A guide for all caregivers and seniors to deal with hip replacement and its challenges.
Each year, more than 300,000 seniors are hospitalized for hip fractures. Many of them go through tremendous pain and end up having to get a hip replacement. Hip replacement takes a physical, emotional, and financial toll on the patient and their caregivers and other relatives.
While we cannot avoid these emotions altogether because it is human to feel so, we can arm ourselves with the knowledge of all that should be done before and after the hip replacement. This comprehensive guide shall help you with the information that you need to negotiate a hip replacement surgery.
Hip Fractures in Elderly
As mentioned in the introduction, many older citizens suffer from fractured hips in the US alone. Based on gender, women are more at risk of having a broken hip since they make up 80% of the total broken back area amongst elderly folks.
A fractured hip predominantly affects mobility in the body. However, as per the Mount Sinai School of Medicine statistics, complications from a broken hip joint can have life-threatening consequences.
95% of senior citizens suffer hip fractures due to falling, which may be due to weak eyesight, confusion, and weaker bones.
The causes are many (osteoporosis, malnutrition, medication, alcohol use, etc.), but thankfully, with a hip replacement, they can receive better treatment and continue living with a painless hip joint.
Hip Replacement – What Is It?
Hip replacement is a procedure where a painful hip joint is removed surgically and replaced by an artificial/prosthetic one. The artificial joint is typically made from metal and plastic material, making walking easier. The sole purpose of this surgery is to relieve the person from a painful hip joint.
The first-ever hip replacement surgery took place in 1969 in the US, and since then, this has grown to be one of the most regular surgeries to be performed. More than 2,00,000 hip replacement operations are done every year. However, many surgical and technological advancements have been made with time, which has only increased the success of total hip replacement surgery.
What is the waiting time for hip replacement?
The waiting time for hip replacement is usually 18 weeks for non-urgent treatments in the US. During this period, you get your tests/scans done and are put on therapy and medication to see if the pan deteriorates.
Your waiting period ends after 18 weeks, or when the surgeon or medical expert decides or recommends hip replacement.
Post Hip Replacement Recovery Schedule
Your post-operation life might be a bit challenging; that is, there are things that you will not be allowed to do for a while, and some things may be out of bounds for the rest of your life.
You might feel lethargic all of a sudden or would want to rest all the time, and this is entirely normal for elderly folks. Your life for the next ten days post-surgery will look something like this –
1-2 Days After Surgery
You will be required to take complete rest with assistance from a caregiver. You will, however, have to try and move for about 30 minutes every day to keep the blood flowing and muscles active.
3-4 Days After Surgery
You may or may not be discharged from the hospital (considering your condition) with medication and assistance from a caregiver or a loved one.
5-10 Days After Surgery
Start with light exercises, physical therapy, continue the medication, and follow the doctor’s guidelines. Also, keep taking help from your caregiver wherever needed. Ideally, the recovery time for a senior is around a month or two, depending on their overall health and commitment.
2-3 Weeks After Surgery
In the beginning, you will need a lot of assistance from your caregiver. From taking medicines to going to the toilet, bathing, and exercising, you will have to ask for the help of your loved one. This may continue for about 2 to 3 weeks and maybe more if required.
3-6 Weeks After Surgery
After 3 to 6 weeks of your hip replacement procedure, you can slowly get back to your everyday life. You can allow yourself to do some light activities such as making your food, walking with the help of crutches, taking a bath but being careful about your incision.
You may also be able to drive after three weeks, but again, do not force yourself and let the natural course of healing take its place.
What Can You Never Do After Hip Replacement?
While your body usually gets back to normal activities after 30 to 40 days, hip replacement surgery comes with a long list of donts.
Body Movements to avoid
- Crossing your legs
- Lifting your legs (for example, while wearing socks)
- Leaning forward when sitting
- sitting on extremely low chairs,
- Bending downwards (puts pressure on the hip)
- Bending your hip or knee by more than 90 degrees
These movements can cause your new hip joint to get dislocated, which is a fairly common occurrence (3-4% of cases get dislocated)
- You cannot skip exercising for a long period
- Avoid excessive intake of Vitamin K if you are using Warfarin for blood thinning
- Avoid touching your incision in general and during bathing
- Avoid heavy narcotics, smoking, and alcohol since they are all bad for bone health
Physical Therapy After Hip Replacement
Your surgeon or doctor will recommend physical therapy to heal your pain and increase mobility in your body. You will be given different recommendations depending on your condition, and it is suggested not to get lazy when it comes to physical therapy after surgery.
The main goal of physical therapy includes –
- Help you recover quickly by strengthening the hip muscles
- Improve your walking
- Reduce the discomfort/tightness around the hip
Your physical therapy shall start within 2-3 days after your surgery. Below are some of the pointers for you to know what to expect during your therapy.
On the first day of your therapy, your therapist will come and tell you about the precautions you will have to take during recovery. The therapist usually starts with helping you turn in bed, correcting sitting posture, getting out of bed, moving in a wheelchair, strengthening exercise in and out of bed.
He or she will also tell you about the correct way to put weight on your legs, depending on your surgical procedure. This will be the agenda for the first 4-5 days after your surgery.
