Hip replacement is major surgery. For some people, it will become necessary after a traumatic injury such as a fall or auto accident. For most elderly people, the decision to undergo the procedure will come after a long period of declining hip function. As the cartilage wears away in the hip socket and bone is rubbing on bone, mobility decreases and pain increases. Pain that can no be longer relieved by anti-inflammatory drugs and loss of ability to maintain daily functions determines that it is time to evaluate and prepare the patient for surgery.
Blood and urine tests will determine whether the patient is carrying any underlying infections. Dental decay is very dangerous to surgical patients, so a checkup and completion of all necessary dental procedures is another essential part of preparation. An EKG and chest x-ray will be done to determine the condition of the patient’s heart and lungs. An anesthesiologist is consulted to explain options for anesthesia. The anesthesiologist and surgeon evaluate how the patient’s routine medications will be affected, and advise which daily medications may be taken before and after surgery. The patient is advised what they may eat or drink before surgery.
The patient will meet with several members of the health care team to discuss pre-surgical and post-surgical needs. A nurse will discuss needs for nursing care. A medical social worker or discharge planner will explain services available at the hospital and in the community. A physical therapist and occupational therapist will discuss preoperative programs to prepare and strengthen the patient before surgery. The patient will be advised what special equipment will be required such as canes and walkers, a raised toilet seat, and appropriate seating. A post-operative rehabilitation program will be designed.
Post-surgically, the patient will be helped to begin exercising at the hospital and move on to rehabilitation after discharge. Rehab facilities are available as well as out-patient physical therapy, but since patient will not be able to drive for four to six weeks, they can choose to have rehabilitation services performed at home by a home health care agency. Medicare rules provide for a 60-day certification for home care after surgeries, and it is one hundred percent covered by traditional Medicare.
Many elderly people feel more comfortable in their own homes. When my good friend’s mother was recovering from her hip replacement, home care minimized complaints about food and the loss of daily routines. Gladys’s non-driving husband could be with her, which relieved the family of arranging transportation for him to visit her in a rehab facility. On a practical level, the therapists were able to point out ways the home could be safer for a person using a walker, and point out which chairs Gladys should use.
Chronic discomfort turns into unbearable pain and disability by the time a hip replacement is required. Hip replacement surgery relieves the pain for over ninety percent of patients and improves their quality of life. Overall physical and mental health is better afterwards because the activity level of the patient increases and regular exercise once again becomes possible. The health care team will guide and support the patient before and after the surgery to achieve the best outcome and add many productive years to the patient’s life.
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