Dad age 86 private elective hip replacement

Indeed. If money was no object I would have paid for an extra couple of days beyond the third day, partly so that my late husband, who had had two strokes in the previous years, did not have the burden of looking after a post-op patient.

After being discharged, I received a phone call 24 hours later from a nurse to discuss any problems I might be having with mobility, my incision and pain control.

Then I had a follow-up appointment with nurses two weeks after discharge to check my wound and remove the dressing, which was the type that isn't removed for two weeks. I had some leg and foot swelling on the operated leg and a doctor was called in to assess for possible DVT. I hadn't been instructed to wear compression socks by my surgeon as they are not always recommended now but had been sent home with 12 days of daily self-injected blood thinners. (I was shown by the nurses how to administer these.)

At six weeks post-op, I had a follow-up with my surgeon. I also had about four appointments with the hospital's physios over the 12 weeks after discharge and also had links to their online exercise videos to do twice daily.

Before my op, I had been given a list of all the equipment I would need at home and I acquired most of this before I went in. I hadn't bought a toilet frame but found I did need one and ordered one next day delivery when I got home.

I had already got two sets of crutches and took one pair into hospital with me but I had not taken in my grabber. The hospital gave me one which I was allowed to take home with me, so I had an upstairs grabber and a downstairs grabber.
These are also very useful for picking up socks and pulling underwear up once you are able to manage socks and pants, by yourself.

I was ambulatory on crutches the day after the op but also using a walking frame for support, especially when washing. I did not have a walker at home, but the hospital issued me with a basic aluminium walker to take home, which I did not have to purchase from them.

Something that hadn't been discussed much was the potential for a long period of foot swelling on the operated leg due to inflammation. My foot and ankle remained swollen for 12 weeks and during that time, I could not wear normal shoes. I had to order a pair of wide fitting shoes and a pair of wide foot slippers would also have been useful, but I made do with non slip socks. I used to do cold footbaths every day, too, to help with the swelling which would get worse as the day progressed.

Your dad will likely be advised to rest for an hour of two in the afternoons with his legs raised and also sleep with his legs raised. I used two of three stacked pillows at night and also needed an extra pillow to support the knee of my operated leg when lying on my left side, once I was able to sleep on my side. So buying extra pillows might be a good idea.

I was able to get up and down stairs once I was home with crutches and then with a single cane but I was much younger than your dad.

I wish him all the very best with his op and recovery. He might feel a bit low for the first week or two and he will need to keep on top of the pain and stick to the drug regime they will give him.

Next week will be the fourth anniversary of my operation and it was worth every penny (it cost over £15K) to regain my mobility and be pain free.

I'm sorry you felt rushed. I did expect they would charge for extra nights and I guess that puts pressure on you to 'feel better' if you're not wealthy.

My 87 year old dad had a hip replacement a few months ago. His local nhs hospital send the easy hip replacements to a private hospital (paid by the nhs). So he had his done at the private hospital. He got great aftercare - 10 sessions of physio. Everyone he knows who was deemed a complicated case and dealt with at the nhs hospital got no physio and no aftercare at all. So from what I saw the aftercare at the private hospital was much better.

I’ve had two major ops in the NHS and had a single room with bathroom both times. Just lucky, maybe.

In private they'll probably be in less of a rush to get their bed back so I'd imagine in that respect it'd be better not worse than using the NHS.

I wouldn't bank on it. Four years ago, I had a self-funded total complex hip replacement carried out in a private hospital. I was 69, so not as old as the OP's relative. I had posterior approach and through my choice, I elected to have it done under spinal block, not GA.

I was booked in for two nights with the expectation of discharge on the morning of the third day but I managed to get an extra night as I did not feel well enough to be discharged after just two nights. Had I wanted to stay beyond the extra night, I would have had to have paid extra for the room and for the nursing care as I was considered fit enough to be discharged.

There's a lot of misinformation about elderly people having such surgery. If the benefit outweighs the risk and you're fit and well enough to undergo surgery you'll get a hip replacement at any age.

Does he have any significant underlying health conditions? The main difference is that private services cherry pick the healthy punters with a low anaesthetic list, and anyone complex is safer done on the NHS due to more back up. If well, private likely to be fine.

