Logistics of hip replacement rehab

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Thinking ahead here as DM has only just gone on the waiting list and has been told 18 months. We are investigating private options but she lives in rural Scotland and has no private hospital within 2 hours drive.

I live 2 hours drive away from here, I have a sibling who lives in the south of England so is considerably further. If mum goes down the NHS route and has her op in the hospital closest to her - what happens about rehab? She cannot come to my house as we have no downstairs loo. Her house is all on one level - but would I be expected to move in with her for weeks or months to support her recovery? Would carers be organised? Selfishly, I cannot simply put my life on hold to move 2 hours away for weeks on end.

Also, my dad died a couple of years ago after having dementia for a good 5 years, mum was left just to get on with it on her own and there was no support from carers at all. Partly because it was just assumed mum would step in and she never made a fuss about it.

Interested in hearing from others who have been through similar with a parent who lives a distance away, with no other family close by.

They may try to persuade you to move in, but don't. They have to provide what she needs - which is likely to be a few weeks in intermediate care (rehab hospital or residential care - in England this is often called 'discharge to assess')) with intensive rehab and an assessment of her capability, followed by visiting carers at home. The first part should be funded by the NHS, the second may need to be self funded depending on her finances.

It shouldn’t be weeks - my DO had his hip replacement last year. He is much younger than your DM (I assume! He was 49) and generally very fit, he needed help to get to the loo etc for about two days, then he could get around okay.
the Dr said for less fit patients it can be a few more days, but everyone should be at least hobbling around and using stairs within a week unless there are other mobility problems.

The only other mobiity issue is that she needs both hips done but they will do the worst one first. And she's 80!

They'll probably try and make you move in but there's no need.

Mine went into a care home for two weeks straight from the hospital, then local friends/neighbours drove her to physio and check up appointments.

She has absolutely no need for a care home usually but it was the only realistic option for the first two weeks.

Ah, I was assuming from the 'weeks or months' part that she had other care needs. But yes if it it's just hips they try to get people back on their feet pretty much the next day.

So it should be hospital/rehab fur a week or so while they assess the result of the operation, get her moving and do a home assessment. Then discharge home with whatever mobility equipment the OT decides on, plus maybe visiting carers for a few more weeks.

And don't even consider taking her back to where you are - long distances in the car aren't feasible straight after surgery and it causes no end of problems if there are complications, infection etc as they're not near their GP or the hospital where they had surgery.

They get mobile pretty quickly after the surgery but we found the problem was getting meals (even microwave ones), carrying drinks, doing laundry.

My grandparent had 2 hips done without us ever moving in with them or them with us.

They had the OP, were discharged to a rehab hospital. They had daily physio etc there and were discharged home alone once they hit certain criteria. For example can do a flight of stairs if they have stairs at home. Also had to prove could go to bathroom unaided, get themselves drink/food.

I was discharged three days after surgery, and the physio I had in hospital included managing stairs, so by the time I went home, I was ok to get up and downstairs. They gave me a thing to raise the toilet seat, so that was not a problem. I could walk enough with crutches to get to the local shops. About the only thing I couldn’t do was drive. I did my own clot-busting injections, and I was given a gizmo to help put on compression stockings, as well as a grabber thing for picking stuff off the floor. My daughter stayed over the night after I went home, but I was fine and sent her home because I didn’t need any support.

if your mum is otherwise independent, fit and well, I don’t think you have anything to worry about.

I am self-employed and work volume comes in peaks and troughs. I have no way of knowing whether I will be at a quiet period when she has her op. I am happy to help out with laundry and cooking but not prepared to offer personal care with dressing/showering and my mum would be horrified at the very suggestion. She lives in a small village with a strong community ethos and my first thoughts is that I would be able to visit every 2-3 days as long as there is someone checking on her in the meantime (mum has funds to be able to pay someone).

Reassuring that other oldies have bounced back quickly.

At every point in the process, your mother needs to make it clear to the orthopaedic team that she has no family at all who can provide practical help. If you visit, that's a bonus. They will then work out if it's more cost-effective to have her at home with carers coming in, or in a residential home for a few weeks after the op. Do not let her tell them that you'll be up every few days or suddenly they'll put all the caring on you.

My mum had a hip replacement recently. She was widowed earlier this year so lives alone. She has other mobility issues- she’s had several operations on her feet. It meant that ‘normally’ she’s mobile at home/pootling about, but gets pain if she does too much/isn’t as steady on her feet as someone without the problems would be. She was very worried about falling (with the added stress that she’d be alone/no one would know). She didn’t have downstairs washing facilities and as her house is very old the stairs are narrow, steep, uneven and twist around.

We had a slightly different situation in that she was an NHS patient, but sent to a private hospital. She asked about ‘reablement’ etc (someone on here kindly told me about it), but the hospital weren’t at all helpful.

Luckily she had the finances to self fund going into a care home for two weeks post op.

It is very expensive (I think it was 1.7k a week), but it meant that she was safe and cared for.

Like you I couldn’t cope with looking after her here with kids/work/two large bouncy dogs/no downstairs bathroom.

They said they’d send someone out to look at ways to help her cope but only once she was already home from hospital. They did… but it was about 4 days after she came home to do the assessment and then the week after when they came with the aides. We’d bought/borrowed some things in the mean time and I visited every other day when she went home to help with the things she couldn’t manage.

Id definitely try and get things sorted in advance if possible, and like everyone else has said do not say you’ll be doing any of it, or before you know it, they’ll have presumed you can do all of it.

