Mother sent home after knee surgery. Any advice?

My mom just had knee surgery too. 3 weeks out. 3 nights in hospital cuz she wasn't doing so well. 7 nights in rehab which was needed. Now back home with me and I guess it might have been too soon cuz she is a totally reluctant patient with me. FIghts EVERYTHING I suggest. Doesn't do her PT except when the guy is here to lead her.

Anyway, she should have gone to rehab right away. I don't know that medicaid would have paid unless she stayed in the hospital for X nights (2 or 3?). If there is any money, having rehab at a nursing home is probably her best bet at this time. Or a full time aid could be hired, maybe through home health services.

It's too much for one person to take care of at home. Is she getting home PT, etc.? I don't know why they send people home from the hospital to an empty home when they obviously can not take care of their ADLs.

Good luck!

Thank you for your reply. It sounds like we have a lot in common. My mom was in the hospital for 5 days because her oxygen was low after surgery. I wish the dr would have suggested she go to rehab. This job is bigger than I can handle at this point. I’m exhausted because I’m doing everything for her -she has no motivation. I can’t continue this. And my family at home needs me there too.

Check with her doctor about rehab, but get a raised toilet seat to solve that problem.

I had the same at 79 and did fine: important to have part-time help & someone to call. I also fixed meals & loaded up the ice box for my return. Good luck: barring any other infirmities she may do ok. She needs a walking aid, & most of all to just be careful.

Hope this isn't too harsh. I am thinking that if your mother didn't have someone taking care of her, she could do it herself. Unless she has some kind of dementia, at 75 years old she should still be capable of dealing with this. She may not like it, but we all have to do things we don't like. If she can operate a telephone and get on the internet, she should be able to arrange for help for herself. I am 73 years old and know many 70-80 year olds who still care for themselves easily. I think you need to tell her that she is fine, needs to deal with this for a while and will get better, perhaps help her make arrangements for food delivery, and then go home.

I had a knee replacement at age 60. It was the most painful three weeks of my life. After the operation I was sent to a nursing facility rehab for three weeks where I got intense physical therapy every day. There is no way I could’ve taken care of myself and I was not 75 or confused. The logistics of getting in and out of bed and off the toilet etc. cannot be handled alone. The hospital should never have sent her home, she needs ongoing physical therapy or that knee will never heal or she will not be able to bend it or extend it properly. Call around today and find a rehab facility where she can go. Insurance should cover at least three weeks. Do not wait any longer or it will be too late.

I work in Physical Therapy in a rehab. I can easily picture your mother and have a few suggestions.

During this initial recovery period, it's critical that she gets as close to daily Physical Therapy as possible to work on increasing her knee range of motion, strength and also safety with mobility. You can advocate for her by asking for as much PT as her insurance will allow. You can ask if she's a candidate for rehab if you feel that your mother is not managing her recovery well at home. Being in rehab is a bit tricky with the rise of covid, unfortunately nursing facilities have a higher risk of covid right now, though many are under scrutiny of state authorities to have a plan for infection control. If one can effectively recover at home, it's probably safer. I guess you'd have to determine whether or not she is being effective in her recovery at home. Ask for input.

If she does stay home, and if the PT thinks she's safe enough to be left alone for periods of time, you can look into having a home health aide come in part-time to heat meals and empty the commode. That would allow you to leave and take care of your own business. If she's not yet safe enough to be alone, then it might help to remember that this is a temporary arrangement, as hard as it is on you. Maybe there are others who can step in and help? I would also recommend her having Lifeline alert (button to press if she is in trouble). Ask the PT (or OT) for suggestions on walker baskets or trays that will allow your mother to carry items or a plate of food. She could practice using them in her therapy sessions.

If the pain is not manageable, you can have a conversation with her doctor/nurse about pain meds. Icing for 20 mins is also known to be very helpful.

If your mother is having trouble with her PT exercises, you could ask the PT what exercises are easier for her to do on her own so that she continues to work on range of motion and strength when the PT is not there. Very important. She should have pictures of her exercises and a plan on when she will do them. Everyone is different in how they recover from this surgery with different pain thresholds. With knee replacements, it is critical to keep working daily on getting the range of motion back or else the knee may scar down and need to be surgically released. That's the worst case scenario. The PT should be explaining this to your mother, but sometimes it needs to be said again.

