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?

Thanks. I guess they might put me in rehab centre for a week then.

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.

If he's making a normal recovery and is otherwise fit, he shouldn't need that level of care, and it could be counter-productive, in that he'd be likely to move around less than he would at home.

You need to discuss this before your op date

My dad paid for a private consultation for his first hip replacement. Very active in his younger days and wasn’t even able to walk to the shop for his paper. The pain meds were starting to affect his liver and kidneys. He had been waiting years. Late 60’s at this point. He paid privately and the consultant put him on his NHS caseload and he had it done within 2 months. Had he of waited any longer, the damage to his organs off the pain medications would have been irreversible and life threatening. It was the best £400 he ever spent. 5 months after the first op he got the second done. He was treated like a king the entire time. Physio was literally within 12 hours of the operation and he wasn’t to leave until he met some milestones. Recovery was hard at home but so worth it. He’s early 70’s now and has a new lease of life.

I had two hip replacements in my early 60s, one private one NHS. I was in the same hospital and had the same surgeon for both.
In neither case did I get a private room or any follow-up care beyond a phone call from the surgeon a couple of months later.

On the positive side, both ops were very successful and I didn’t require any personal support at home, just a bit of assistance with shopping and laundry.

I work in a private hospital and had both hips replaced by the time I was 51 due to osteoarthritis, luckily I had private health insurance.
i would definitely recommend your dad goes into respite care for first week or two.
I my package I had a private room, physio as soon as I was able and stayed in 2 night.
6 outpatient physio sessions were included in the package but I only needed 5. I had a follow up appointment with consultant at 6 weeks plus wound check appointments with nurses at 2 weeks.
I know forget these are the hips I wasn’t born with, I’m able to ride my horse and 2 weeks ago I did a sky dive for our local hospice. These were with my consultant’s blessing

My Dad was really quite poorly and in hospital for nearly two weeks after his. There were no complications, the operation went well, but at 83, he didn't bounce back in a few days like he'd been led to believe. The healing took a long time and made him feel quite ill in the process.

If he can afford it go for after op rehab care in a home. My mum had her knee replaced last year, NHS but in a private hospital and the aftercare was minimal. It took her a lot longer than she expected to get her mobility back and frankly it was awful. She needed loads of care and it was a real strain on everyone.

But he would have the 24/7 support from qualified staff that he may need. If he is doing well he can return home. It is just an option and better than going home with no support x

i had mine done at 51 years old the first week was like I’d been hit by a bus and I was like a newborn kitten , helpless . By week 3 I was ok on one crutch and doing most things by myself but I was 51 . Also there is no aftercare from the NHS only follow up appointments. It’ll be a slog for him but my god it’s made my life soo much better

NHS nurse here. If you've got the means to go private and not wait so long it's the best option. His recovery will be quicker if he is going from active to active again instead of if he waits, it slows him down due to pain etc and then his physiotherapy afterwards is further away from his baseline. You can also get extra private physiotherapy which I would highly recommend if he is able to.

Hips are increasingly being done as day case operations these days and usually with good results. That said, someone who's nearly 90 is less likely (but not totally impossible) to be one of those cases. Generally speaking, where it's safe, the less time someone that age is away from home the better - it really doesn't take much to become institutionalised and end up needing more care. If he were my relative I'd want to know before going ahead that the anaesthetist doing the list thought it was a sensible idea/know what the back up plan is if there are any problems. I'd probably want them to put some numbers into the risk calculators so that he has a rough idea of some of the issues that may arise (including softer things like functional decline even if everything goes completely to plan/ post-op cognitive impairment etc). In the NHS he'd quite possibly be going through a high risk clinic to discuss all of these things, but that's less of a 'thing' in the private. I'd also want him to see physio/OT pre-op and to know if there is anything that may help in terms of pre-hab/ what's available to him in his post-op care/what might he need to pay extra for (and how long does that take to organise). I'd also remind him that just because he's paying for it doesn't always mean it'll be better. Hips in octogenarians can be life-changing (in a good way!), but come with some slightly different issues compared to younger customers, and 3 weeks isn't long to identify/plan for those.

