Home Care After Hip Replacement Surgery?

In Home Physical Therapist

As a home care physical therapist of over 20 years, I think you already know my answer to this question and it is a resounding YES.  The benefits to you receiving in home physical therapy after hip replacement including physical therapy, occupational therapy and nursing services allows you to focus on your recovery.  

There is a newer movement ongoing from both surgeon and health care systems to push hip replacement recipients directly to outpatient physical therapy.  In my opinion, there are zero benefits to going straight to outpatient PT services right after surgery.

The important thing to understand is that you would be performing the same initial therapy exercises in an outpatient setting as you would in your home.  Yes you heard that correctly. You will be doing the same exact PT exercises regardless of location.

Don’t forget that in order to get to an outpatient clinic you would need to leave your home and get into and out of a car twice each day, 3 times per week.  In addition this normally requires going up and down stairs to get to your car and preparing yourself with a shower to get refreshed before leaving the home.

I have not met a single patient in my in home physical therapist practice that when given the open choice of home care vs. outpatient PT after surgery chose the outpatient route.  Many times there are outside influences steering people one direction or the other which happens often in healthcare decisions.  Be aware that you the patient have full rights to choose whichever options suits you best.  

Isn’t Home Care For Disabled People And Not For Hip Replacement Patients?

Too many people have this narrow vision of home care services as only for the elderly or disabled persons.  Its an unfortunate mindset for people who might benefit from more temporary home services like those who had recent hip or knee replacements.

Home care services come in many shapes and forms not least of which is the orthopedic patients I see in my practice.  For my practice, I generally see patients 2 or 3 times per week for 1-2 hour sessions each.  The goal of all home care services is to improve one’s ability to safely leave the home again.

For hip replacement clients, the normal timeframe of recovery to enable safe mobility outside of the home is 2-3 weeks.  This can vary from person to person however understand this is a temporary service and not something that continues on for long term.

Yes there are more longer term home care situations including those with more debility related issues. However within the realm of hip replacement clients this is rarely if ever the case. 

Does Medicare Cover Home Care After Hip Replacement Surgery?

Most Medicare patients, both fee for service and managed care, have full in home physical therapy coverage with no per visit costs at all.  In addition Medicare often pays for additional equipment such as a walker or portable commode to ease your transition home.

For those under Medicare age using regular insurance, you would need to check with your insurance directly but in 99.99% of cases you will have full home care coverage. In addition, most times you will not pay a penny for any of your in home physical therapy or nursing needs.

The same cannot be said for outpatient PT services.  In most cases you will have an insurance copayment with each visit which can get up in the $50-75 per visit range.  If you prefer to pay $75 for a visit to an outpatient clinic vs $0 for an at home visit, by all means you are free to make this choice.

Will I Need a Nurse, Physical Therapist and Occupational Therapist At Home?

This answer to this has two prongs, one being your surgeon’s preference and the other being the need of you the patient after surgery.  Your home care setup ends up being a mix of the two factors to best improve your functional mobility in and out of the home.

Regarding the surgeon preference, some surgeons mandate that a nurse be involved in the home care setup. Most often nursing is included to assist with surgical wound care and general status monitoring.  In some cases an in home nurse is required for bloodwork or other testing needs.

Some surgeons leave the decision up to the home care agency on whether or not to include all of the services in home.  Some patients in good health status simply do not need nursing services involved as the therapist can often provide wound care and blood pressure vitals monitoring.

Often times you will not want or need 2 or 3 people coming into your home 2 to 3 times per week.  Sometimes there can be too many cooks in the kitchen and this can create additional stress and issues that can be avoided.

Occupational therapists can be extremely valuable early on in your return home on many levels. Basic care needs such as showering, getting dressed and bedroom tasks can be greatly eased with some important OT tips and tricks.

In home physical therapists can greatly improve your walking and movement around the home with some proper teaching and followup.  Maintaining your hip precautions can be tricky and you will likely have many questions on dos and don’ts after your surgery.

How Do I Choose A Home Care Agency After Hip Replacement?

In your local area you likely have numerous options for home care and again you have complete choice on which company to use.  Your surgeon may have a suggestion or preference to which home care to use so discuss this with them first.

In general, if you have had any previous connection with a home care agency or a therapist you may just want to stay with them again.  If you can trust a specific nurse or therapist in your home this is very important for your confidence.

Most in home PTs will be providing similar exercises during your home care however small tips or directions in performance can make a huge difference for you.  Also the timing of when to advance your exercise program and allow you to transition from walker to cane takes experience from the PT to properly assess.

One big question to ask when choosing a home care company is whether you will get the same PT or OT each visit during your rehab.  Some larger home care agencies will have PT assistants do visits simply because they use PTs for evaluations only.

I would suggest you try to select an agency that provides you the same therapist for each visit throughout your care.  Having consistency in your care makes visit transition much easier and prevents unnecessary re-visits of your status to a new therapist.

In your final choice, go with who you feel most comfortable with.  If you have no direction or preference, trust your surgeon and or ask friends and family for suggestions to guide you in the right direction.

How Should I Prepare My Home After Hip Replacement?

Most surgeons have pre-operative classes or instruction on what you should do before surgery to best be prepared for your return home.  Getting things in order will be a smart move to make your transition smooth.

Included in these instructions are purchasing some needed equipment for your hip replacement .  Included in these are a raised toilet seat and a hip kit which includes a grabber, long handled shoehorn and sock donner device.  

If your stairs do not have a railing you must have one installed before returning home to perform safely.  If your shower is a tub style you may want to purchase either a tub bench or larger transfer bench.

Remove all area rugs and floor coverings that can move under your feet.  If you have larger pets that can be rambunctious you may want to consider having them looked after elsewhere for the first week until you regain some strength.

Final Thoughts On Home Care After Hip Replacement Surgery

• You Have 100% Patient Choice on Your Home Care Agency
• Only Progress to Outpatient Physical Therapy Once Mobility is Regained
• Choose An Agency That Provides Consistent Care Visit to Visit
• Prepare Your Home Ahead of Your Surgery For Ease of Return Home