It is easy to feel discouraged, but doing nothing is not the way to recover from this surgery. Perhaps the PT can think of ways to make her feel like she is making some gains and increase her motivation to participate. The more she can do in her own recovery, the better off she'll be and the less you will be needed. She may need you more at first and then gain confidence and increased independence as she continues to recover and the knee heals. Keep consulting with her medical team about her progress and safety and if they have a reasonable sense of how long she will need this extra watchfulness and assistance that you've been providing. Usually it's hardest at the beginning but gets better, but everyone is different in how long recovery takes, so ask questions and get some guidance from her team.

Best of luck!

She should have gone to rehab first.  They would have pushed her to do the exercises necessary and dealt with pain management.  Then she could have come home and you could have had a week with her to get her acclimated to her new normal.  I realize hind sight 20/20....

You're going to have to call her doctor and see what they can arrange.  When my mom had her knee replacement, they had rehab come to her house to work with her.  Buy a freezer full of microwave meals that your mom can easily heat for herself.  Have a deep conversation with her and explain that you can't stay there and that if she doesn't push herself and follow the exercises that the dr is telling her to do, she will have to go to a long term care facility to rehab.

If she has some mental decline, that's another conversation all together.  My mom was acting weird before her knee replacement, but we had no clue it was dementia.  I just thought she was being an a**. LOL  After moms surgery, things worsened and it became obvious that she had cognitive decline.  My mom was in her late 60's at the time.

I have a philosophy, to protect my pocketbook! I have had 2 knee replacements and two shoulder repair/replacement. My philosophy is: If anything is going to go wrong with these recoveries, it is NOT going to be my fault. I make sure I do my exercises as many times as required, make sure I watch where I walk (not on gravel), take my meds if required, etc. I think most people feel this way.

Unless your Mom is/was an active person able to take of herself, she should be in skilled nursing after knee surgery. My first knee replacement, the doctor insisted at least 10 days in skilled nursing. My second knee replacement at age 75, I told the doctor I could go home instead of skilled nursing, because it was important my husband not be alone. The phys. therapist came to the house for the first 2 weeks, like for your Mom. I was capable to do whatever I had to do ( I did not do housework or cooking, had meals in freezer, and was going for my walk in the street, down a slanted driveway the 3rd day after returning home.) But, I was in great health and able to do that.

Your Mom MUST do what she is supposed to do to be sure she gets better. Since she will not, she will NEVER recover from the knee replacement, it could become badly INFECTED, she won't be able to walk if she doesn't heal right, which is what physical therapy is for. Skilled nursing assures she will have medication for her pain, for sleeping if you talk with the doctor, and they also have a physical therapist who gets the patient out of bed to walk and do some exercises.
Please let her doctor know what is happening with your Mom and get him to agree to skilled nursing. Medicare paid for my skilled nursing as my supplement did as well.
Your Mom will also have to go to physical therapy after 2-3 weeks at home, and she must do the required exercises that the therapist requires she do at home every day several times. If not she will d*mn the doctor who did the knee replacement, and it won't even be his fault. Believe me, I know of this as one man I knew had multiple infections after knee replacement as he didn't do the exercises and his knee never healed.
Please consider what I've said here, as her pain will be worse than before the replacement and you can't damn or sue a doctor if you don't follow the guidance he has set forth for recovery. Lot to think about.

Call the Dr and her Insurance Co let tgem know she needs to go to rehab because you have to get back to your own home and it is unsafe fir her to be alone.

She'll need at least another 2-3 weeks help.

You could install a 4-6" booster toilet seat on top of her regular commode which makes it high any actually more comfortable to sit on then a bedside potty.

That's what I did for my 96 yr old dad but in the beginning when he was using a beside pot, I lined the bucket with a small plastic garbage bag which made it very convient to tie and dump. No cleaning needed.

You might also consider having a Caregiver come in a couple hours and she could empty the pot or bag.

