I don’t believe that anyone can go through this operation alone.  You either need a mobile and dedicated caregiver 24 hours a day for a solid 2 weeks or you need to go to some type of rehab hospital.  There is no discussion about this.

In recent years, there have been discussions that joint replacements do not need to go to rehab facilities and they can go home.  That chatter has been perpetrated by government and insurance company administrators and not anyone who cares about the safety and satisfaction of patients.

My experience going home after the surgery was dependent on a few important factors.  First and foremost, my caring and loving wife who aside from being healthy to be able to assist attended the preoperative joint camp with me and became a caregiver expert in the process.  The list of basic things a caregiver does ranges from the simple to the dramatic but they are all important.  I am sure this next list is partial at best:

1. Making sure all the prescriptions are available and within reach
2. Access to food
3. Being there at times of tiredness and dizziness to help position on a chair or a bed
4. Observation while walking for safety
5. Helping in the bathroom (believe me, in the first two days this is a big one from toilet to shower!)
6. Helping to change ice packs
7. Getting pain medications in the middle of the night
8. Assisting in transfers from bed to chair to other rooms
9. Helping the communication with the doctor in times of need

The minimum is a person full-time in the house.  A home health aide 4 hours a day is not the same.  That is helpful but you need basic, non-medical help around the clock.  If you don’t have that you don’t need to go to the most intense rehab facility in the world but you do need a basic skilled nursing facility that understands the process of joint replacement.  They need to get you up 6-8 times a day, apply cooling therapy (for patient comfort) as needed, access to pain medications if needed, and formal physical therapy at least twice a day.  I think that depending on your own health, upper body strength, and progress a rehab admission should be 5-10 days.

Rehab aside, if you can go home- go home.  There is no place like home…

Here is a video discussion of the experience of being a caregiver:

Transcription of the video:

 

We did the joint camp on Skype together, and it was fine. We went over the booklet, and sort of what we needed to sign off on, and be aware of, and no problems with it. The SwiftPath Patient Guide is really helpful, because in particularly, for the post-operative course, when you want to know what to expect each day, and what you’re supposed to be doing, what you’re supposed to be giving. It’s perfect, and then if you have any questions about any specific thing, you can refer back to it. Yes, they did, and I think that for any caregivers who are a little nervous, and think taking your loved one home the day of surgery, and why aren’t they staying in the hospital?

The things that you’re doing are just the things that the nurses were doing in the hospital before, which was really just making sure that you’re giving the pain medication on time, and elevating the leg, icing the leg, and using the Incentive Spirometer, and these are all things that are very easy to learn, and easy to keep track of, and don’t require any sophisticated medical background, so it was very, very helpful, and no problem.

Well, this protocol and having the patient come home after surgery, we felt, was actually better for the patient. Better for Dr. K, because recovering in your home is much more pleasant. Usually a little bit of a speedier recovery. You’re up and about more, all of the risks associated with being in a hospital bed, and not being home, you just don’t have to deal with that when you come home, and you just make a much more rapid adjustment to your settings at home. You can use the equipment that you need at home, and get familiar with it, so I would say if you’re medically cleared for outpatient, do it in outpatient.

I do have a medical background. I have to be up front about that, so I was pretty comfortable with it, but additionally, when I spoke to the surgeon, and he explained to me the things that we were going to be doing at home, exactly what they were, which is all that the nurses were doing in the hospital, and could easily be done at home, so I had no problems with that. Well, it’s great not to have to go to the hospital and visit your … It’s great to have him home, and I think it’s just a better recovery, physically and mentally. I just think being back at home, it also makes you maybe a little bit more motivated, because you want to do stuff again. When you’re in the hospital, maybe a tendency more to just, well, you’re going to go from bed to chair, and chair to bed, so I think all that is good about the home.

A couple of things. The walker is … Can’t do it without a walker. I’m sure he’s shown you this pillow that he’s using for elevation, which has been really helpful. There is a shower chair seat, which is a must. I mean, it makes taking a shower very easy for the patient by post-op day three, I believe it is. Maybe two or three. After 48 hours, he can get in the shower, so if you have that chair, it’s pretty easy to take care of yourself. Give yourself a shower and do that. No, not at all. I think that the team was checking in with Ira, and there really wasn’t too much that we had question about in the last few days. Pretty much just recovery from surgery.

I think that covered everything. I think the equipment is a big deal. That shower seat, and the walker, and the pillow really key, and just … It’s great to be able to recover at home. It’s nothing that most people can’t handle, assuming you’ve been cleared for outpatient surgery. It’s really the way to go.