Caregivers Guide for the Hip
When your friend or loved one has undergone a hip replacement surgery, as a caregiver, you will play an important role in his/her recovery. There are various aspects you need to be aware of to ensure the safety, comfort and recovery of the patient. Some of these include:
Some of the changes you would need to make around the house include:
- Pick up rugs lying around, secure loose carpets and place carpet on slippery surfaces.
- Place all regularly used items well within reach.
- Ensure that there is good lighting throughout the house and avoid floor hazards such as small objects lying around, pets, cords and uneven surfaces.
- Do not allow the patient to lift heavy weights for about 3 months after the surgery.
- Rearrange furniture to provide more walking space to accommodate a cane or walker.
- Un-tuck bedding to make it easier for the patient to move in and out of bed.
Some of the factors you may have to keep in mind about the patient’s changes in bodily functions include:
- The patient may have a poor appetite, so ensure that they take in more fluids until their desire for solid food increases.
- The patient may have difficulties in sleeping which can last up to 3 months.
- Provide the patient with laxatives or stool softeners to combat constipation, which is a common side effect of certain pain medications.
- You may be advised to give the patient blood thinners to avoid blood clots in the leg.
Patients may be prescribed special stockings to compress the veins in the legs, which will help reduce swelling and lower the chances of blood clot formation. Factors that you need to be aware of about these stockings include:
- Make sure the patient wears the stockings continuously, removing them twice a day, for one or two hours.
- If swelling persists, help the patient raise the leg above heart level on pillows, while lying down.
- Inform the physician when pain or swelling in the legs increases.
Some of the instructions that you will be given about incision care include:
- In most cases you will have a clear plastic dressing over your incision that can be left in place until follow up. Some patients will have an adhesive silver dressing placed that can be removed in 7-10 days after surgery.
- Inform the physician if there is increased redness, drainage, odor or pain around the incision. We discourage you from going to the ER for wound issues unless you feel you have a life threatening infection.
- Inform the surgeon immediately if the patient’s temperature rises above 101.5°F.
Controlling pain and discomfort
Caring for the patient will include various methods of helping the patient control post-surgical pain.
- Pain medications should be given at least 30 minutes before physical therapy.
- You can encourage the patient to gradually reduce pain medications. Patients who can tolerate anti-inflammatory medications (NSAIDs) such as ibuprofen and naproxen may take these medications when they are only on aspirin to prevent blood clots. Tylenol may also be used to help reduce pain. The patient may alternate between NSAIDs, opioid pain killers, and Tylenol so long as these medications are taken as prescribed.
- Use ice for about 20 minutes every hour to control pain.
- Encourage the patient to change position every 45 minutes.
Recognizing and preventing complications
A few complications, such as dislocation, blood clots and pulmonary embolism, can be identified and prevented in the following ways:
- Dislocation: can be identified by severe pain, shortening of leg or difficulty in walking. This can be prevented by avoiding pushing the hip beyond what is comfortable and avoiding extremes of hip motion.
- Blood clots: can be identified by swelling in the ankle, calf or thigh, and heat, pain and tenderness in the groin, back of knee or calf. This can be prevented by using compression stockings, blood thinners and walking. Some swelling is normal after surgery and often is worse with activity. If you are concerned about your amount of swelling, contact your surgeon’s office.
- Pulmonary embolism: A blood clot formed in a leg vein can break away and travel to the lungs causing pulmonary embolism. This is identified by sudden chest pain, rapid breathing, shortness of breath, sweating and confusion. It can be prevented with anticoagulant medications, compression stockings and physical activity which can help reduce blood clots and speed up the recovery process. If you experience these symptoms, you should go to the emergency room immediately or, if necessary, call an ambulance.