Dad age 86 private elective hip replacement

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My Dad has been a very active man his entire life but his arthritis has got significantly worse over the last year. He has been on an NHS waiting list for 6 months for the assessment appointment and it would likely be another few months wait for the procedure. He has decided to go privately and they have offered him a slot in 3 weeks. He is desperate to get it done. I’m really concerned about the aftercare. As it’s private I suspect they won’t provide it the way the NHS does? This hasn’t been discussed with him. He lives with my mum who also has mobility issues. There house has bedrooms upstairs. I’m an hour away with a full time job and young child. Can anyone provide advice on care in the private sector?

My mum recently had one, she's 83 and there was no real aftercare from the NHS to be honest - she was sent home very quickly.

Did you need to provide any care? How quickly was she mobile again?

I don't think there is much difference apart from the timescale. I was quite shocked that after my dp paid £££ for surgery, they were sent home with a link to an app for physiotherapy exercises as aftercare, which was a bit crap.

My Dad (88) fell over the summer and had an emergency hip replacement. I'd suggest that they look into local homes that provide rehabilitation care. My Dad went to one for three weeks - he was supposed to go for six but decided that he was fit enough to go home early. The physios came daily to do his exercises with him, and I think it made a big difference.

Edit to say that personally, I think that's the safest option given your Dad's situation. Your Mum can't really look after him and neither can you. I felt alot better knowing that my Dad was safe and being looked after immediately post-surgery.

If he’s paying privately, then he’s got to pay for staying in the hospital
I would’ve thought that would make them less likely to ask him to leave before he’s ready? Also, if he can pay for care and private physio, then he can have those things?

It sounds like you’re more concerned that it’s happening privately. I would be more concerned if it was happening on the NHS.

I haven’t seen anyone experience this surgery in their 80s, my mum’s friend had it in her 70s, but she was very fit and well. She’s very pleased with it.

My DH (60s and fit) had one privately last year. Lots of advice, walking sticks, cool packs, painkillers etc. The real challenge is the 2 to 3 weeks after. Needed my help dressing, showering, doing the exercises, (essential). I would worry that your mum wouldn't be able to deal with it. Stairs not easy.

The care home next to my DM’s have a lot of elderly people stay for 2-6 weeks after a hip replacement. It’s a care home that does a lot of rehabilitation.

Exactly @Whatshitnow. That's why my Dad went to a rehabilitation place for three weeks. He's alot bigger than me so I couldn't have provided the necessary care (showering, etc.), plus having the physios come daily made a big difference.

My mum’s had both hips and both knees done on the NHS. However, all four ops were in a private hospital. I suspect the care was identical whether you paid or not.

I would check out the local NHS community therapy teams/intermediate care teams and have a conversation with them. He will need to plan for downstairs living. He is also likely to be on hip precautions so would need equipment for that....NHS could provide but there would likely be a delay so he may need to fund this privately. I would ask the private provider what aftercare they offer, PT, mobility aids etc. I would also research local care agencies so that the information is on hand should extra support be needed at home

Gosh I’m surprised they gave an 88 year old a hip replacement. I’m pleased to see he’s doing well that’s incredible, good luck to him

My dad in law had his hip done on the nhs (one of them twice) plus other joints like knees. one hip was in his early 80s. He was well looked after. Had great care and physio, recovered well and was out of hospital and mobile quickly because it was much better than before. He was also a determined fit for his age guy.

I know NHS care is hit and miss but it can be ok.

I should add he did have sons nearby to help him and his wife as needed. But he was a tough cookie.

Sounds like more info is needed from the private hospital but every extra will be charged accordingly.

My mother was 80 and lived alone. She had a private hip replacement and then went to a private rehab facility for a week. It was excellent. It was like a luxury hotel with physios. Would this be an option?

As previous answer, our experience was very little aftercare within the NHS. Discharged with exercise sheet once back on feet and able to manage a few stairs. Would imagine it wouldn't be much different in private.

You may want to consider arranging a carer for the first week at home (hour in morning, hour in evening is standard), but obviously your dad would need to agree, many are reluctant.

Private physio would also be a very good idea. The NHS aims to get you back to "good enough" function but as your dad is active, he should aim over and above that.

I've had 2 private hip replacements. One at age 60 and the other last summer, aged 67. Both at the Nuffield hospital in Leicester. I was offered physio, but as I lived too far away they knocked £500 off the price so I could buy my own physio locally to my home. The consultant sees you again at 6 weeks post op and 6 months post op. They provided crutches which I returned on my 6 week appointment.

