help me plz

[GEM9]

my Mom is 79 yrs old and thinks that she can recover at home on her own with out 24 hr care after hip replacement surgery . i keep telling her she cant do this! but she is insisting that she can! how can i convince her that she is going to need 24 hr care for at least 4 to 6 wks?

 

[ruthz]

Hello Gem: What is your mom's physical condition? How active has she been prior to her surgery? What is her home like? I ask these questions because these things factor into how soon post op she may be ready to be on her own.

I'll just tell you my experience with bilateral (same day) hip resurfacing. I left the hospital after three days and returned home to a two storey house. I had no trouble from the very beginning getting around on my own, even going up and down stairs.

My son stayed with me full time for that first week post op, and the second week my husband just came home at lunch time to check on me. I used a walker for 1 1/2 weeks and then a cane for another 2 1/2 weeks and then used no walking aids.

I was cleared to drive, start out patient physical therapy and start water exercise at 18 days post op. I went back to teaching ballet and pilates and my own dancer rehab at one month post op.

I am younger than your mom, yes. It seems though, that 24/7 care for six weeks should not be necessary with a normal hip replacement. The goal of physical therapy early post op is to get the patient as self-sufficient as possible as quickly as possible. I bet your mom is very eager to take back her independent life! Again, each person is different, with widely different needs post op.

I'm sure others will also respond to your post. Take good care,
Ruth Z
bilateral hip resurfacing 4/6/06

 

[GEM9]

thank you Ruth for responding! other than the fact that she has high blood pressure and cholesterol and arthritis shes fine she is having a complete replacement! she does not respond well to pain meds at all! she has two very large dogs that demand her attention constantly and 4 birds she must tend to daily! her home is a ranch style home and the neighbors are not a friendly bunch! she seems to think that she will be able to care for herself the day she comes home from the hospital! and the only reason she needs anyone there is to take care of the animals while shes hospital bound. the dogs are unpredictable 1 has bitten me my cousin and my husband for getting to close to her and i am affraid that it will hurt anyone who tries to help her or trip her up and have her on the floor without any help around. i could not in good consience leave her on her own 3 days after surgery! she is stubborn and pushes the envelope too far insisting that she is capable of things she shouldnt be doing anyway!

 

[jaz]

She will definately need someone to take care of her for the first week at least but I don't think she'll need 24 hours care for the full 4-6 weeks.

There was a lady in hospital when I had my THR that had her knee done who was also 79. She really struggled with the pain so didn't do the exercises which meant she didn't recover too well. She intended going home alone to a house with internal stairs!!! In hospital just walking to the bathroom was a struggle let alone showering, meal preparation etc. This lady ended up being transfered to another hospital then going to her daughters once her daughter returned from holiday.

I would talk to her about how she is going to do the basic tasks (stand long enough to cook a meal, carry meals and drinks to a table to sit down, shower, get dressed, do laundry etc). Hopefully she'll see quite soon that she can't do it alone. As long as someone can be there for the first week she may be able to manage after that with someone popping in most days.

Here in New Zealand you must attend a Patient Education Session before your surgery. This lasts about two hours and you have speakers from Physio, OT's, the pain management team etc. They are quite clear about what you can and can't do and many in my group had brought their caregiver (spouse/daughter etc) along. The speakers were very insistent that one widow in my group have someone in the house with her the first week. I still can't unload shopping from the car, carry the laundry basket downstairs to hang out the washing or do a lot of housework and I'm five weeks post op and 39 yo.

 

[GEM9]

well now she wont talk to me at all or my sisters because we are asking her to delay this until she moves closer to where we can care for her! and wont drop everything at the drop of a hat as she has insisted we do! she is hell bent on having this done! and nothing we say will change her mind!! none of us are in the position to be in LV for any amount of time.