In the meantime, but easy to fix microwaveable food. They sell breakfast and lunch meals.

My Dad loved the Jimmy Dean's Breakfast Sandwiches and their Cuzine meals.
Easy and Fast to fix and no plates to wash.

Hi, your mom should have been sent or scheduled by the doctor who did the surgery for some form of rehab/physical therapy. I would get back to them ASAP and follow up as to why she was not recommended for those services.
Best of luck.

"The Dr that did her surgery thought she would be OK going home."

Was that because you were there and told the doctor you would be with her at her home?

You need an occupational therapist in there, pronto. I'm surprised the PT hasn't already recommended this?

How much longer were you planning to stay?

First thought: put a booster seat on the toilet.

I think CTTN has a point - - I think doctor may have made his decision partly due to knowing daughter would be there. I've seen it happen where the doctor's impression of the post-op environment is not accurate but yet decisions are being made.

I know an elder who was discharged inappropriately after a serious medical event. She desperately wanted to go home. So, when asked if she lived alone, elder stated she did not live alone and while her statement was technically true..... The honest to goodness truth is that she had a renter staying with her. Not a caregiver - a renter. Renter worked a full time job and there was no expectation that renter would cook, clean, toilet, laundry, transport, meds or do any of those things that elder now needed done for her. Family, of course, did not know until much later that elder was asked the "living alone" question. Family scrambled like mad to assist elder but the discharge was a disaster in general.

I had a total knee replacement last June. I am 66 with Multiple Sclerosis. Medicare refused to pay for any in patient hospitalization. I was discharged in 24 hours. Went to out patient PT rehab 3 days later. It was incredibly painful for 3-4 weeks. Fortunately, I had wonderful friends to look after me as I was recently widowed. Someone stayed overnight into the 4th week. I used the raised toilet seat, rolater, ice, and ate frozen food. And I did the exercises 2-3 times a day. The recovery was long for me. I continue to have pain behind my knee with flex ion but do see signs of improvement. Walking is greatly improved with little or no pain. Hang in there.

I also strongly recommend the booster or extender that fits over the regular toilet. All waste is flushed and nothing has to be emptied. I am visiting someone this afternoon who got one after a surgery and she has been using it ever since.

Actually, I am sitting here and blessing her MD. Sorry/not sorry....but I am a younger (63/64) person who made it clear when I had an emergency situation of my own requiring a hospitalization and surgery there would be NO REHAB. I am a social worker for years and knew too much...mostly bad about those in our area. Day before discharge, I had a little trouble getting up and out of bed...the bullies, knowing I was going home to no help, convinced me to go to rehab...not even for that long as they said....so I picked one. It was beyond dreadful. With COVID no visitors allowed except window visits and the window had to be CLOSED. No help for my 100+ year old deaf father who uses and iphone transcribing app. They ran out of MILK! You had to beg for condiments! It was one of the worst mistakes I've ever made and you can be sure I never ever will make that one again. Scope out local agencies, particularly your local office on aging or the area on agency on aging. Google it and you will find the links. Find an agency with a good reputation and make arrangements for someone to be in 1-2 times a day....help up in the AM and breakfast, and making some easy to grab lunch before leaving, another in the PM for dinner and help getting into bed.
They make raised toilet seats, get one and a walker to get there if she needs that for support. Otherwise the aides will need to tend to the commode chair. And if it can be afforded, before you go, get a new toilet installed...they make them now at "comfort height" not totally raised, but higher than the old ones which is much easier on the knees. While you're at it, add in some guard rails so she has something to hang on to, and maybe an emergency alert button, just in case. Might not hurt to give the local fire dept the heads up, and oh, DO check on the availability of a knox box program with them. In our community a small deposit allows us to use one....these boxes will hold extra keys to the house...so god forbid there is an emergency, they don't have to bust locks or windows to gain entry. ONLY the fire dept has the master key so no one else can get in. With COVID, if it were my family member I would do all I could to keep them at home, and make sure you ask the agency what precautions they have their staff take. I would want the person wearing a mask, and hope your mom would cooperate and wear one as well. As far as I can tell, the only other alternative, is taking her home with you...and I can only imagine that you might need help with her there as well. Also, make sure the timing of pain meds coincides with doing any PT efforts. And don't overlook the PT effects of normal life! Walking was encouraged for me....it was wonderful when a friend picked me up and we walked...with me holding onto the shopping cart at a local store...I saw my stamina increase as we wandered aisles etc. wishing you both luck and love....Oh...and don't forget the possiblity of frozen meal deliveries so she has a stash of easy to make food, or meals on wheels....

