Broke a Hip, Now What?

You HAVE TO FIGHT! For your RIGHTS! TO DIE IN AMERICA!

By Julie A. Franklin

Written, Reluctantly, Without the Benefit of AI, in a Post-Apocalyptic World

So, it turns out, that when it comes to an old person you love who was fine the week before but ended up tragically (killing a spider, reaching too high, doing too much, thinking they were 67 instead of 83) falling and breaking a HIP, you have to be hyper aware.

First. One must ensure that they (*your loved one,*)  has previously engaged in an asset protection plan, years before. If not, be prepared for the fact that whatever they own in the form of real estate, property, and bank accounts will be considered in a medicaid application determination with some exceptions, so if you did not foresee this happening more than five years ago because you hate looking at the negative and enjoy your loved one and thought, rightfully so, that they would thrive and survive…

#YOUDIDITWRONG.

# GETREADY.

Objectively, there are certain inalienable truths to the world in which we occupy. You are born. You suffer. At some point, hopefully, you experience joy. But in any event, you eventually die. Planning for this occurrence, knowing what you know, being privy to the sort of human conditions that you were unequivocally made aware of, (with you as a witness, of your great-grandparents, possibly your grandparents, and perhaps your actual parents passing out and refusing to speak or breathe, effectively…) dying before you, this health care agent is going to be either you OR your siblings, or your children. You MUST plan for this inevitable fact, but only of course, when you are lucky enough to call your early 60s young and you were omnipresent enough to handle the situation, at that time.

So when you, or your loved one, cracks their femur reaching to dry a handwashed garment and wobbles to their fall when they try to hang it on a light fixture, and they go in for surgery, you both need to make sure you have some things.

1.      A Health Care Directive 

(A document executed and/or in favor of, given to someone who is not going to inherit from the loved one’s estate because to do this would be objectively a great way to murder people for gain, witnessed by 2 disinterested witnesses and depending on the state, may be required to be notarized. Georgia and South Carolina do not require a notary and their standard form is freely available for download.)

Here's the link:

Georgia: https://aging.georgia.gov/document/document/georgia-advance-director-health-care/download

South Carolina: https://aging.sc.gov/sites/default/files/documents/Legal/SCHealthCarePowerOfAttorney.pdf

Note: These are the forms available on the state websites as of June of 2026. Depending on when you read this, check the state's website to make sure you have the most current version, they do update them from time to time.

  i.      DO YOU KNOW WHY YOU WANT THAT?

1.      Because there are 2 or 3 people present that witness whether the individual signing the document is with it, (OR NOT), and these people, who are not related to you and do not stand to inherit from your loved one's estate, therefore cannot profit from their passing.*

*NOTE OF IMPORT: A lot of times though, a notary doesn’t know you. The people that witness your signature also don’t know you. These routine witnesses, they don’t ask you questions, they literally (if they do it right) require you to pull out your state issued driver’s license to prove your identity, a thing you’ve been doing since before you can remember, and if you can do this, you passed the threshold.

SECONDARY NOTE OF IMPORT: If you know for a fact that your loved one has been diagnosed with dementia and/or you know that they do not understand what they are doing, they should not sign this document, nor should you encourage them to. If you find yourself in this position, you need to reach out to a local qualified probate lawyer to guide you further, as you will probably need a conservatorship and guardianship over your loved one, especially if they do not understand what they are signing, as soon as possible.

2. If your loved one is on serious pain medications and cannot communicate whether they wish to have surgery, their designated health care agent can do it for them.

Did you know? that a surgery on a broken hip in an elderly person really needs to occur within 12-48 hours of the fall for the maximum possible success? And even then, there's no crystal ball, so it is ABSOLUTELY necessary to act as quickly as you can.

2) Hutzpah. Be prepared to fight back.

