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Rehabilitation facilities

Description

Most people hope to go directly home from the hospital after hip replacement surgery. You should talk about this issue with your doctors and nurses in the weeks before your hip replacement. They can advise you about whether going directly home is good for you.

If you are weak before the surgery, you and your doctor may plan on you staying in a skilled nursing facility ahead of time.

Even if you and your doctor planned for you to go home, your recovery may be slower than expected. When you no longer need to be in the hospital, the hospital will discharge you so that you can go to a place that can give you the right care. As a result, you may need to be transferred to a rehabilitation or a skilled nursing facility.

If you reach the point where you no longer need to be in the hospital but still need care by health care providers, the hospital may transfer you to a rehabilitation or "rehab" facility. This is for people who are likely to recover quickly. These facilities offer more intensive, short-term (1 to 2 weeks) physical therapy.

If you have other health problems, such as heart or lung problems, which may delay recovery, you may be sent to a skilled nursing facility. You'll receive longer-term nursing care to help you recover.

It is important to plan where you would like to go before you have your surgery. Look for one that provides quality care and is in a good location for you and your family.

Take these steps also:

  • Have more than one choice. If there is no bed available at your first choice, the hospital still needs to transfer you to another qualified facility.
  • Make sure the hospital knows about the places you have chosen.

Who needs to go to a skilled nursing or rehabilitation facility?

When it is time to leave the hospital, you may still not be ready to go home. Before you can go home after surgery, you must be able to:

  • Safely use your cane, walker, or crutches.
  • Get in and out of a chair and bed without needing much help.
  • Be able to walk well enough that you can safely move from where you sleep to your bathroom and kitchen.
  • Go up and down the stairs, if there is no other way to avoid them.

Other factors may also prevent you from going directly home from the hospital:

  • Your surgery may be more complicated.
  • Because of where you live, you need to be stronger or more mobile before going home.
  • Sometimes infections, problems with your surgical wound, or other medical problems will prevent you from going right home.
  • Other medical problems, such as diabetes, lung problems, or heart problems have slowed down your recovery.

Choosing the right facility for you

While a doctor will supervise your care, other trained health professionals will be helping you grow stronger:

Registered nurses will:

  • Care for your wound
  • Give you the correct medicines
  • Watch out for other medical problems

Physical therapists will teach you how to:

  • Make your muscles stronger and get up and sit down from a chair, toilet, or bed
  • Climb steps, keep your balance, and use your walker, cane, or crutches

It's a good idea to check out different skilled nursing facilities that you would like to go to. Visit two or three facilities and choose more than one facility where you would be comfortable.

Important factors in the facilities you choose will include:

  • Where the facility is located
  • How well it is maintained and kept
  • What the meals are like
  • What types of patients are staying in the facility

Your most important goal is to get safely back in your home. The quality of care you will receive at this facility plays the biggest role in getting you home.

So, when looking into the facilities that are near you or those suggested to you by friends or the hospital, find out about the following:

  • Do they take care of many people who have had a hip replacement? Can they tell you how many? A good facility should be able to show you data that shows they provide good quality care.
  • Ask whether they have physical therapists that work at the skilled nursing facility. Make sure the therapists have experience helping people after hip replacement. Ask whether you will see the same one or two therapists most days.
  • Do they have a system for taking care of patients after hip replacement?
  • Do they provide therapy every day, including Saturday and Sunday? How long do the therapy sessions last?
  • If your primary care doctor or your orthopedic surgeon does not visit the facility, will there be a doctor in charge of your care and how often do they check on you?
  • A good facility will take the time to train you and your family or caregivers about care you will need in the home when you leave the facility.
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Review Date: 12/31/2018

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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