Mother sent home after knee surgery. Any advice?

I had a knee replacement at age 60. It was the most painful three weeks of my life. After the operation I was sent to a nursing facility rehab for three weeks where I got intense physical therapy every day. There is no way I could’ve taken care of myself and I was not 75 or confused. The logistics of getting in and out of bed and off the toilet etc. cannot be handled alone. The hospital should never have sent her home, she needs ongoing physical therapy or that knee will never heal or she will not be able to bend it or extend it properly. Call around today and find a rehab facility where she can go. Insurance should cover at least three weeks. Do not wait any longer or it will be too late.

Check with her doctor about rehab, but get a raised toilet seat to solve that problem.

Hope this isn't too harsh. I am thinking that if your mother didn't have someone taking care of her, she could do it herself. Unless she has some kind of dementia, at 75 years old she should still be capable of dealing with this. She may not like it, but we all have to do things we don't like. If she can operate a telephone and get on the internet, she should be able to arrange for help for herself. I am 73 years old and know many 70-80 year olds who still care for themselves easily. I think you need to tell her that she is fine, needs to deal with this for a while and will get better, perhaps help her make arrangements for food delivery, and then go home.

My mom just had knee surgery too. 3 weeks out. 3 nights in hospital cuz she wasn't doing so well. 7 nights in rehab which was needed. Now back home with me and I guess it might have been too soon cuz she is a totally reluctant patient with me. FIghts EVERYTHING I suggest. Doesn't do her PT except when the guy is here to lead her.

Anyway, she should have gone to rehab right away. I don't know that medicaid would have paid unless she stayed in the hospital for X nights (2 or 3?). If there is any money, having rehab at a nursing home is probably her best bet at this time. Or a full time aid could be hired, maybe through home health services.

It's too much for one person to take care of at home. Is she getting home PT, etc.? I don't know why they send people home from the hospital to an empty home when they obviously can not take care of their ADLs.

Good luck!

I work in Physical Therapy in a rehab. I can easily picture your mother and have a few suggestions.

During this initial recovery period, it's critical that she gets as close to daily Physical Therapy as possible to work on increasing her knee range of motion, strength and also safety with mobility. You can advocate for her by asking for as much PT as her insurance will allow. You can ask if she's a candidate for rehab if you feel that your mother is not managing her recovery well at home. Being in rehab is a bit tricky with the rise of covid, unfortunately nursing facilities have a higher risk of covid right now, though many are under scrutiny of state authorities to have a plan for infection control. If one can effectively recover at home, it's probably safer. I guess you'd have to determine whether or not she is being effective in her recovery at home. Ask for input.

If she does stay home, and if the PT thinks she's safe enough to be left alone for periods of time, you can look into having a home health aide come in part-time to heat meals and empty the commode. That would allow you to leave and take care of your own business. If she's not yet safe enough to be alone, then it might help to remember that this is a temporary arrangement, as hard as it is on you. Maybe there are others who can step in and help? I would also recommend her having Lifeline alert (button to press if she is in trouble). Ask the PT (or OT) for suggestions on walker baskets or trays that will allow your mother to carry items or a plate of food. She could practice using them in her therapy sessions.

If the pain is not manageable, you can have a conversation with her doctor/nurse about pain meds. Icing for 20 mins is also known to be very helpful.

If your mother is having trouble with her PT exercises, you could ask the PT what exercises are easier for her to do on her own so that she continues to work on range of motion and strength when the PT is not there. Very important. She should have pictures of her exercises and a plan on when she will do them. Everyone is different in how they recover from this surgery with different pain thresholds. With knee replacements, it is critical to keep working daily on getting the range of motion back or else the knee may scar down and need to be surgically released. That's the worst case scenario. The PT should be explaining this to your mother, but sometimes it needs to be said again.

It is easy to feel discouraged, but doing nothing is not the way to recover from this surgery. Perhaps the PT can think of ways to make her feel like she is making some gains and increase her motivation to participate. The more she can do in her own recovery, the better off she'll be and the less you will be needed. She may need you more at first and then gain confidence and increased independence as she continues to recover and the knee heals. Keep consulting with her medical team about her progress and safety and if they have a reasonable sense of how long she will need this extra watchfulness and assistance that you've been providing. Usually it's hardest at the beginning but gets better, but everyone is different in how long recovery takes, so ask questions and get some guidance from her team.

Best of luck!

Thank you for your reply. It sounds like we have a lot in common. My mom was in the hospital for 5 days because her oxygen was low after surgery. I wish the dr would have suggested she go to rehab. This job is bigger than I can handle at this point. I’m exhausted because I’m doing everything for her -she has no motivation. I can’t continue this. And my family at home needs me there too.

She should have gone to rehab first.  They would have pushed her to do the exercises necessary and dealt with pain management.  Then she could have come home and you could have had a week with her to get her acclimated to her new normal.  I realize hind sight 20/20....

You're going to have to call her doctor and see what they can arrange.  When my mom had her knee replacement, they had rehab come to her house to work with her.  Buy a freezer full of microwave meals that your mom can easily heat for herself.  Have a deep conversation with her and explain that you can't stay there and that if she doesn't push herself and follow the exercises that the dr is telling her to do, she will have to go to a long term care facility to rehab.

If she has some mental decline, that's another conversation all together.  My mom was acting weird before her knee replacement, but we had no clue it was dementia.  I just thought she was being an a**. LOL  After moms surgery, things worsened and it became obvious that she had cognitive decline.  My mom was in her late 60's at the time.

Call the Dr and her Insurance Co let tgem know she needs to go to rehab because you have to get back to your own home and it is unsafe fir her to be alone.

She'll need at least another 2-3 weeks help.

You could install a 4-6" booster toilet seat on top of her regular commode which makes it high any actually more comfortable to sit on then a bedside potty.

That's what I did for my 96 yr old dad but in the beginning when he was using a beside pot, I lined the bucket with a small plastic garbage bag which made it very convient to tie and dump. No cleaning needed.

You might also consider having a Caregiver come in a couple hours and she could empty the pot or bag.

In the meantime, but easy to fix microwaveable food. They sell breakfast and lunch meals.

My Dad loved the Jimmy Dean's Breakfast Sandwiches and their Cuzine meals.
Easy and Fast to fix and no plates to wash.

Hi, your mom should have been sent or scheduled by the doctor who did the surgery for some form of rehab/physical therapy. I would get back to them ASAP and follow up as to why she was not recommended for those services.
Best of luck.

I think CTTN has a point - - I think doctor may have made his decision partly due to knowing daughter would be there. I've seen it happen where the doctor's impression of the post-op environment is not accurate but yet decisions are being made.

I know an elder who was discharged inappropriately after a serious medical event. She desperately wanted to go home. So, when asked if she lived alone, elder stated she did not live alone and while her statement was technically true..... The honest to goodness truth is that she had a renter staying with her. Not a caregiver - a renter. Renter worked a full time job and there was no expectation that renter would cook, clean, toilet, laundry, transport, meds or do any of those things that elder now needed done for her. Family, of course, did not know until much later that elder was asked the "living alone" question. Family scrambled like mad to assist elder but the discharge was a disaster in general.