, do occur. We had a LOL once who was just walking down the hall, went to the floor for no apparent reason, and BAM...broken femur. And she had been a good walker...steady, good posture...it was the craziest thing. On the other hand, staff do need to be careful with care giving on fragile residents. Way back when, when I was a CNA, I was trying to put a pull-over sweatshirt on a res. I had to reach through the sleeve to pull her arm through, and when I did, her arm jerked, I lost my grip, and somehow my arm flew back and smacked her right in the face . She ended up with a HUGE black eye. Needless to say, there was an investigation and it was found to be an accident, but I still felt awful. Sometimes it's almost impossible to dress/undress people who are contracted, resistive, etc. Who's idea is it anyway to buy these residents pull over tops and snug-fitting clothing? Anyway, I'm rambling...back to the subject. Yes, it is possible for injuries to "just happen". And sadly, it is common for "nothing" to be done, since sometimes the residents condition does not make repair possible. The most we can do is try to keep them comfortable.