OMG my MIL is booked in for a hip replacement in two weeks and is staying with me. She thought she would be bounding around and going home the week after the op, is that not the case??

For one hip I brought my mum up to me for the 1st week, for the 2nd she had 2 weeks of carers arranged by the hospital so I just popped in.

She recovered quicker on the 1st (as she was a few years younger) but I was fairly brutal - she needed to be able to do everything for herself if she could as she was going back to her own flat. I was there purely for safety and for the few things she actually could not do initially. She went up and down our stairs from day 1 (which was Day 3/4 post op)

I think the carers running round after her on the second actually discouraged her from doing some things herself that she could actually do (make herself lunch/get herself dressed) etc. because who doesn't like being looked after.

Both times she had a trolley/frame/toilet seat raiser from Occupational therapy which helped.

Everyone has different circumstances so it may look entirely different for your mum and I don't know what is available post op in terms of carers/follow up by community team - this was England.

Have dropped my DM off this morning for a shoulder replacement.

The lady in the bed next to her was going home after a hip replacement, was over 80, had been in 6 days and lived on her own. She was a bit nervous but glad to be getting out. There was much discussion between her and my DM about them being 'old school' and getting on with things.

I'm staying with my DM for 2 weeks post op and our plans are based on the fact she can't move the arm already, so post op won't actually be worse than she is now.

Just bumping this thread... due to the lengthy NHS waits we are trying to persuade mum to have the worst hip done privately. She has funds for this, but is reluctant to spend the cash. We have persuaded her to come to the nearest city for a initial consultation, no-obligation, see what her options are etc etc.

Going private would mean we would have the flexibility of arranging the operation at times to suit me and sibling, and we could arrange for one of us to be there for the first two weeks at the very least, possibly longer. The ONLY concern is that the hospital would be a 90 minute drive from her home - would it be feasible to put someone in a car after a hip replacement and drive them for 90 minutes? Could make stops along the way, but still.

You might not get much flexibility though, although you would presumably be able to say if a date didn't suit you and get another one.

I had private surgery last year and the surgeon only operated at the private hospital one morning a week so it had to be on that particular day. Other than the initial appointment which I booked myself online, I was sent appointments for checks and surgery by text message and allocated the next available slot for those.

I had a THR six months ago. From my experience, the first four weeks were quite brutal. I did all the recommended exercises, but was still in a lot of pain.
I was not allowed to bend more than 90 degrees for 6 weeks. Had to sleep on my back for 6 weeks also.
My DH helped me to get dressed during that time.
I cant imagine those first few weeks without having help to do meals & household chores.

Also in Scotland, but Edinburgh. FIL had his hip done by the NHS, and arranged for a private carer to come morning and evening for 2-3 weeks after as he was alone. He paid for it himself. TBH the hospital went much use, they just kept pushing SIL too do it all 🙄 He was very resistant to it but DH and SIL insisted. SIL popped in at lunchtime every day for the first week to get him lunch.

it worked out fine, he actually enjoyed chatting to the carer (who was from Fiji).

A hip replacement doesn’t require weeks of rehab or reablement generally speaking. It is very much not the same as breaking a hip and needing care afterwards.

Is your mum very frail? By and large patients stay in hospital two to three days or until she has met her goals (able to mobilise independently to the loo, kitchen etc). I haven’t heard of our team pushing any relatives to stay for any period of time tbh and by large most patients do better post op as their pain is gone. Breaking a hip or being admitted following falls is a very different scenario though.

No she's not very frail - but she is almost 80! Still trying to organise the initial consulation and we'll take it from there.

My mum is staying with me after a hip replacement following a fall. She's 75.

Your mums house is all one level so that's a bonus. My mum has been told no car journeys until an assessment of the car is done - had to get an ambulance home and I can't take her out yet.

If I'd not have taken over care then there would have been carers 4 x a day for washing dressing feeding etc. I don't know if they do laundry etc but mine is complicated by incontinence so washing definitely needed.

She came home with a raft of meds too with some complex instructions including self administered injections.

It seems the recovery process is going to be long. No bending at the hip for 6 weeks. No showers until bandage removed. Started with a push along walker that can only be used indoors, not moved to crutches yet as mum is very nervous of them. But we are only 9 days post surgery. We've been told 3 months to be back to normal. It's complicated by the fact that mums house has only a bath upstairs and really steep stairs. Downstairs is two rooms so not ideal. There is no indication as to when she will be "allowed " home or what the criteria is for that. It was mentioned that swapping homes is actually more difficult as they have to asses you each time.

It's really disruptive having her here and she's driving me crazy but I'd imagine recovery alone would be a very lonely process.

DF had his 2nd hip replacement at 79. He had it done privately but was in for longer than anticipated due to the wound seeping. His old neighbour is a retired Consultant Anaesthetist and a word from her got his medication changed and he was out 18 hours later. She collected him by car, however, she may be good at knowing drugs but she is a terrible driver and the trip took well over an hour. He was fine physically from the journey.

BiL stayed for one night as he was passing through, then I went the next day and stayed for the weekend. DF only needed help with putting his socks on and those awful compression stockings. He lives in a ground floor flat and already had grab rails etc everywhere. He borrowed a trolley thing with sturdy handles so he could make himself a drink, put it on the trolley and wheel it to his armchair.

DF's 1st hip replacement was done under a GA when he was 57. The 2nd was done under a spinal block, so he recovered very quickly from it. He was back driving quite soon afterwards as it was his left hip and his car is automatic.