I think you are right to ask the question. Private care doesn't cover ICU should things go wrong they hand you back to the NHS. MIL paid for a hip replacement privately and ended up with a DVT so moved to NHS hospital.

Some good advice here. I wonder if it's worth a discussion with the GP about what the NHS could offer with aftercare? It's not an uncommon situation and he would be saving the NHS some cost.
Either way the mobility and physio after the surgery is crucial for the best long term outcome.

@AlexandraCarrington Absolutely agree with this.

My mum had two ops at different points in her 70s, my dad just one (do not live together)

I either went and stayed for a few days or they came to me. I was purely there as a safety valve/ motivation/ nagging. NHS arranged equipment - toilet riser, zimmer frames.

If they wanted to return to independent living they needed to manage their recovery themselves - and they did. They did it slowly and carefully but they did it themselves. They washed themselves, they mobilised, they sat down to prep food.

It took a bit of facilitation but 99% of it was their own motivation and work.

They continue to live independently now, 5-10 years later.

It’s common for very old people to have an elective hip replacement in old age, many are in their nineties.As long as they are otherwise fit, there is no reason not to have one, as it improves their quality of life.

Yeah I'm having surgery soon and my surgeon also works privately.

I'd think the surgery itself to be identical just you get a private room, nicer food, and you're not necessarily urged to leave the moment you're physically capable. It could even be in the same building/ campus.

You don’t need a plan for downstairs living. I had my right hip done by the NHS, they didn’t discharge me until I could use the stairs which is surprisingly easy. In fact, the physios are pleased if you have stairs!

I’m 80, and had a full knee replacement a few months ago. No GA, i had an epidural and deep sedation, far fewer nasty after effects. NHS overnight stay, walked and climbed stairs with physio before I was discharged the next day. I had DH at home for support. We have no downstairs bathroom, but I managed the stairs with a crutch and banister.

Follow up physio appointments at hospital, and within a few weeks the lack of pain when I walked meant throwing away the walking stick. Following the exercise instructions was important for a full recovery.

Sorry, I meant in terms of actual facilities at the hospital

The wait time is the biggest factor.

Surely the biggest factor is own room and bathroom?

My mum is 90 and has just had her NHS appt through for her hip replacement, its next month.
She lives in a bungalow, and i live 2 doors away. We're waiting for the pre-op appt.
She well definitely do all the pre & post op exercises.
She recovered really well from a full hysterectomy when she was 86, having found an ovarian cyst that was 17cm x 11cm.
I work part time and have taken some time off to be around, although she'll be keen to be up and about as soon as she can

My mum was looking into having hers done privately - she'd got as far as ringing the hospital and asking how much it would cost and was on the verge of making an appointment - when the nhs contacted her and said could she come in next week, because a lot of people were cancelling and they had space.

I agree, the main difference is the wait time and you get tuna sandwiches with the NHS and prawn in private hospitals. The surgeon may well be the same person in either setting.
He will need a plan for afterwards wherever he gets it done.

FIL had his done age 80 ish, he did it privately and paid for some sort of convalesence home for 2 weeks after, the physio saw him everyday and 2 years down the line it's really improved his quality of life,

I can't see why paying would get you worse aftercare? They keep you in the hospital til they can see/prove you're physically well enough and mobile enough to leave. In private they'll probably be in less of a rush to get their bed back so I'd imagine in that respect it'd be better not worse than using the NHS.

He can go to a rehab or get home carers to help while he recovers? If it isn't smooth sailing.

Based on family experience, please check who will be doing the op. In the private sector surgeons can be operating after they have stopped doing them on the NHS (even if they are still there as consultants). Ideally, you want a surgeon with very up-to-date skills.

Is he having anterior/posterior/lateral incision?
It will make a big difference to the rate of recovery.
Anterior is what I had and recovery was very easy.
https://www.osmc.com/blog/anterior-vs-lateral-vs-posterior-hip-replacement-what-does-it-all-mean/

Neither Fil nor mil really recovered - I think the general anaesthetic messes with the brain in older people.

A lot of help is needed: someone to organise raised toilet seat, shower stool, basin seat etc (all available from Red Cross but you need someone to fetch them.)

An elderly spouse is not much help; buying in assistance is the best option if someone lacks dutiful offspring!