This is a long blog, but there are some key tips for anyone wanting a Functional Recovery from a Total Hip Replacement:
· Ask for material at your pre-admission appointment to guide you on your needs post-surgery
· Buy and have delivered as much equipment you need pre –admission, but before you do, call an Occupational Therapist (OT) to complete a pre admission visit to your home. They can provide you with education on how to best approach things when you get home (and point you towards extra community supports if you think you are going to need it). Although Functional Living is only in Melbourne, we can provide interstate links to Private OT’s
· Make changes permanent – of the advice given you by an OT makes life easier post-surgery, keep it that way, preserve your joints so it frees you up for the fun stuff in life
· Follow post-surgical advice from your Doctor and allied health professionals
Following is a Case Sudy on my own Mum, who has just had her hip replaced.
A bit about Mum and I:
I am a 40 year old white collar professional. I live in Melbourne with my husband and daughter of 4. I am self-employed, the Director of Functional Living. My Mum, still working, is 66 and lives by herself in our family home of 40 years in Perth WA. Mum, recently had a total hip replacement, 4 weeks ago. I found myself in Perth “looking after Mum”. Because my new business directly relates to Mum’s current situation I decided to write about Mum's experience in a case study.
Some Background
Mum has had Rheumatoid Arthritis (RA) for 8 years now. She manages her RA with prescribed medication and ‘being sensible and careful’. From what I can gather, without wanting to pry into Mum’s medical records her wrists are completely fused, as are most joints in her feet, or they would have considerable degeneration at the very least. She also now has RA attacking her ankles, knees and hips. More recently, Mum’s ability to ambulate without considerable pain diminished. She went from being a lady who could walk to the beach and swim most days, went to the gym most nights, worked 4 days per week in an office based role, takes walks along the coast, fishes with mates, holidays with mates and takes long walks with friends etc (ie generally lead a very active life), suffering sleepless nights and being reliant on panadol 4 times daily for pain relief. She gave up the gym, walking to the beach (she did go on a holiday to Egypt and surrounds, but found it tough going).
Mum eventually convinced her GP to refer her to an Orthopaedic Surgeon and underwent a Total Hip replacement on Saturday 14th May 2011. At her pre- admission appointment she was given a patient information pack, which included a list of equipment that could be hired from the Hospital pharmacy as well as details of an OT that contracted to the Hospital.
7 days after surgery Mum was discharged and I arrived at her house within a half an hour of her arriving home from hospital.
Pre Surgery
Luckily, I am an Occupational Therapist and could recommend some equipment for Mum prior to her going into hospital. Even without my input Mum had information given to her by the hospital (private) that she could contact the OT if she needed to know what to get. Although tracking down most of the equipment Mum required was easy, my familiarity with Perth’s equipment suppliers had diminished somewhat having relocated to Melbourne some 10 years ago.
Day One at Home
On the day she arrived home we soon realised the hired chair was both uncomfortable and cumbersome and UGLY!! With a wedge cushion on the kitchen chairs, Mum was able to sit quite comfortably (and they were far less ugly than the chair). For those of you who don’t know, the hip replacement Mum had did not allow her to bend her hip much at all post surgically (you are supposed to keep your hip at an obtuse angle). Some surgical approaches are different, and people’s abilities are different, this is a unique case, I am sharing just so you can get an idea of what is involved in assisting someone with a TEMPORARY LIFE HURDLE.
And even better, Mum was a fit and slender lady, so she was ambulating with one crutch from Day One of returning home, and could get in and out of bed, on and off the toilet and in and out of the shower with no problem at all.
The Bathroom
We did install some ‘suction’ hand grips in the shower (which I was a bit reluctant to do because they sometimes lose their suction) but Mum convinced me that she would just use them as a support, not putting full weight on them. Mum also said the suction mat on the shower recess floor was great. Mum had already hired an over toilet frame with arm rests and that was in place. I noticed the bin was on the floor and raised it onto a small occasional table. Mum was just so lucky that she and Dad had thought that a second bathroom with flat access to the bathroom and shower might help them in the future. They did not have the extra funds however, to widen the door to that room (which was an old study). This door, would render this room totally useless if Mum ever needs a wheelchair, or assistance from a carer to get in and out of the bathroom was required (it is just not wide enough for a carer to assist). It has got the width for a wheeled commode to go into the bathroom and shower if needed.
The Bedroom
My brother and I were going to set about putting bricks under the ‘spare room bed’ which Mum had decided to use as it was closer to the bathroom than her own bedroom was to her usual bathroom. Instead we came up with the idea that the bed would be just the right height if we put Mum’s mattress from her room onto the spare room mattresses and removed the castors from that bed. This, combined with a bed rail, saw Mum very nicely get in and out of bed without compromise to her hip joint/replacement sight.
The Kitchen
Mum had been very organised and had prepared and froze a bunch of meals prior to surgery. Problem is, the freezer is too low. How do we get around this?
Our Functional solution to a bottom door freezer: when Mum had mates come over to visit she would ask them to take the food from the freezer. Thanks goodness Mum had an amazing group of mates, who were very active. Mum had also labelled all of the food clearly, sticking the labels on the top each container, so that when she asked me or her mates to grab something out, we would know what we were looking for eg Steaks, or Vege Soup, or Cheese Scones.
Some other easy Functional Solutions in the Kitchen (to overcome this temporary hurdle):
Mum’s kitchen is all cupboards and small drawers. So there are plenty of very difficult to reach spots. Over 50% of the kitchen storage was pretty much rendered useless, in the short term.
The Functional Solution: I went through all cupboards and rearranged them so that most frequently used items were placed at knee height or above. Mum also told me of the wonderful new kitchen she had been planning, complete with 100% draws. Great stuff Mum! I have yet to have a look at Blum’s products installed into a kitchen, but once I have I will be passing on to Mum the wonderful findings made and giving her some more ‘freeing up function’ in the kitchen tips.
The Bin was small and at ground level. The Functional Solution: A temporary solution, bench based bin.
The Pantry had a plastic bag recycling (behind the bin. The Functional Solution: moved to above knee height for easier access.
The Oven - All good, it is wall based. Thank goodness.
The Laundry – Mum’s ancient laundry has a ‘chute’ that opens toward you and it drops the dirty washing to below knee level. You then open a low level cupboard to empty the cupboard. The Functional Solution: don’t use it. Place dirty washing in a laundry basket at knee or above in height (keep it hidden behind the laundry cupboard away from visitors eyes or course!), or throw heavier items straight into the machine (eg sheets) and the rest use your long handled pick up stick.
Here is Mum’s equipment list (you may need more or less depending on your level of fitness post op and the design of your home and the amount of assistance you can get).
· Elbow crutches
· Wedge cushions (she had 2) – it’s handy to have one for the car
· Adjustable Over toilet frame
· Long handled shoe horn
· Frame for Pressure Garments (lower limbs)
· Bed rail
Other things Mum found out:
As a private patient and someone who still works, Mum found there was no government assistance available to assist with cleaning post op. She managed to get 2 hours of assistance per fortnight from Silver Chain.
Mum was given details of a private carer’s organisation that may have been able to help, at a cost.
The Outcome
Mum’s was a ‘text book’ recovery. She is a new woman!
If you are in Mum’s boat, give us a call at Functional Living, we may be able to assist…..03 9346 7553.