After 1 Week
After the first week of your therapy, you will be asked to practice some simple exercises under the guidance and supervision of your therapist. Some of the most recommended exercises for a hip replacement include
Kicking while sitting
Your therapist will help you lift your foot (one at a time) as high as you can while sitting on your bed or a chair. This usually demands repetition of 10.
Making circles with ankles
In this movement, you will take a supine position, bend your ankles, pull your toes down, and vice-versa. Then, you shall slowly make clockwise and anti-clockwise motions with your ankles. Your therapist will assist you in the ten reps of the same on both sides.
Thigh and buttocks squeeze
You will have to tighten the muscles of your thighs and buttocks and then release them over and over for at least ten repetitions. Your therapist will guide you through this as well. Usually, people hold for 10 seconds before releasing, but your therapist will guide you better.
After 2 Weeks
By the time the next week approaches, you will be able to extend the period of the above exercises and even become better and more flexible at them.
As you work with your therapist, after two weeks, you will work on:
- Walking and climbing
- Balancing your body with your new hip joint
- Crossing the legs
- Standing for a definite period of time
- Inward turning of the legs
During this time, your therapist will recommend and help you indulge in activity-focused exercises such as lifting, pushing heavier things, agility exercises, climbing stairs, jogging, walking, etc.
All the above exercises can take place at home. However, if needed, your therapist may recommend a short-term rehabilitation facility to help you recover fast.
Most doctors recommend treatment for at least two to three weeks before rechecking your condition and extending it further if it deems fit. Physiotherapy is essential for you because it will help you improve your muscle strength, balance, and overall mood. It will also help you keep a positive attitude throughout your healing journey.
How Can Seniors Recover Quickly From a Hip Replacement?
The fastest way to recover from hip replacement, especially for senior citizens, is to follow the guidelines given to them by their doctor. Apart from physiotherapy, the following things will also help you recover quickly.
It is essential to manage your post-replacement pain well since it can accelerate your recovery. Pain, if not managed well, can also lead to an increased risk of a blood clot and inability to move.
It is essential to communicate the pain you feel, especially after surgery, and continue taking medicine, therapy, and all the guidelines cleared by the medical expert. Additionally, you can go for icing, meditation, pain relievers, etc., to manage the pain.
Have a healthy diet
You are what you eat! Thus, even as a senior citizen, it is essential to be wary of your post-surgery diet. Include more fruits, vegetables, probiotic food, and grains to recover entirely quickly. Protein, Vitamin C, fibers, and calcium are recommended in your meals to see great results.
Ask for assistance
As discomforting as it may seem, your recovery needs to ask a loved one for their service for at least a week or two. They can help you get up, go to the washroom, bathe, remind you about medication, etc.
How Can Caregivers Help? Pre-Surgery
The caregiver’s duty to a senior undergoing hip replacement starts before the operation.
Help prepare for the surgery. Accompany your old person to doctor’s appointments and, further, the hospital for the final procedure. Arm yourself with the knowledge of hip replacement and everything that comes with it.
Some doctors recommend pre-surgery exercise to maintain agility in the hips. For this, you can visit their homes from time to time and help them keep the discipline. If needed, move in with them for a while and help them heal faster.
How Can Caregivers Help? Post-Surgery
Once the surgery is over, and the senior citizen is discharged, you can take them home and thus, take your responsibility as a caregiver more seriously. You can start from the following pointers.
- Firstly, you need to make specific changes around the house for safety purposes. For example, ensuring good lighting in the patient’s room doesn’t trip and fall.
- Un-tuck their bed to make it easy for them to move while they rest.
- Create more walking space for them around the house. For this reason, you can rearrange the furniture, place carpets on a slippery floor, keep the feet clean, etc.
- Poor diet or appetite is a side-effect of surgery. Thus, it is essential to ensure that the patients have fluid intake before fully recovering from having solid food.
- Constipation is another side-effect of hip replacement, and it would help if you made sure to give them stool softeners.
Wound Dressing and Care
- Ensure that the incision remains dry and covered until the staples are removed. You can keep reminding your elder one about the same.
- Inform the hospital if the patient’s body temperature rises above 100 degrees F.
- Ensure that the patient takes their medication at the right time without skipping the same.
- Also, making them motivated about getting physical therapy is a big task that you must undertake. It is even better if you remain present during the process.
- If any complication, such as dislocation, severe pain, blood clots, pulmonary embolism arise, difficulty in walking arise, it is best to immediately call the medical professional and take them to the hospital.
- Help them control pain and discomfort by reminding them to change positions from time to time. You can try alternative healing methods for the quick recovery of the elder citizen, such as icing, meditation, sitting exercises, and more.
Hip replacement is not easy for people of any age, but it can be unusually tough for senior citizens. Thankfully, the positive results of hip replacement are pretty high in the US, but it is essential to be very careful and disciplined during the recovery process.
For this very reason, a caregiver with a sense of love and empathy is needed for the first few weeks for the elderly, and we hope that whenever required, all of us will stand up like a rock for our parents and other senior folks.