physical therapy at home for hip replacement patie

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   Our user asked: "My father had hip replacement surgery about 4 weeks ago. He is currently in a rehabilitation facility/nursing home but the therapists there, dispite our continued requests, refuse to work with him at a time of day when he is awake and alert rather than drowsy from medication. (He also has Parkinson's and related dementia.) Because of this, they have reported to Medicare that he is "uncooperative and not making any improvement" and is now being sent home. Before his fall and subsequent surgery, he could walk, unaided by a walker or cane and with minimal help getting up from the seated position. The surgeon said he should be able to regain that level of activity once again. We are preparing the house for his return and my mother will be with him 24/7 to care for him and help him. Where would you recommend we look for exercise/therapy information we can use with him at home to help to strengthen his hip and get him moving again. We were not allowed to participate in what little therapy he had at the nursing home until the doctor visited a few days ago and demanded he be given proper treatment and that at least his wife be able to participate and learn what to do since they are sending him home. We are very upset about the lack of treatment he has received but our first concern is providing him with proper treatment once he arrives home. If there are books and/or websites which would provide helpful information we would be very interested in learning about them. We are also looking into local outpatient physical therapy centers. If there are particular questions we should ask to be sure he will be given the proper treatment, any advice in this area would be greatly appreciated. Thank you. I look forward to hearing from you if there are any suggestions you have to help us help Dad."

Ask a PT Response: "I am so sorry to hear about the rehab experience that your father had to go through. Rehab facilities/nursing homes can be extremely busy, but that should not compromise quality care. The therapist should have at least attempted to see if better results may have been obtained when your father participated in therapy at a time of day when he was more alert and oriented. 

I was wondering if you have asked your father's MD if your father could have an order for home physical therapy. If he is not doing well and has great difficulty leaving the house even with assistance Medicare will cover a PT to come to your father's home to work one on one with him. I think this would be the best option for now. Otherwise, I would recommend that he participate in outpatient PT services ASAP. As far as exercises go, the usual exercises which are prescribed by PT's to their patients to perform in sitting or in bed can be performed (ie. ankle pumps, quad sets, glut sets, heel slides, hip abd, short arch quads, SLR's, etc.). Since your mother and family will be taking care of him, I would also want to remind your family of the hip precautions that your father should follow: no bending past 90 degrees, no turning the foot in (hip internal rotation), and no crossing the legs (hip adduction). Breaking these precautions could lead to dislocation of the new hip. I hope your father's future rehab experiences will be better and wish him the best of luck with his recovery!"

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Ask a PT Members Profile Send Private Message Find Members Posts Add to Buddy List Senior Member Joined: Jul 07 2008 Status: Offline Points: 954	Post Options Post Reply Quote Ask a PT Report Post Thanks(0) Quote Reply Topic: physical therapy at home for hip replacement patie Posted: Jan 08 2009 at 2:21pm
	Our user asked: "My father had hip replacement surgery about 4 weeks ago. He is currently in a rehabilitation facility/nursing home but the therapists there, dispite our continued requests, refuse to work with him at a time of day when he is awake and alert rather than drowsy from medication. (He also has Parkinson's and related dementia.) Because of this, they have reported to Medicare that he is "uncooperative and not making any improvement" and is now being sent home. Before his fall and subsequent surgery, he could walk, unaided by a walker or cane and with minimal help getting up from the seated position. The surgeon said he should be able to regain that level of activity once again. We are preparing the house for his return and my mother will be with him 24/7 to care for him and help him. Where would you recommend we look for exercise/therapy information we can use with him at home to help to strengthen his hip and get him moving again. We were not allowed to participate in what little therapy he had at the nursing home until the doctor visited a few days ago and demanded he be given proper treatment and that at least his wife be able to participate and learn what to do since they are sending him home. We are very upset about the lack of treatment he has received but our first concern is providing him with proper treatment once he arrives home. If there are books and/or websites which would provide helpful information we would be very interested in learning about them. We are also looking into local outpatient physical therapy centers. If there are particular questions we should ask to be sure he will be given the proper treatment, any advice in this area would be greatly appreciated. Thank you. I look forward to hearing from you if there are any suggestions you have to help us help Dad." Ask a PT Response: "I am so sorry to hear about the rehab experience that your father had to go through. Rehab facilities/nursing homes can be extremely busy, but that should not compromise quality care. The therapist should have at least attempted to see if better results may have been obtained when your father participated in therapy at a time of day when he was more alert and oriented. I was wondering if you have asked your father's MD if your father could have an order for home physical therapy. If he is not doing well and has great difficulty leaving the house even with assistance Medicare will cover a PT to come to your father's home to work one on one with him. I think this would be the best option for now. Otherwise, I would recommend that he participate in outpatient PT services ASAP. As far as exercises go, the usual exercises which are prescribed by PT's to their patients to perform in sitting or in bed can be performed (ie. ankle pumps, quad sets, glut sets, heel slides, hip abd, short arch quads, SLR's, etc.). Since your mother and family will be taking care of him, I would also want to remind your family of the hip precautions that your father should follow: no bending past 90 degrees, no turning the foot in (hip internal rotation), and no crossing the legs (hip adduction). Breaking these precautions could lead to dislocation of the new hip. I hope your father's future rehab experiences will be better and wish him the best of luck with his recovery!"

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