Joint replacement surgery is becoming more and more common and is occurring and younger ages. It is to your advantage to think through how you can approach surgery for the best possible recovery and outcome. Start by considering these four major categories as you prepare for upcoming surgery: Overall Health, Prehab, Home Environment, and Post-Op Help.
Surgery of any kind can be challenging. Depending on what type of anesthesia he will be having, it can be a determining factor in Dad's recovery. Many times, the use of "general anesthesia" has a longer-term recovery period, than surgeries that use a more local form of anesthesia such as a "block" or "spinal." Even with the lesser forms of anesthesia, there is fatigue that usually always accompanies recovery, as well as increased weakness, and a reduction in baseline balance, strength, and sense of wellbeing.
If Dad's baseline strength and health are good, he will (as you might expect) have the best chance of a shorter recovery time. If he is struggling with poor mobility and overall challenged health, be realistic in your expectations for a more complicated and longer recovery. During the appointment with Dad's surgeon, ask if a consult to Physical Therapy prior to surgery would be advantageous.
It is becoming the norm (finally!) to participate in prehabilitation, or "prehab," before joint replacement surgery. Prehab supports your healing, even before surgery occurs, by identifying your joint and muscular limitations and targeting a customized exercise plan. It's possible that by initiating a prehab program before surgery, you can dramatically improve your recovery after surgery.
Many insurance plans cover this. Prehab is so beneficial and advisable because you will:
- Improve range of motion, mobility, balance, cardiovascular strength, and endurance.
- Modify strengthening to avoid potential injury to areas of vulnerability.
- Become familiar with post-operative exercises and limb mobility.
- Decrease pre-op anxiety with detailed instruction of post-op expectations.
- Develop a trusting relationship with Physical Therapy provider, who can help you set realistic expectations based on your pre-op status, previous level of activity, and understand individual limitations and goals.
Assuming that joint replacement surgery is not going to require careful consideration of Dad's environment...is a big mistake. Imagine needing to use crutches for a sprained ankle for several days and how that would impact your independence. Stairs become an issue, carrying items into his home, meal prep, transportation... to name a few. Paying attention to risks (falling, managing pain, and general post-op care needs) can have a significant impact on his recovery and avoidance of a post-op complication.
- Availability of someone to help around the clock, for the first few days
- Temporary relocation of his bedroom to the first floor
- Use of electric bed and power assist reclining chair
- Removal of scatter rugs to facilitate use of walker or rollator
- Prepared meals (ahead of time, ready to go)
- Easy on (and off) clothing
- Shower chair or bench and grab bars (installed)
- Pillows (and lots of them, trust me on this one…)
You would rather have too much help for Dad… than not enough. If he is fortunate and finds himself recovering well and not needing as much post-op help as you may have anticipated - congratulations! Call off the troops.
Just as an "FYI," Dad may need help with:
- Dressing changes
- Transfers out of chairs, bed, and the shower
- Walking, positioning, and getting into a comfortable position
- Carrying just about anything (he may be using an assistive device)
- Managing visitors and well-wishers (doorbells and telephone callers)
- Pet care and housekeeping
- Laundry, meal prep, errands, and transportation
He will likely have some "Visiting Nurse" home care, which may include a nurse, physical therapist, or both, for some time at home. These visits are usually 30-60 minutes in length, 2-3 times per week. They are targeted on medical care, and not geared to personal support. Dad will receive instruction from these professionals about his daily regime of care and exercises and will be expected to follow their instructions.
Dad's recovery and the success of his surgery is a very individualized experience. Much depends on his commitment to follow through with his post-op care. Maximize the opportunity of what this surgical intervention offers and help him set realistic expectations about his level of activity, mental attitude, and overall wellness.
There are many ways to receive care, get help, and be well prepared. Take advantage of the expertise readily available in the community. You can help your Dad achieve the very best possible outcome of his surgery. Good luck and...I hope he gets well soon!
Joanne MacInnis, RN, is the founder and president of Aberdeen Home Care, Inc., of Danvers, a concierge private duty home care agency in business since 2001. With 35 years of nursing practice, management and administration experience focused on home care and hospice, Joanne and her team specialize in advising and supporting families addressing the elders in their lives retain dignity and quality of life.