is thorough, on topic, substantive and demonstrates you have read the post of the student you are responding to Should Mary's family members authorize the double hip replacement?No, I do not believe

 is thorough, on topic, substantive and demonstrates you have read the post of the student you are responding to 

Should Mary's family members authorize the double hip replacement?

No, I do not believe Mary’s family members should of authorize the double hip replacement. This is not due so much to her advance age since there are many very active 87 years old seniors that would benefit from this.  It is due to her condition deteriorated physical condition.  She is in a wheelchair most of the time due to her arthritis, has a heart condition plus she suffers from diabetes. These factors make her is a high-risk patient due to medical complications. Just the fact that she has diabetes, she is more likely to suffer from infection after surgery, slower healing than normal plus heart problems.  Also, the arthritis will not help when it comes to the recovery part of the post-surgery making physical therapy extremely difficult.  Furthermore, the heart condition will play a factor when she is put in anesthesia.

What factors should be considered?

The factors that should be consider are first her age. The older a patient is the higher the risk for any operation. Then there is the diabetes which brings complications of its own to anyone that suffers from it. Some of them are slower healing, infections and heart problems. We also know that she has a heart problem that would compound the issue when it comes to general anesthesia. Finally, there are the last two factors that go hand in hand that will play a factor in her post operation. There is her arthritis along with her mental condition. These two conditions will make it very difficult to due physical therapy to insure a proper recovery due to the pain she will be in. Also, her mental condition that makes her withdraw from the real world will compound that problem with the recovery.

Who else, if anyone, should be considered?

This is a somewhat a hard question to answer. The first person that should be considered would be Mary since she is the one who is having the surgery. The problem here would be her mental status which can make her response very hard to assess how she feels. The seconded person I would consider would be the surgeon that will be doing the procedure. S/he would be the best qualified in this scenario to say what would be that outcome of the surgery and what are the risk in having it or not having it.

What are the implications of that decision on the parties involved: Mary, her children, the facility staff?

The implications of the decisions would be as follow. For Mary who is the one most affected would be the continuation of the deterioration of her health.  If she does not have the surgery, her hips will get worse as the time goes by. On the other hand, if she does have it. She is a very high-risk patient. For her children would be the ramifications of either decision since they are in a non-winning situation.  They will have to consider the pros and cons to better their mother’s health. Since she can’t make it on her own. The last would be the staff who will have to care for the patient in worsening conditions of try to give acute care along with prolong care for Mary’s recovery.  

References:

Pratt, J.R (2016) Long-Term Care Managing Across the Continuum, 4th edition