In Patient rehab or going home after Hip replacement?

[Anonymous]

My dad (age 79) had a successful hip replacement yesterday and seems to have come through the anesthesia with flying colors.

That's the good news! The orthopedist is trying to send him straight home and he and my mom (also 79) would prefer he go to in patient rehab. He has been immobile for more than six months with his bad hip being a limiting factor to him getting stronger. He also has CHF. He has been cared for at home by unskilled nursing and my mom.

Does anyone have experience with this? Any thoughts or suggestions would be greatly appreciated!

[Anonymous]

He might get better/more consistent/more frequent physical therapy in a rehab than with home therapists.

If he has to be lifted/held up and is a serious fall risk because of debility, he might be better off in a rehab than at home unless he can afford aides to handle that.

An unfortunate drawback of rehab is the possibility of hospital-acquired infection. If his mental status is such that he would require a lot of supervision to avoid falls and other dangers from climbing out of bed unsupervised, a rehab might not be able to provide that consistently.

[Anonymous]

Anonymous wrote:He might get better/more consistent/more frequent physical therapy in a rehab than with home therapists.

If he has to be lifted/held up and is a serious fall risk because of debility, he might be better off in a rehab than at home unless he can afford aides to handle that.

An unfortunate drawback of rehab is the possibility of hospital-acquired infection. If his mental status is such that he would require a lot of supervision to avoid falls and other dangers from climbing out of bed unsupervised, a rehab might not be able to provide that consistently.

Thankfully his mental status is very good, so he is a cooperative patient. He does have "helpers" he could hire to be at home with him but our experience with the Medicare home PT is that it isn't very high quality.

[Anonymous]

Rehab. More consistent care. No fear of no shows. As mentioned above-PTs who come to the home did not seem very good and we actually had an accident requiring ER trip. If AL ends up being needed, easier to move when already used to being away from home.

[Anonymous]

Home. In-patient rehab isn’t needed for hip replacement.

[Anonymous]

Rehab. My father (78 at the time)broke his hip during Covid, and rehab meant we could not visit him for the whole time. He still chose rehab and soldiered through it. He said if it wasn't for rehab, he wouldn't be able to walk again.

[Anonymous]

Medicare generally will not cover inpatient rehab for just a hip replacement.

[Anonymous]

Rehab 100%. My 84-year-old mom broke her hip 5 weeks ago and is still in rehab. PT and OT there are amazing, and she's gotten so much stronger. Was this a total hip replacement? How on earth could he be ready to go home immediately?

[Anonymous]

Rehab.
My FIL, 85, had surgery mid-October after hip fracture. From hospital to inpatient rehab, where he received many hours of PT daily.
After 2 weeks to a different rehab facility (they reside in a continuing care community, so he is temporarily not in his apartment, but across the street at their rehab facility) where he receives 3 hours of PT weekdays and some OT.
He is very happy with the level of care and said he could not imagine that he would be standing/walking at all without the rehab.

[Anonymous]

Anonymous wrote:Home. In-patient rehab isn’t needed for hip replacement.

You cannot be serious! My mom broke her hip last year in a fall. I could not even have gotten her home from the hospital in a car! She was taken by transport to rehab for 6 weeks and yes, medicare paid-because it was needed.

[Anonymous]

Physical therapist for 20 years here. A hip fracture is very different than an elective hip replacement.
Unless he had severe mobility issues, I would vote home. And like PP mentioned, rehab may not be covered. I would guess less than 10% of patients currently go to rehab after a hip fracture.

[Anonymous]

Anonymous wrote:Medicare generally will not cover inpatient rehab for just a hip replacement.

Not true.

[Anonymous]

Anonymous wrote:Physical therapist for 20 years here. A hip fracture is very different than an elective hip replacement.
Unless he had severe mobility issues, I would vote home. And like PP mentioned, rehab may not be covered. I would guess less than 10% of patients currently go to rehab after a hip fracture.

Right. Hip replacement VERY different from breaking a hip/hip fracture. My 78 year old dad just had his hip replaced two weeks ago. Spent one night (after surgery) in hospital and then went home. Moved to bedroom on first floor but otherwise hobbling around okay.

[Anonymous]

I was also going to say that your biggest issue is going to be finding a payor source. Also inpatient rehab requires that you be capable of and require three hours of rehab b per day. Not sure that you really want that or need it. If you’re insistent in inpatient you might have better luck with a SNF.

[Anonymous]

My mom (80) came home after a knee replacement with one night in the hospital. Tougher surgery than the hip I understand, but it sounds like she was probably more mobile than your dad, and she lives with me and my family so (as far as the hospital saw it) plenty of help. I think she was happier at home than she would have been at rehab (although she was pretty miserable, as was I) but the at home PT was pretty minimal and while she would have hated the rehab I think it would have ultimately made for a better recovery for her. If there is ever a next time I will push for rehab.