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?

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

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'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.

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.

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.

DM(83) had a private hip replacement 6 months ago. She lives alone, on three floors, so DSis moved in (unemployed, single, adult children) for 3 weeks. DSis was a strict but effective nurse on making sure DM ate properly, did her exercises, took her drugs, kept her surgical stockings on and generally looked after her - and walked the dog. DSis can’t drive, so I took DM to her wound care clinic, physio sessions and check up with the surgeon.

Having DSis on site was superb. By the time she went home, DM was confidently mobile, and pretty much able to do everything except bend down for the washing machine and change her surgical stockings. I visited after work for another 2 or 3 weeks, after which DM was fed up with the sight of us!

DM was not allowed home from hospital until she could do stairs. The hospital physio taught her how to do this with crutches, but she needed an “extra” night in hospital to be strong enough.

DM said that the pain of surgical recovery was nothing like the hip pain she’d been in. The hip pain was gone immediately.

DM had 3 x hospital physio sessions post surgery, and that is genuinely all she needed. These were included in her “package”. The key is to do the exercises you are discharged with, but not too much at once and build up.

DM found that the painkillers she was sent home with really muddled her head, dampened her appetite and made it difficult to wee. She perked up a lot when she stopped taking them after about 5 days.

The hospital provided one set of crutches, one toilet riser and one walking frame. We found it helpful to get an extra toilet seat riser so that both toilets had one.

DM felt she was functional after about 6 weeks, and pretty much back to normal after about 3 months. Now at 6 months, she is fitter and stronger than she has been for years. Her surgeon was keen to emphasise that he was doing the surgery for pain relief, any improvement in mobility would be a bonus.

Sounds as though your sister did a great job. Good to hear that your DM has had an excellent recovery. Getting a bad hip fixed really is life changing.

I have worked in both NHS and private hospitals.

The main thing I would be considering is what if something goes wrong. In the majority of NHS hospitals there are full intensive care facilities who can care for patients when things go wrong either during or after surgery whereas in the majority of private hospitals there are none of these and if something serious goes wrong they will often have to call an ambulance and transfer the patient to the NHS.

When your DDad goes for an initial consultation about his hip, it’s worth finding out what’s included in the cost. For DM, the extra night in hospital, aids, physio, wound care clinic and all the drugs she needed were included in the price as a package.

DM chose the surgeon whose NHS waiting list she was on (it was 12 months for an initial assessment, then 9-12 months on the surgical waiting list), so he had access to her X rays.

DM had her op in a small private hospital, so another concern was access to A&E if needed. The surgeon reassured me that they had a resuss room on site, and also an ambulance to take patients to the nearest A&E of needed (12 mins away).

I hope this burble of our experience is helpful. Key is doing the exercises!

You know what. There is no love lost between DSis and I, but respect where it is due, she did an excellent job, and took a lot of heat off me. She lives abroad, o live half a mile away. We tagged teamed well!

Other aids I found helpful after my op was a step to help get in and out of bed (I have short legs and a tall mattress). I bought this one which is very sturdy and can also be used when getting in and out of the bath - once you are safe to have baths:

https://www.essentialaids.com/bathroom/bath-steps/adjustable-height-bath-step.html

and for anyone who wants to eventually return to gardening or kneeling, one of these. Four years on, I continue to use mine as the one thing I do find a bit tricky still is pushing up from a kneeling position if there is nothing to hang onto:

https://www.amazon.co.uk/janoon-Garden-Kneeler/dp/B07JK3YSVY/ref=asc_df_B07JK3YSVY?

I also ate plenty of protein in the weeks following my op.

Yes, proximity to NHS facilities in the event of an emergency is a consideration.

Fortunately, the private hospital I used is just across the road from a large NHS teaching hospital. My private surgeon also works for that NHS hospital and had access to my X-rays, CT scan and MRI reports and NHS blood tests and he was able to liaise with my NHS gynaecologist, as I had co-morbid gynae stuff going on plus recent anaemia.

Did you pay privately for the physio too? Or was that provided via the NHS?

@Littlefish I'm pretty sure they were provided by the NHS. I don't know for sure as my Dad handles his own finances, but he likes moaning about spending money so I think I'd have heard if he had to pay for the physios. 😂 I think they saw several people in the care home, not just him.

You can use a private provider on the nhs, waits are much shorter. He will need support afterwards

Thank you. My reason for asking is that following a month in hospital after a badly broken leg, a 10 day wait for a surgeon, a 4 hour surgery to repair it and then multiple infections eg pneumonia, UTI etc exacerbated by his obvious symptoms being reported by us, but not acted on by the nursing team, my dad is just at the point of being discharged, hopefully to a care facility for rehab. We’ve been told there will be ‘regular’ physio visits, so I’m just interested in what that might be.

I’m hoping to speak to the physio team tomorrow to get some further clarification on timescales, physio expectations, possibility of visiting the home pre dad’s discharge etc.

It will depend on the hospital. I had a private knee replacement surgery last year. All physio was covered for as long as I needed ( I probably had around 10 sessions… with exercises for me to do at home ). Plus 2 follow up appointments with surgeon. A friend of mine had a hip replacement and her husband was away on business after her surgery. She went into a private rehabilitation centre for a week after the surgery. Worth checking out these options. ( I’m in the South East England,) my hospital was part of the Nuffield Health group.
wishing your father all the best.

My mum had a hip replaced this year with NHS and she is 86. She also has a partner with mobility issues but they live in a small bungalow with lots of adaptions. She only really needed help with transport and shopping.

Sadly, the after care is pretty much a postcode lottery and depends on the NHS services available in your area. I know 10-20 years ago, things were better, sadly not now.

Would your dad consider going into a convalescent home or a local nursing home, where trained nurses are available 24/7?
It would be just for the first couple of weeks after discharge. He could stay longer if required. He would have access to the physio and the nursing staff would be able to keep an eye on him. It would also take the pressure and worry off you and your mum? Just a thought!

MIL early 70s had a private hip replacement. She was sent home 48 hours later (I dont think she should have been). DH stayed with her the first 48 hours and SIL the next 5 days as she lives alone.

She could get upstairs on the first day but did struggle getting back in bed in the night. Her first appointment back with them was approx 2 weeks after the operation and then another a month after that. So not much after care.

I’m on the waiting list and live alone. Do you think I will be able to manage stairs that have no bannisters/handrails?

I can’t face the idea of a commode!!!

Sadly, I think initially, it is unlikely you will be able to manage the stairs on your own. What would happen if you had a fall, who would be able to help you 🤗

Could you have a bannister/ handrail installed? I’ve just had a knee op and use I crutch and the bannister Would be dangerous otherwise. You will also need some help for a while with housework, cooking etc.Also a frame around the toilet and a toilet seat raiser will make going to the loo a lot easier

Are they walking exercises?

It would be a real shock to the system for a very independent person to be in a care home. I'd suggest arranging some homecare for a fortnight or so and arranging for a local private phisio to visit to offer support with the exercises.
I used to run a homecare service for a charity and we often took bookings for care after hip surgery. A lot of the care booked was cancelled as the service users made a much more rapid recovery than they expected.