Knee replacement at 85

[Barney16]

Has anyone's parent had a knee replacement? And could you tell me what their recovery was like? My mum is determined to investigate whether a knee replacement would help her, admittedly shocking, mobility. She has a consultant appointment next week. I'm completely baffled by how her recovery could be managed. I have asked her about how we would manage and she just says she doesn't know. I suspect she thinks that I and my children would rally round. I am an only child, I work full time and live three hours away. My dad is alive but very frail. Literally every time I try to discuss it she just says she doesn't know and changes the subject.

Could she afford a nursing home for the recovery period? My DM's friend who has no family did that after an operation. It was vastly expensive though.

Thank you for replying, I hadn't even thought of that but I will do some investigation. They could probably afford it but I suspect she will think her family should do the looking after. But I'm going to check out anywhere local to her that may offer short term stays.

There’s also the question of who would care for your dad (if she is his carer).

My aunt recently had a knee replacement and my 78 yr old mum stayed with her for 7-10 days to look after her. My uncle, who’s disabled, went into respite care for 2-3 weeks while aunt was in recovery. Social services helped arrange that but I’m not sure who paid. Since he came home, carers have been coming twice a day as she can’t physically manage to get him washed / dressed etc even with the knee replacement.

When my FIL had a hip replacement and no one available to help, we / he hired a private carer to come morning and evening with SIL popping in at lunchtime. I think it was for 2 weeks. He paid for that.

PS she will be asked as part of the preparation to confirm that someone will be available to help her at home, but our experience was that her reply will be taken at face value. So if she says family will do it, they will not probe further. You may need to be explicit with her, both about her own needs and who’s going to look after your dad while she’s out of action.

When my MIL had an accident and was temporarily immobile, she had a live-in carer for a few weeks. This was because she was main carer for FIL, who had dementia. If she'd lived alone, I think she would have gone into a convalescent home instead (they had one nearby).

MIL had a knee replacement at a similar age. She stayed with her children for a week at a time before returning home about 4 weeks later.

Her problem was that she didn’t do any of the exercises. We got a physio to come to the house a few times, but she never continued exercises. Her knee pain has gone but her mobility is terrible. She can shuffle with a walker but struggles to get out of a chair and do basic other things eg dress herself. She’s been in a care home for the past year but she is now 90.

My mother had her two knees replaced at 89 (and 11 months) and 90. The +11m is important because there would have been greater reluctance to give a 90 year old a general anaesthetic for an elective surgery. This was in France, where they also provided a month's residential rehab each time to support her rehabilitation supervise her exercises. She was 2cm taller afterwards and pain free for the first time in years. She is now almost 99 and still living independently. Thinking about it, that might not have been possible without the knee surgery which rescued her from painful and debilitating immobility in old age.

Your poor mum. I hope the hospital will ask her properly what her arrangements are for when she goes home and only operate when something is in place.

I have had a total knee replacement. It’s possible to manage alone with good planning but it’s hard. The leg will neither bend nor straighten completely at first and it’s painful. Several weeks before moving around is easier. And it’s important to exercise regularly. Sleep is rubbish and the drugs are strong. Ideally your mum would have help for at least a fortnight.

My DM had a shoulder replacement at 84. Like you I'm an only child and live miles away.

I took 2 weeks off work and she was in hospital for one of them and at home for the second. Our main take away was that she was masses better after the surgery as her debilitating pain was gone. Also that I spent most of the second week ordering stuff from Amazon to make her life easier.

I was really impressed with the set up in hospital who were very experienced at operating on frail elderly people and getting them home safely. My DM hired a private carer but if she hadn't, she would have had the reablement team instead.

As she has an appointment, you need to be very straight with her about what care you and your family can or cannot provide.
If that’s nothing - that’s what it is, you can’t pay the bills with thin air. The consultant may be able to advise on respite care for both her and your DF.

I’ve had both knees replaced, ten years apart. I am not young.

in my experience one absolutely must do the exercises. They are extremely painful to do, extremely painful, but if they’re not done the consequences means the NHS have wasted thousands on the patient! Take pain relief regularly but wean off as soon as possible. I hardly took any.

Think of the internal workings of the knee as being like wall paper paste. It’s loose and slack but if you leave it to stand it thickens up and is difficult to work with. That’s what happens to the knee. Everything has been disturbed, tendons, muscle etc and need exercise to stretch them and get them back in shape. It’s a killer!

On discharge after 2 nights in hospital, I could manage, with care and my crutches, to do the stairs. I could move around and make simple food before I needed to rest. Ready meals, sandwich and tinned soup. It was massively painful to bend legs to lower onto the toilet! Breath through it, like childbirth!

Ice packs were my saviour. After any exercise in house or elsewhere, I put feet up frequently and wrapped ice packs around knee. You can buy the knee wraps from Amazon. They bring massive relief.

I was out in the fresh air outside my house within 4 days of discharge, walking with crutches in the lane outside. I walked with crutches along a sea front on my 10th day. Not far, not fast, accompanied by my partner.

So, with care and determination and the exercises, it will quickly restore pain free mobility. I am now at the gym x3 per week and I regularly swim. I’m not young.

It will be wise to press the medics for aftercare/carers availability but if the patient is not feeble of mind, they won’t starve because they must get up out of bed or chair and use that knee to move around!

Mind over matter. Mind over matter. Feel the pain and do it but dont over do it!