My Mum had a knee replacement in September. She is 86, no dementia. She arranged for someone to stay with her for the first two weeks and someone to take her dog for a long walk each afternoon.

A few thoughts:

Toilet riser, we rented one from the Red Cross. Mum used it for the first 6 weeks or so.

Ice machine, worked wonders at helping to get the swelling down.

Mum was given too much pain relievers, so she cut back to bearable/manageable pain levels.

Mum was motivated to get back to her regular covid life. Se told me the other day she is at 90% mobility. She does have to be mindful of not overdoing it.

You do need to get back to your life. Can you arrange for meals on wheels for a short period of time?

Mum had rented a walker from the Red Cross, but we also purchased a snazzy red one with a seat for $35. Mum could use it to stand to heat up a meal, then put her plate on the seat to take it to the dining room.

Z, you've gotten a good range of advice; there are some aspects I want to add, and emphasize.

The doctor who performed the surgery can script for PT at home, or in in a rehab facility.    Medicare will cover for a limited amount of time, given that script, but I don't recall the number of days (it's been awhile since I've been involved in that aspect).    When the allotted time approaches, the rehab facility staff will approach you about follow-on care, at home.

There are so many benefits to a GOOD rehab:    rest, higher level of care, limited PT and OT, and NO concerns about coping issues that arise at home.   

As to toileting, you might want to (a)  ask the doctor's staff about good DME facilities, and/or (2) search online for them locally.    You can get a good seat riser that she can sit on.    They look like this:

https://www.wish.com/product/5ae424bf0b43217c6ae945a9?from_ad=goog_shopping&_display_country_code=US&_force_currency_code=USD&pid=googleadwords_int&c=%7BcampaignId%7D&ad_cid=5ae424bf0b43217c6ae945a9&ad_cc=US&ad_lang=EN&ad_curr=USD&ad_price=26.00&campaign_id=7203534630&gclid=EAIaIQobChMIicLalsjQ7QIVq1PVCh1X3Qe2EAQYBCABEgLHAfD_BwE&hide_login_modal=true&share=web

(or search for DME, "seat riser for toilets".    The handle bars help provide stability when rising.   And they're a lot more stable than commodes, which can tip over.

As to meals, since she's homebound, she might be eligible for Meals on Wheels.    In my father's area, they were coordinated through the local Senior Center.     In addition to one meal a day, and potentially weekend and holiday meals, I've found those who deliver the meals to be very friendly and compassionate, so there's a bit of companionship involved.   But no one has to breach safety protocols and get physically close.  

Forget about a shower chair and use no rinse products, and make it a pleasant ritual.  Put on a CD of her favorite music, let her help wash herself except areas she can't reach, then have some kind of treat afterward, whether it's watching a favorite DVD, listening to more music, reading a novel, or just napping.   

https://www.google.com/search?source=hp&ei=kPzYX92WOsPWtAbolJSoDQ&q=Walgreens%2C+no+rinse+products&oq=Walgreens%2C+no+rinse+products&gs_lcp=CgZwc3ktYWIQAzIFCAAQzQIyBQgAEM0COggIABCxAxCDAToLCC4QsQMQxwEQowI6BQgAELEDOg4ILhCxAxCDARDHARCjAjoICC4QsQMQgwE6CAguEMcBEKMCOg4ILhCxAxDHARCjAhCTAjoICAAQsQMQyQM6BQgAEJIDOgIILjoCCAA6CAguEMcBEK8BOgsILhDHARCvARCTAjoFCAAQyQM6BggAEBYQHjoCCCY6BQghEKABOgUIIRCrAjoHCCEQChCgAVC0BFivImDiI2gAcAB4AYABhAKIAcwWkgEHMTcuMTAuMZgBAKABAaoBB2d3cy13aXo&sclient=psy-ab&ved=0ahUKEwjdnuuey9DtAhVDK80KHWgKBdUQ4dUDCAw&uact=5#spf=1608055957491

Or search on "no rinse products", using just that or adding the name of a preferred pharmacy first.   