 

[jaz]

She may end up going into a recovery centre for a week or so after her surgery before going home and could end up making this decision in hospital. I don't know how it works in the USA but in NZ they have social workers in the hospital that will assess your situation and decide if you need home help. They arrange it all before you go home. Ideally its better to have these arrangements made before you go into hospital however.

It sounds like she is quite stubborn. Maybe you need to leave it awhile then casually ask questions like 'how are you going to get groceries when you get out of hospital' and 'what are you going to do when you need to change your sheets'.

 

[rejoyce318]

Assessments by a social worker or nurse practitioner are also done in the States. I can't see a reputable (!) hospital discharging a patient to live at home alone if that person cannot demonstrate basic self care (dressing; climbing stairs, getting in & out of a car, bathing - all that fun stuff the hospital OTs & PTs teach us). Most often, the patient would be sent to a rehab center. In fact, the people in my parents' retirement community who have had joint replacements have been automatically sent to rehab for at least a week, & most of them are about the same age as Gem9's mother.

Jaz, you brought up some great questions for Gem9 to "casually" ask her mom. Doing one's own laundry, even with a grabber tool, is quite an experience, too. I bought disposable plates, bowls, & utensils before my THR so I didn't have to fuss with the dishwasher for a while, either.

 

[Josephine]

It's a BIG problem with these folk who think they are superhuman and can cope with anything! You have my sympathies.

My stepmother was grossly crippled with rheumatoid arthritis for many years though she was only 67 when she died. Nevertheless, apart from the RA, which affected most of her joints, she was ok. BUT despite being unable to walk without a walker and unable to open even open a kitchen cupboard door much less get out a plate, she resolutely refused to accept any care or help. It was awful to watch and to know how she was struggling. I always knew when my siblings had visited her as they would called me after, insisting that 'we' (meaning me!) DO something. But I am going to tell you what I told them - albeit I realise the circumstances are somewhat different here than with my s/m; she was an intelligent, mentally competent woman and had chosen her path. Just because that path wasn't what WE would have chosen doesn't mean we had the right to impose our choices upon her.

Now I don't mean you shouldn't care and be concerned. Of course you should do that. But, after the hospital has done its assessment and decided she can go home, if she continues to be resolute and refuse help, then you have little choice but to to comply. She sounds like an intelligent woman who has been accustomed to her independence. You and she will just have to ride this through the best way you can. No doubt she will be in touch when she wants to but you shouldn't beat yourself up about it.

 

[Stanj]

If your mother is otherwise sound physically she probably knows best what she can do without help. She should stay in a controlled environment, say, hosptial or recovery center, for the first 10 days so she can just rest when it is needed most and be away from the responsibilty of animals and a large house.
I had a THR at the beginning of June and had no one at home when I left the hospital 9 days later and did fine but I did not have large dogs or a spread out house to deal with. Cooking and laundry went fine, well, cooking as bad as normal for my skills, but stairs, walking for groceries etc. were normal activities I do every day before and after the operation.
Does she has a nearby grocery store? Is there anyone with a car who can be called for big loads? People here recommend tools for helping extend reach and so on, but I never had any of that and was fine. An independent lady, as your mother must be, will probably recover faster when just returning to normal life as soon as possible. My biggest problem was boredom after leaving the hospital (where it was quite pleasant except for overly bland food) being at home alone so I started walking to work starting 3 days after release from the hospital. Getting back to normal activities right away was probably the reason I recovered so quickly and had no pain. I highly recomment it. My stamina was not great right away but that quickly returns, and prevents over-stressing since there is a limit to the energy available to over-do it even if you wanted to.

 

[jessie]

"I still can't unload shopping from the car, carry the laundry basket downstairs to hang out the washing or do a lot of housework..."

Hey Jaz, Me too, wink wink, nudge nudge.

 

[jaz]

Haha Jessie, yes I thought I might keep it up for a few months. I'm quite enjoying the break from the never ending jobs around the house and the family have become appreciative of just how much I used to do.