Turns out that health care systems are governed exclusively by insurance companies, and insurance companies are run on actuary tables, and therefore they give LESS THAN ONE-HALF ZERO thoughts about your 83 year-old rockstar’s particular health and well-being. In fact, as de-regulated as they are, the more you die, the less they care. They’ll get paid, or get your loved one to the place where they have died, and will still try to get paid.

And if, and when, they seek to discharge your 83 year-old rockstar, verbally or via writing, fight back.

Fundamentally disagree. Even though it breaks your absolute heart to allow them to stay in this facility where you know that everyone isn’t getting paid enough (thanks Mamdani for giving us a new hope, this is some star wars new hope up in NYC lately, I’m all about that), you have to fight to keep them there.

Make it clear that you can’t handle this new healthcare development on your own.

Seek help and assistance, ask who you can reach out to that may be able to provide your loved one with a new front rolling walker, accommodations above and beyond the current living arrangements already, and the possibility that if they are not skilled nursing, at 2AM on some errant Thursday your loved one will move about the cabin, disable the videos, not trigger the sensors, and die so that when you go in for breakfast the next day, they are dead and cold in their tracks, and it will feel like it is probably your fault.  

GROSS. So another thing you need to know.

3) Your Loved One is NOT READY to be discharged. 

But their attitude, or their money, isn’t right.

Because the money man from the facility has bottom line requirements, but YOU KNOW they can’t come home, get the number of the appeal third party the MOMENT the facility verbally or in writing tells you the discharge date, make sure you ask how long you have to appeal, and do not delay. CALL THAT NUMBER.

Fun facts:

b)     When the facility calls you and says that they have to discharge your loved one, tell them you disagree with their verbal notice and will not accept said notice unless it is in writing. In that call, ask for the date (AND TIME, write it down) that you are required to appeal, and ask for the phone number. Write down the number.  HANG UP and call the appeal people.

c)      Tell the appeal people that your rockstar can’t come home for necessary medical reasons, that they cannot function at home in their current state, and they need to remain in the facility because they would medically benefit from additional SUPPORT services, including to the extent they would prefer, OT and PT or skilled care.

d)     An independent physician who is not monetarily compelled by the facility weighs in on the case by virtue of the appeal. When they agree with you, you’ve WON the appeal.

4) This is STILL NOT ENOUGH. REQUEST FROM THE FACILITY IN WRITING EITHER LONGTERM CARE OPTIONS THRU MEDICAID PENDING APPROVAL OF SAID APPLICATION, OR A REFERRAL TO HOSPICE THROUGH EXISTING MEDICARE.

You need a few markers for hospice. Substantial weight loss. Ulcers. Contractions. Dementia. Find a liaison subpart Medicaid group (that is basically a “no kill shelter,” in the sense that they will work with you and your loved one even if they last longer than six months) and work with them, and once you have found a liaison group, put in writing to the facility that you want to be referred specifically to that group. Sometimes these parties can be paid through existing medicare, and medicaid is not needed. Ask.

IF the facility due to the regulatory requirements send you documents and demand you do something, look it over with care and if it isn't the best option for your loved one and your family, decline, put your preferences in writing back to the facility, and start making phone calls and doing your research on better choices, including reaching out to the dedicated physician/social worker at the facility and asking for third party assistance locally in the area to help you.

5) ALWAYS BE PREPARED TO DECLINE.

Let’s get serious, the fight is not with the staff, so don't be rude to them, you need them and they are doing the best they can in the system in which they operate. If anything, it's with the large scale accountant, be it medicaid, medicare, or a third party insurance company, so your fight ultimately is with the accountant. The business side of things and the regulations that make this a problem for you, your loved one, and the facility. Make those powers that be spend so much energy trying to get rid of your person that they quit because you have done everything right. Don't give up.

6) Get absolutely everything in writing.

YOU GOT THIS! Life is hard, wear a helmet. If they raised you up, you can help them by gracefully assisting them to stand down. Believe in yourself! Go YOU!!!!