My MIL had a hip replacement at 84, spent around a month in hospital followed by 2 months in an NHS/Council run 'hospital to home' care facility.

She had been a very active person but Covid lockdown ruined her walking fitness which meant recovery was slow.

It's very common as the hip is often broken in falls in older people. It is somewhat risky but there isn't really much choice because if it isn't replaced after a break it is unlikely to heal at all and that person won't walk again.

I’d definitely consider respite/rehabilitation in a care/nursing home. He will be encouraged to be active, do his daily exercises, take any medication at the right time and dose, and be well fed. Plus it will have the advantage of him having more social interaction than at home. This is just as important for his recovery as the exercises. If he is at home it’s too easy to put off something that feels too much, such as having a shower or getting dressed. If he’s got carers looking after him he’s more likely to do as they suggest.

I would get him involved in choosing which place he goes to (perhaps don’t visit those offering dementia care); put it to him that he’ll be helping his DW and he can treat it a bit like a holiday for him. I’d look into how you can arrange for your DM to visit him (if she doesn’t drive, perhaps ask if any of her friends can give her lifts or recommend a reputable local taxi firm). Most homes will be happy to provide her with meals too (for a charge), so they can have meals together - she’ll know he’s being well looked after and he won’t feel abandoned if she’s able to visit most days. And make sure it’s clear to your DF how long he’ll be staying and if he can leave earlier than planned if he feels able to.

Go for it and if required pay/arrange for any after care as needed.

TBH - I would be more worried about having it under the NHS which is a broken mess of a system.

My mum had hers done on the nhs at 89. An OT visited the house before the op to see if it would be suitable for her to return there - it was. There were things they could have offered if needed, forget now what they were.

They got her up and mobile in hospital very quickly after the op. The physio saw her on the ward and gave her some exercises to do. They also checked that she could go up and down stairs before they discharged her.

At home, the district nurse visited a few times to give the blood thinning injections. She did the exercises. She had a few follow up appointments at hospital. Hospital transport was provided, but there was a lot of waiting around and she felt confident to get the bus after a couple of appointments.

Just to add, Mum's op wasn't after a fall, it was due to joint pain and reduced mobility. She said the consultant said her general level of fitness was better than many much younger people.

I had both hips done on the NHS in my 40s and there were septuagenarians and octogenarians having them done on my ward. We were all got up very quickly once anaesthetic wore off and discharged as soon as we could walk with crutches (manage stairs if we had them at home). Hips are very straightforward procedures nowadays. Far easier recovery than most other joints. The most important thing is to do the exercises for at least 3 months afterwards to train the muscles around the hips which helps them support the joint better and future mobility (vital for future health outcomes).

My mum had a hip done privately last year and there wasn't much follow up - although there was a 24/7 number to call to the hospital in case of worry. They also offered physio sessions weekly after discharge but she couldn't do those as the hospital was quite a way from home.

What made a huge difference to mum was doing the pre op physio exercises and building up those muscles. You will also need things like toilet seat raisers and litter pickers / grabbers which he may not be provided with. A proper armchair with arms he can push himself up from. If he lives alone, we were told to move the basics of cup, mug, plate, cutlery from high up or low down cupboards onto the kitchen worksurface, bending is to be avoided.

Mum is stubborn and was determined to do things for herself. She stayed in hospital 2 nights and once discharged home, had someone with her for another 10 days. Immediately after discharge she was able to take herself to the loo, have a shower, dress herself (using the grabber for pants and socks). The aim is to encourage them to do as much as they can for themselves, without overdoing it.

To add - what made things so much easier for mum is that her house is all on one level and she has a walk-in shower, not a shower over the bath.

In your situation, a team of private carers, or going into a home for rehab might be easier for everyone.

Had various relatives have hips done. Key thing (and even more so for knees) is the physio afterwards.

NHS now shows you what to do and expects you to get on with it. Sounds like this is what some on here have also experienced in the private sector.

If this is likely to be an issue I'd look into private physio sessions post discharge to get full function. The person I care for did fuck all physio post op and has had a very poor result. It makes EVERYTHING hard as their mobility is so limited.

And is yet another facet in our complicated relationship as at the time I located a physio with availability but it wasn't utilised and now 8 years later the shitty capacious decision comes back and makes my life harder. Like so many aspects. But I derail.

The care home they are in regularly accepts people for rehab stays. I met one of them the last time I was up visiting as she had come back to visit the friends she made while in which was nice all round. And gave me a slightly scary insight into my own life as she was relatively young but lived alone and simply recognised that going straight home alone was going to be too hard. Therein lies my future.