These no rinse products are used in rehab facilities, and in my experience, they provide good stability in a potentially dangerous situation, a refreshing cleaning, w/o the ordeal of undressing, sliding over on a bath chair, getting cold w/o clothing on.

Consider a rollator instead of a walker; it's far more safe.   It does have to be adjusted for height, so if you get one from a DME, ask how to do that so it can be done at home.

Rollators look like this:  

https://www.binsons.com/search?q=rollator

The third style includes an open basket, so you can see that there's storage space for carrying what might be needed in a different location in the house.  The seat also allows someone to sit down if fatigue or other issues arise.  That's a major benefit that walkers lack.

If she's not getting relief from the pain meds, and they cause dizziness, ask the surgeon to script for something else.   

Schedule some down time for you, when you and Mom just listen to CDs, watch a favorite program on tv (if you can find any good ones - there aren't too many), or just chat.   

I hope some of these and suggestions made by others help you  navigate this complex challenge.

I think they messed up bc my grandmother she was 82 at time & is currently 84 had the same procedure done & they kept her in hospital for a week or two & then sent her to a rehab hospital for 3 months before they let her come home so it may have to do with the insurance that she has or something but I would def ask the doctor who did her surgery & just explain to them that you don't feel that she's ready & needs alot more help than they thought & you have used all the time off work that you had right now so you need to go back to work & you don't feel comfortable leaving her alone bc of everything she needs assistance with still. They can sometimes help get things approved that aren't usually covered with certain insurance policies. Alot of times if the doctor request things or says they need specific things then insurance will usually cover it but it may hafta be requested by doctor. Insurance can be silly like that at times. But I definitely think they did not think that thru or I hate to say they didn't care but there was def some kind of mess up there bc she should have had some kind of rehab afterward to make sure she does her PT bc otherwise it could end up worse than before surgery. I really hope this helps at least some bc I know it can feel like it's alot more than some of us can handle at times but alot of times we are spot-on with our judgement & we just need someone outside the household to confirm what we are thinking. I have second guessed my judgement & thoughts so much since I started taking care of family members & usually it's just because I wanna make sure I'm doin the best thing for them & thank god I'm lucky to have family members that have always agreed with my decision or trusted my decisions so far. I hope you can get her into a transitional care facility to help her get back to doin what she had been & more than before. Good luck to you!!

Realistically she needs to be in patient rehab either in a NH that has a full rehab unit or a speciality rehab in patient center.
She should be scheduled for follow up with ortho MD or PA on her case maybe 7-10 days from her surgery. Perhaps? this week? I’d start a very detailed list right now on all the problems you’ve described & add that she has significant “medication management” issues. This you have got to clearly discuss at the followup visit so they can write order for her to go into a facility. If her visit is set for longer than 10 days from surgery, imo you need to instead call the ortho ASAP once you have you list written out, to either flat just get orders written for in unit rehab or get her in ASAP for a check up. If her doc is in a larger health science center type of practice, there will be SW who can help you find a spot for her to go into for short term rehab. Medicare will pay post hospitalization rehab but you have to get on it to get it into the allowed coverage period for the diagnosis code used for her surgery. You have got to let them know that you are NOT 24/7 for her and you are at best reachable on the phone for her. There is no spouse or live in family or caregiver.

On medication management issues, those pain meds she is on, I’m guessing, it’s Hydrocodone acetaminophen/ Norco 10-325 combo & maybe Ecotrin 325 mcg. Their serious pain meds and will affect her judgement big time. Like you can’t drive or be left on your own as meds have your judgement impaired. She’s not competent to determine what she can or cannot do. (I had out pt. knee surgery Oct 2019. Not replacement but pretty extensive arthroscopy, I had tears, cartilage fissuring & Baker cyst & PT for 2 mos after, the drugs are great but I was confused on AM vs PM for days). She can’t manage her drugs.

