What post hospital plans are needed for an elderly hip replacement patient?

Last week, my 83-year-old mother broke her hip. She is still in the hospital, and we are trying to make plans for when she gets out. How can we tell if she should return home or go to a nursing home?

There are a few ways to predict how a patient will do after surgery for hip fracture. Age, mental status, and the ability to get around before the fracture are three factors that predict outcome. In addition, patients who can get out of bed and walk 50 feet by the second day after surgery are more likely to do well at home. Those who can’t get up and walk may need extra help at home, or they may need to stay in a nursing home for a little while.

The hospital staff is available to help you make this decision. In addition to your mother’s doctor, you may want to consult nurses, physical and occupational therapists, and social workers.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

My mother has both dementia and arthritis. Can she handle a knee replacement?

My mother is in a nursing home and has early stages of dementia. She also has severe arthritis in her left knee. Some of the staff think if she had a knee replacement she would be more active and this might help with the dementia. Can people with dementia handle surgery and rehab?

There are no known studies of patients with dementia having total hip or total knee joint replacements. Most physicians agree that dementia is one reason patients should NOT have this surgery. There are great concerns for patient safety after joint replacement.

On the other hand, improvements in the implant design and surgical technique have changed the course of treatment. Patients have fewer restrictions. They can get up and walk on the new joint right away.

Physical activity and exercise are very important in all patients. This is especially true for nursing home residents. They are often at risk for other health conditions made worse by inactivity.

The decision to give your mother a knee replacement must be made by the entire team. The group should include family, physicians, nurses, social workers, and rehab staff. Both her primary care physician and gerontologist (if she has one) along with the orthopedic surgeon should assess all aspects of her health, the operation, and the goals for surgery.

If everyone is in agreement, then the surgeon will make further decisions about the type of implant and type of surgical approach to use. Likewise the nursing staff and physical therapists will develop a plan of care to see her safely through the rehab program.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.