Following hip replacement surgery, it is crucial to get physical therapy, rehabiliation and follow the doctor's order, to avoid, re-injuring the hip.
Exercises to Get Better
It's key that your parent follow the physical therapist's instructions and those of the medical staff in the rehabilitation center. Your dad, the tennis player? He's motivated to practice walking on his own because he believes it will get him better faster. If he goes about his exercises wrong, and if he has what are called "weight-bearing restrictions," he could put himself most at risk for injury (at risk for fall, at risk for dislocating the hip joint). And walking or doing exercises with no supervision means he is likely going about it incorrectly—his eagerness can actually hurt him in the long run.
And what about your cognitively impaired mom who is suddenly baffled by being in a strange environment and a walker at her bedside? The rehabilitation center staff likely will clip an alarm to her clothes to alert them immediately should she attempt to get up without assistance. Her care plan will include fall precautions specifically designed for someone with cognitive impairment. The staff will explain as often as necessary why she has a walker and why she needs to call for help should she need to get up from her bed (the rails will be raised while she in bed) or chair. As caregiver, one of your jobs is to reinforce that she is not to get up on her own and why she has a walker. However, you can be certain that your parent with cognitive impairment is not the first to come through the rehabilitation center; the medical staff is accustomed to working with people just like your parent and will do everything possible to ensure his or her safety.
A physical therapist is the safest and best bet to ensure that your parent is doing the proper exercises, walking correctly, bending the right way, and not overworking any muscle group. Partner with yours.
As the caregiver, ask plenty of questions. If you feel that your loved one is not progressing at the rate you expected, ask the physical therapist questions. Additionally, most rehabilitation centers have a social worker on staff. If you notice something else is going on (depression, unwillingness to follow physical therapy exercises, loss of appetite, etc.), speak with the social worker about your concerns. These professionals have seen it all before and can help you navigate through these issues.
Perhaps the most important thing for a caregiver comes at the point of discharge from the rehabilitation center: Now what? Will the rehabilitation center have done "enough" for your parent to come home? Will you be equipped to handle your parent? What do you need to know? The physical therapist will teach all of the things that your rehabilitating parent will need to know so he or she can function safely and properly without risk of injury at home. As caregiver, you will want to take part of this so you know what to expect at home.
Occupational therapy recommendations/teachings may include:
- How to pick up things correctly
- How to tie shoes correctly (or, switch to pull-on shoes without laces)
- How to reach for things correctly using a long-handled grabber
- Wearing an apron around the house to carry items
- A tote to hang on the walker
- Using special pillows underneath knees to prevent injury/maintain comfort
- Using a special, long-handle device to pull on socks and a long-handled shoehorn
Prior to discharge, your parent's home may require certain modifications to ensure the safest environment possible. At an absolute minimum, your physical therapist should make the following recommendations:
- Grab bars in the bathroom (tub/shower area as well as by the toilet)
- A long shower hose
- Shower bench/seat
- Raised toilet seat
- Sturdy handrails on all staircases
- Removal of all area rugs/other trip hazards (including bath mats)
If your parent has a comfortable recliner, try to set that up as "home base," because that may be the center of their universe for several weeks. In fact, he or she may decide that is the most comfortable place to sleep. Keep everything that they will need near the recliner. You may even consider a portable commode if it's a long walk to the bathroom. For the first few weeks, everything may feel like an exceptionally long walk.
Remember, there is no "set" time on how fast one is going to heal from hip replacement. Ultimately, the goal is to eliminate the pain and increase mobility.
If you notice a change in mobility, contact the doctor.
5 Issues to Consider Following Hip Replacement Surgery
It's time for mom or dad to have that problem hip replaced. You've found the right surgeon and made plans for the surgery and hospital stay. You're ready, right? Let's make sure you know what to expect following the surgery and subsequent discharge to the rehabilitation center.
As with any surgery, anesthesia has the potential to linger in anyone's system for quite some time. Remember, nobody's system is accustomed to surgery and anesthesia; the body requires time to heal from both. Add to that the trauma the body endures in replacing a worn or shattered hip joint with a manufactured one, and the body requires more than just a few days in the hospital to recover. In the hospital, your parent was encouraged to drink lots of water to flush that anesthesia out of his or her system. In the rehabilitation center, that should continue. As caregiver, you should encourage this to help promote the healing process.
Understand that your parent is going to be uncomfortable. Depending on the person, overall health, and the situation he or she was in prior to surgery, some will be more uncomfortable than others. At the rehabilitation center, the physical therapist and medical staff will work with your parent to prop pillows in bed to make him or her as comfortable as possible and prevent injury (dislocating the new joint). However, the surgery itself is going to cause pain. As the caregiver, you'll need to advocate for your parent. Don't be afraid to ask for painkillers or ice packs to ease the discomfort. While heat is generally not a recommended therapy following a hip replacement, it can offer temporary relief for those who aren't having much luck with traditional methods. It can't hurt to ask if this would be a good option for your parent. The physical therapist will advise you of the care plan and the best options during the rehabilitative process.
Depending on your parent's age, cognitive abilities, and activity levels prior to surgery, the hospital staff may have had him or her up and walking immediately. At the rehabilitation center, this will be the most important piece in the rehabilitative process: walking. For many people, this can be a slow, frustrating process. For others, this can be a slow, rewarding process. Others breeze through it. But one common thing is that everyone starts using a walker.
Even if your dad was playing tennis three days a week prior to surgery, he is going to start off using a walker. This can be a tremendous blow to someone who was very active. For your cognitively impaired mom, it can be very confusing, because she may not understand why she suddenly must use a walker. Both of these individuals are most at risk for injury. It is important for you to know the physical therapist's care plan for your parent so that you can be your parent's partner and cheerleader. Each step is a milestone, and they will need to know they're doing great.