She’s going to have to work with PT and couple of times a day in exercises & get weight bearing movement to get recovery done. She can’t get all Princessy “it hurts not gonna” right now. She’s got this narrow critical window to get up, get weight on it and get going. Otherwise she’s going into a wheelchair or a walker. She’ll end up needing daily help to able to live on her own. If she has stairs to manage or get in & out of her house, all will need to be reconfigured to be handicapped accessible or this turns into a safety nightmare. Like can mom get up & out if there is a fire.

Going to be something that motivates her. Try to figure that out & remind her. For me, it was I had a huge job committed for myself and a team of 5, & they’d kill me if I turned it down. When my mom had rotor cuff surgery, her goal was determined to be able to set her hair and she was going to do those arm & shoulder exercises to be able to get those rollers and pins in. Your mom has something that motivates her. If you cannot get her going, she’s going to need to be in facility where they impress on her stuff needs to be done.

Your family is not gonna help. You can’t make them. Just approach all this as if your an Only child. Keep a journal to remind yourself just how worthless they have been.

The pain is a beast, I totally get it, I had daily pain to some degree for 6 mos and used a thigh hi compression snood and Dicofenac gel on my knee for 6 mos after that when on a busy knee day to keep swelling & pain at bay. I got released with a Breq cube (cooler) after surgery and it is quite amazing in keeping swelling minimum so no swelling = less or no pain. I used mine off & on for abt a year. Ask abt getting one for her. downside of it is that it has to be fed ice often so it’s slushy cold water pumping thru. (I was fortunate is that my hubs was very supportive, did whatever & ignored my rants). So someone will need to keep cooler replenished with huge bags of ice for daily or replacement into the Breq cube. But it is amazing.

Talk to the doctor and see how he can set it up to put her in rehab. He might get you to take her to hospital for pain or confusion issue so he can release her to a rehab. I can't swear to it, but have heard release to rehab is much easier than from the home. If rehab is a no go, you're going to have to take her home w/you and get PT/OT set up at your house - someone to come in for the exercise. And/or, get a caregiver to come in to handle some cleaning and meals for her. You might also ask the doctor about the passive exercise machine (I think that's what they call it) that she lays down, puts her leg in and the machine is in constant motion.

There's no way to leave her alone like this, so it's going to be rehab, in home or your home to provide help she needs

You definitely need to speak to her hospital surgery team. It should be possible to get her into rehab if her discharge date from hospital is fairly recent. Not sure why they sent her home unless they discussed with her and she said she would do it at home. It's been my experience that while everyone wants to get home asap, staying in a facility for rehab in better in the long run. They are going to push you nicely. You mentioned Medicaid but is your Mom also receiving Medicare? Under traditional Medicare (the one with the red, white and blue card) a total knee replacement qualifies her for intense rehab for a min of 20 days (if she can keep up with them, lol). After the 20 days, if she still needs rehab and is still working and improving, Medicare will pay approx. 80% of rehab up to 80 days (that's where a supplement insurance would pick up the difference. - maybe Medicaid would do this). If she can't keep up with the intensive rehab, she can always step down to short term rehab which is about 1.5 hours per day but can still be in a skilled nursing facility.
If she has an Advantage program it will probably pay for some of her stay at a rehab facility. If she has an Advantage program, she might get less days rehab .... that depends on the Insurance company and the individual policy.
Intensive rehab is done at the hospital (or a specialized facility) and it often referred to as "inpatient physical therapy". The less intense rehab is general referred as short term rehab and is usually conducted as skilled nursing facilities (used to be called "nursing homes" ). Getting the MD to put her back into a facility for rehab will give her a better chance to resume her lifestyle and at least for a few weeks, take the burden of cooking, cleaning, showering and medication management off your hands.
I would suggest that you also plan for the possibility that she may rather like all this service she will get in the rehab center so make sure you explain to the MD about the need for to be able to toilet herself and to fix meals so occupational therapy will be needed also. And it's also possible that she has reached a stage where she may need more assistance that you can provide with your family life. The other relatives are not going to help so don't waste time and energy. See if she qualifies for any other services under Medicaid when she goes back to her home.
Good luck and keep us posted.