Are his feet in good condition?
Any foot problems ( long nails /thickened nail/ callus/corns) will affect his mobility as he tries to recover .
Might be worth an appointment with Podiatry ( probably private as NHS is limited )

And his footwear - no sloppy worn shoes . If bending is difficult , a Velcro fastener is ideal . ( Check the brand Cosyfeet for shoes and slippers )
One of those "grabbers" to pick up small fallen items without bending -some have a magnet .
Can be used to hold a shoe steady and if the velcro is tricky , it can be used to help fasten this .

Slip and Trip hazards indoors . If you can get him to look round his house . Rugs , loose carpet , random things that are in the way .

If he needs the op he should get it, and at his age as fast as possible. Temporary bedroom downstairs. Most importantly, does he have a downstairs toilet?

My dad had his hip replacement done privately (a bit younger than your dad though and he was fit and well at the time). He was out of hospital within a few days. Aftercare was 2 or 3 private physio sessions. He didn't need any personal care when out of hospital and didn't need a lot of pain medication after a week.

It might depend on how fit/ mobile your dad is prior to the operation?

I’ve had patients in their ‘90s get new hips

NHS provide physio and OT at home following discharge here

DH has his hip done privately, shop around for a deal which is an all inclusive set price so you get the aftercare and physio included - also covers any infections and unexpected care needed. Does he have ground floor toilet and sleeping arrangements? If he does, I think he'd be ok

@Blushingm I'm amazed at how well my Dad (88) has recovered since his partial replacement this summer, he's going on holiday next week! OK, it'll be a relaxing break, he wouldn't be up for alot of walking, but he's fine.

My Mum has had 3 knees now.

The first 2 privately in her early/mid 70s and then when one was worn out in her late 80s with the NHS as an emergency as it was loose internally and she was in danger of falling, breaking it and making matters worse.

TBH little difference in care or the operation of either. In both they got her up quickly, made her exercise and gave her exercises.

Advantages of private for her - a carpeted room, a more relaxed atmosphere + cups of tea for visitors. But these are minor.

Follow the instructions - MIL's 'boyfriend' had a new joint - told not to go home into a low slung car and to be careful. What did he do - went home in a low slung car. Popped joint out and was in agony.

If he waits there is more danger of a fall - either his or your Mums.

All the best.

Also - consider getting a stairlift. My Dad needed one but after he died we considered removing it as my Mum was fine.

But we kept it, she got used to using it, its operation became habitual. She used it until she started living downstairs, dementia meant she forgot it was there and climbed past it both up and down.

My mother had a new hip on the NHS at 87. She was still walking regularly so it wasn’t too bad and she still had very good muscle tone. Because she didn’t want her children to be tied up looking after her, she paid to go into a nursing home for 2 weeks to be looked after post op. The NHS offered a physio but there was nothing else .
im so glad she made the decision to pay for extra care . She was in a lot of pain to start with and, she needed help for everything. They helped her with her physio and she ended up staying a third week even though she didn’t like it there.
when she finally moved home she had carers coming in every morning for a couple of weeks to help her dress.
she is very much a “just get on with it” sort of person and I think she was surprised at just how difficult the recovery was. It would have been very hard looking after her at home and I would have found it extremely difficult
personally.

Yes, that's what I did. Nuffield Leicester did an all in one price, but knocked off £500 off as I lived too far away to use their physio. I am covered for any glitches that might pop up afterwards such as infections.

I moved my husband to the private wing of the NHS hospital after he had an emergency operation in the NHS wing. The NHS ward was chaotic, very noisy and under-staffed. In the private wing he had an en-suite room and if he rang the bell he was attended to straightaway. He was under the same consultant. Another plus was that the phone was answered promptly. Surprisingly the food in the private wing was nowhere near as good in the private wing. All in all I think your dad would do better going private especially given that you are not nearby. I'm not sure it’s relevant but we already had health insurance in place. I hope your dad does well whatever you decide.

OP here. Some great advice here. Really appreciated. We are trying to convince him to go for respite care to the local nursing home. He is not keen on the idea but I’m hoping may come round after seeing the consultant again. The surgeon is discussing with the anaesthetist, the anaesthetic is a worry. My mum had a GA a few years ago at 81 and was very confused for weeks. Am I right in thinking that the hips can be done with a spinal block and sedation? Someone had posted about baseline fitness, my dad hurt his back recently and his hip has been worse since, mobility has suffered so sooner for the hip is probably better. He is very headstrong and has decided he is doing this. Just need to ensure we can cope with the care after.