My father had a knee replacement at 85, and an ankle replacement the previous year- different leg. The hospital will make sure you can walk, and climb and descend stairs before you are discharged. Eg, there’s no need to have a bed downstairs, which Dad did need to do with his ankle. A toilet frame is a good idea for the toilet, with a raised seat if needed. They don’t cost much. Doing the exercises is crucial. And the ones you find hardest are the ones it’s most important to do. It’s possible to manage by yourself, with some aids and simple meals prepped. But getting some carers to drop in for a week or so might be handy.

Yes there are private facilities that offer post-surgery care and rehab. I know someone who went for six weeks but she was very rich and posh! As pp said, ££££ but excellent care offered.

I think you need to Google something like “in-patient knee surgery rehabilitation near me”

If the exercises are done right, it can make all of the difference in the world to someone’s quality of life. I’ve seen it happen!

There’s often reablement teams who help - occasionally with home care but with OT and physio

Thank you so much for all your replies. I think I may have been a little bit pessimistic about her potential op. I know if they say yes she will definitely go for it and I think I was imagining she would need assistance for a long time. My dad can see to himself, his mobility is better but not great but he wouldn't be able to help her. He's already worrying about it. He keeps saying oh you can just stay upstairs which has already made her cry once. I will speak to my children. I can probably take some carers leave and some annual leave. On a broader note I find it very hard to help them, basically they have told me what to do my whole life and they don't really like it is that's reversed in any way. I feel their need for help and support, when I try I get rebuffed. It's very odd.

My MIL has had two knee replacements over a period of eight years apart.
The second one, surgery back in February, has taken longer to heal as she’s older now (81) but the pain she was in meant her life was severely restricted.
Post op is a very long process for the knee, much worse than the hip.
She needed a lot of support in the months after it, not overdoing it and damaging the soft tissues.
FIL was run ragged as well as help from family members taking her to appointments and doing shopping runs so if there is no one to look after her at home you will to look into how much a nearby rehabilitation centre would cost.
Unfortunately is a long slow healing process!

It depends on her attitude really - if she’s determined it will work, and she grits her teeth and does the physio, it’s probably worth it.

If she needed to sleep/live downstairs for a while - could she do so?

for the medium to long term I would be thinking about having a cleaner in to help the at least once a week (maybe you could align it with timing of online shop arriving so the cleaner could help unpack). Especially for the heavy difficult jobs like taking out the bins to the kerbside and changing the sheets.

I found the consultant had zero interest at the appointments in how my mum would manage after. However it turned out he knew the system worked.

Grit is definitely important. A lady was going home after a hip operation the day my mum arrived. She explained she lived on her own, had reablement coming but was worried- but she was very proud of being in a generation that just gets on with it.

I know you’re asking about knees not hips but I had a hip replacement at 57 and my mum had one at 83 nearly 3 months ago and the recovery has been, unsurprisingly, massively different.
After two weeks, she said to me that she realised she hadn’t really taken the operation seriously!
She was totally unprepared for the pain, absolutely couldn’t ‘grin and bear it’ as suggested upthread, and has said (at this point in recovery) she will never have the other one done.
I am very much hoping that at some point she decides it was worth it.

Not the same, as my Mum had a hip replacement this April at 89. However I had exactly the same worries beforehand as you do now. My mum lives on her own in a bungalow about 15 minutes drive from me. I decided beforehand to stay with her the week after surgery and then decide what was needed going forwards. What actually happened was that I stayed for 5 nights, and then visited twice a day for a week and then once a day for another week. Then once a week from then on. Mum did her exercises diligently, and still does, and started getting more active day by day. Her pain was considerably less after the operation than before, so that was a blessing. Mum is now charging about and doing great. I understand that a knee replacement takes longer to recover from, so factor that in.

Dear @Barney16

remember that you still get to choose how much you do for them.

I’m finding the same as you - for my parents it all goes one way, and they hate the idea that they might need help from me. They would rather struggle on and probably have a much harder time than they would need to.

When you ask her about recovery and she says ‘I don’t know!’ don’t let the conversation drop at this. Try and get them to talk about specifics for say at least 2-3 weeks off her feet. will she need a bed downstairs, who will do shopping / cleaning / laundry / cooking? But think about your own responses in advance - decide what hello you are willing and able to offer. If you aren’t, then be ready with possible solutions - private carers etc.

Mine had a hip done, but similar circumstances, although lived alone. She went into a residential care
home for ten days after (self-funded) as no one lived nearby who could help her. I managed to arrange to visit but couldn’t stay for a week due to my young family.
You have to be really blunt about what support can be provided, otherwise they can just assume you’ll do it! And the hospital will go along with that.

Mine didn’t bother with the exercises so didn’t get much benefit from the surgery. But she’s always been lazy.

Although she was mobile fairly soon afterwards, it was things like flat access to a shower/toilet that were needed. She could probably have prepared a very simple meal or hot drinks but wouldn’t have been able to carry them to a table. Wouldn’t have been able to manage laundry. Getting to appointments was an issue too as no driving for six weeks.

It may not be as bad as you fear. My father (78) was in this situation. I stayed with him for the first 3 nights, but after that he was on his own and managed perfectly well. He could get up and down stairs, although I'd assumed he'd have to sleep downstairs, and we stocked his freezer with ready meals. My brother stayed a couple of nights with him during the second week but he was already using only one crutch by then.

I’d forgotten Dad had a knee done late 70s. He was actually pretty fit before (could walk round a golf course but then had a cyst that burst causing a lot of pain). He recovered incredibly quickly. And I don’t think he needed help in the house (I can’t remember it being an issue and it’s less than 10 years ago). The contrast with mil was huge. Underlying fitness and mobility and willingness to do exercise will be key to recovery.