Wow, lots of good advice - but the main point is she can’t be left alone when you go home. Call her surgeon’s office. They can set up Rehab at a facility. Best of luck.

Imho, speak to her physician. She never should have been discharged to her home. Prayers sent.

I think you and your mother's doctor vastly underestimated the amount of care and support that your mother would need after total knee replacement. I have been through the process twice. Each time my doctor enrolled me in a program that began the physical therapy a month before the surgery to strengthen the muscles in advance. There was a class several weeks before the surgery for a group of us who were having the surgery. The program used a sports analogy which was a little corny but very effective. I was required to attend the class with my "coach" who would learn with me what we would need to do in the weeks following surgery, how to prepare the house, what my limitations would be, etc. We were also encouraged in this class to set goals for what we wanted to accomplish after the surgery. To that end, I also enlisted my sisters to be my "cheerleaders" who took turns visiting me and reminding me of how wonderful it would be when I would be able to walk on the beach, sit and stand without pain, and live a more normal life again.

The first week or two after surgery most people are taking a significant amount of pain killers, especially prior to exercise. Falls are a particular threat for a person with a recent knee replacement, as it is impossible to get yourself up as well as possibly destroying the newly remade joint. I was advised to do no cooking or other kitchen work that involved reaching, lifting, stretching or bending for at least 2 weeks. The only things I was to do was to concentrate on doing my therapy and exercises, walk with the walker, and put the leg up the rest of the time. I did very well and my therapist was thrilled with my progress, but without my "team" of helpers it would not have gone so well.

There should have been a high rise seat on the toilet before your mother even went in for surgery. There should have been something like a wooden kitchen chair in every room she expected to inhabit, as bending the knee as much as 90 degrees is difficult at first, bending it further than that is very painful.

It sounds as though nobody has discussed proper pain management with either you or your mother. She needs to time the exercises for a time when her pain meds will be at their most effective. This can vary with the meds, but for the ones I took it was best to begin working at the therapy 30 minutes after taking the meds. Then start gently, get used to the feelings in the joint and press on carefully, to keep doing more flexing, but never to the point where the pain is too much. Push it a little, see what can be borne, ease up, go again.

I am quite shocked that anyone would expect your mother to be alone in her home with no assistance just one week out of the hospital. She probably should have someone with her until she has fully regained her balance on the affected leg and is done with taking pain medications. A total knee replacement requires a lot of adjustment in how you stand and walk. Add to the imbalance created by the surgery the effects of pain medication and you have a person who really needs to have someone to be sure she is ok. Be aware that getting off those pain meds can also be difficult. It helps to have someone around for encouragement and moral support.

You should probably call a senior's resource center and find out what the process would be for putting her into rehab. She cannot be left alone.

Z1889D--I agree completely with those who say your mother was sent home from the hospital too soon. I have had 2 knee replacements (Thank heaven I have no more than 2 knees!). I spent 2 weeks after each surgery in a rehab facility, and could have used more, where they actively did physical therapy. If I had been expected to just exercise my knee, no amount of instruction would have helped. The pain was too much. I needed pain med before each therapy session and at night. (They no longer use the knee exerciser machine with ice although ice packs do help the pain). On top of that, the anesthesia used for the surgery left me mentally confused, unaccountably angry and generally an emotional wreck. I hated the way I was acting but couldn't seem to help it.
Someone should have told you she would need an elevated toilet seat. I needed a shower chair and use one to this day, several years later, because it is easier and allows me to shower safely.

By the time you receive this, you may have already been able to get mother into a rehab facility or, at least to gotten some help. If she needs more surgery maybe you can get some physical therapy that will actually work with her not just leave her (and you) with instructions. I would like to say things should get much easier as she heals. If she needs more surgery, get a doctor who is willing to get her into rehab (knee surgery is not the only indication for this, and medicare pays for a certain length of time). Make sure, ahead of time, what discharge planning can be implemented. So sorry you have been through such a difficult time. Sounds like you have been both brave and patient!