About hip replacement?

[hippidyhiphip]

Mother is in her 70s. Her neighbour 3 doors down is 85.
Her neighbour is having a hip replacement in a few weeks time and they are sending her home with no care plan and with no family the day after the operation.
Consultant has said as long as she can climb 3 steps then she's allowed home. My mum is at the end of the phone for her friend, but I'm worried she's taking too much on and she'll be roped into being a carer.
Friend lives in a cottage with very steep narrow stairs to the upstairs floor. She has no bed or toilet downstairs.
Does anyone have any experience of the help her friend may need? She's happy to cook friend meals etc, but not the idea of intimate care etc.
Will she be able to climb up to bed, make food/snacks, get on and off a toilet for example?
Should there be a care package in place?

I've just been told it's 2 nights she'll stay in hospital. But I'm still concerned for her.

My mum had a hip replacement and the 1st night home had to have someone with her (me) the seating needed to be a certain height so when sitting the hips above the knees, my mum had a toilet seat and a stool thing from occupational health - a nurse came in for about 2 weeks to inject her, 9 months later had the other one done

Definitely , especially if she lives alone. She'll need dressings changed, occupational therapy input to assess heights of chair/bed etc plus any equipment needs and possibly carers to help with self-care short term. Are you sure she has not said she will manage and has someone available to help?

She, or her relative should ask for an OT assessment with regard to managing on her own after the op. She should refuse to be discharged until this is done and the OTs have said it is ok.
The best your mum can do is be very clear what help she is, or is not able to provide.

There should be some discussion and involvement of an occupational therapist to look at height of loo/ chairs etc.
Is it nhs or private? Your dm needs to make sure it is known by the hospital what she will and won’t do.

I didn’t have hip replacement but a different type of major hip surgery. She will be taught how to go up and down stairs with crutches before being discharged. She shouldn’t need help with toileting, just as PP mentioned, adaptions to help her keep her hip in the correct position to begin with.

I'm wondering if she's said she'll manage and has neighbours (ie my mum) to help.
My mum said about her needing injections and how she'll be injecting herself for 2 weeks after.
She's said she's not got a care plan or having any carers in, as if she can climb 3 steps then she's fine to go home and look after herself.

Her friend will need an occupational therapy assessment so aids and adjustments like a bed downstairs can be arranged if necessary. She will probably be able to manage most things re her personal care if she otherwise able but might need help with dressing, especially the stockings if they give her them.

In short she’d probably benefit from some care for a little while and should ask her GP how to access it. Home from hospital care is free for 6 weeks I believe.

I think the problem is that she thinks she'll be fine on her own and doesn't want carers coming in. And she thinks my mum popping in once a day for 10 minutes will be all the care she needs. Not that my mum is strong enough to do physical care anyway!

This is very unlikely to be true
The hospital have a duty of care
She's not the first elderly person living alone ever to have a hip replacement. Systems are in place as a routine.

They will have to assess that she is able to care for herself before sending home
There will obviously be support
District nurses to do injections
Commode issued if no downstairs loo
Reablement care package
Community physio

As long as we are taking UK them this stuff is as standard

It can only be true if she had capacity and declined the help

I'm really hoping they'll send a district nurse out after, as if she is needing additional help then I'm sure the nurse will try to organise something!
Mums friend is very independent and thinks she'll cope absolutely fine, but I'm just worried incase she does need help.

How has someone in need of a hip replacement been managing with a narrow staircase and no downstairs loo before the op?

Honestly hip ops are such a standard planned thing that all this discharge stuff is in place as standard
You get sent home with the chair raisers and stuff and the district nurse is made aware
No way do you just get left to it

I actually think that if you declined in advance to have any post discharge support they just wouldn't do the op.

Not sure how she's coped. She's still out driving to the shops most days and very independent so I didn't realise she had a bad hip.
All I get is this second hand through my mum.
She needs to stay 2 nights in hospital, if she can climb 3 stairs in hospital then she's fine to come home and climb the 10 or so steps in her house so doesn't need a loo or bed downstairs.
She's had a new bannister fitted a couple of weeks ago as she previously only had one on one side of the stairs.
She has no family and has asked my mum to pop in once a day!
I'm more worried about her 3 cats tripping her up and sending her flying.

DM 81 had a hip replacement in October despite Covid she was in hospital for over a week
On discharge day she was taken home by ambulance and met there by OT and physio as well as me - they then assessed her in her own home
They said she needed a frame round toilet, perching stool in kitchen, commode in bedroom for night use and raisers for sofa
Plus 4 care visits a day for first 2 weeks
All the items were delivered by 5pm and the care package started that evening
I was very impressed with the service provided
DM was managing quite well so care visits dropped to 3 then 2 a day over first 6 weeks
Then with our agreement stopped
Physio appointments were done over zoom so one of our family had to be around to set that up for her
DM had recovered full mobility by mid January and was passed by her GP as fit to drive again
Physio checked up on her still but discharged her in March

Oh wow.
She's asked my mum to take her into hospital and collect her and take her home, so I'm hoping she still gets the same kind of support?

That's honestly what I'd expect

Is she having the operation privately or via NHS?

It's via nhs. I'm really hoping she'll get the OT and physio meet her at home the day she is discharged.
I know no one has been to her house so far to put plans in place.
All my mum knows is that her friend says she won't have carers going in because she won't need them. Hopefully this will change if the OT sees her home set up.

I had hip replacement, would not have managed on my own at first. Needed a hand to get in and out of bed. Needed both hands on sticks at first, progressed slowly to just using one. Never had any visits from district nurse re dressings getting changed, had to do it myself. They did supply raised chair and thing for over the loo. They did an assessment after the op but had to collect chair etc. Didn’t have blood thinning injections just a tablet to take along with other meds. She will need more help than your mum popping in.

I’m sorry if I come across as snippy but do you honestly think that the hospital would merrily discharge an elderly lady with no thought to how she’s going to cope? Thousands per year have hip replacements and the vast majority are elderly.

There are pre op discussions as to needs and requirements, care plans cannot be finalised in advance because less or more may be required, and both OTs and physios have to sign off as safe to discharge. So yes if she has three steps to navigate that will be part of it, but so will the ability to self care in that individuals circumstances. Lots of patients can self inject otherwise DNs go in.

On the other side, she may have refused additional support and then there is nothing the hospital can do if she’s a competent adult.

When my mum had hers done, the OT visited beforehand to see what aids, if any, she would need. The District Nurse visited daily afterwards to give injections. The lady should be able to get herself up and downstairs and use the toilet and manage personal care. My mum soon abandoned the crutches and used a stick. She managed better on the stairs holding onto the bannisters.

She'll probably be sent home from hospital with some exercises, and it's important that she does them. She should also keep mobile around the house as much as she can.

The only thing she shouldn't attempt at first is cooking where she needs two hands to lift a hot baking dish or saucepan. So your mum could see that she's stocked up with ready meals and things to make light meals.

Sorry reading that back that is entirely snippy and unwarranted. Apologies!

The physio and OT are unlikely to go to her home and will rely on her imparting information. I totally understand that you’re concerned that your mum may be left struggling to help and that’s the origin of your worry. The best thing to do is encourage your mum to Crystal clear as to her limits of help and, if the lady passes on her details to the therapy teams, she is also realistic to them. They do usually ring and check with the nominated person that they are in fact happy to do everything the patient says they are.