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:

Home Safety

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 items that you regularly use 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.

Body Changes

Some of the factors you may have to keep in mind about the patient’s changes in bodily functions include:

  • The patient will often have a poor appetite for days to weeks after major surgery. Their body knows some major event has occurred, and goes into survival mode. Their hunger may be suppressed, their gut slows down and they feed off their own fat and muscle stores. They may be very disinterested in food, and indeed a little nauseated. It is important to ensure that they have easy access to fluids until their desire for solid food increases.
  • The patient is often fatigued and disinterested. They may have difficulties in sleeping at night, yet need to nap frequently during the day. Daytime napping should best be done with curtains open so their body clock does not get confused. If possible, they should not sleep too long during the day.
  • Provide the patient with laxatives or stool softeners to combat constipation, which has many causes following surgery, including as 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.

Rest and Elevation

  • Frequent rests, preferably with the feet elevated on pillows (and therefore above the level of the heart) reduces swelling in the legs.
  • Sitting for long periods of time is not recommended. This increases swelling and pooling of blood in the legs, kinks the veins behind the knee and in the groin, and may lead to blood clots.
  • Inform the physician when pain or swelling in the legs increases.

Incision Care

Some of the instructions that you will be given about incision care include:

  • The wound will usually be covered with a ‘waterproof’ dressing. This is fine to shower with, and the dressing can be removed at about ten to fourteen days post-operatively.
  • Immersion in a bath should not occur until discussion with the surgeon at the six-week post-operative visit.
  • Inform the surgeon if there is increased redness, drainage, odour or pain around the incision.
  • Inform the surgeon immediately if the patient’s temperature rises above 38.1°C.

Controlling Pain and Discomfort

Caring for the patient will include various methods of helping the patient control post-surgical pain.

  • Pain medications may be given 30 minutes before physical therapy.
  • You can encourage the patient to gradually reduce pain medications.
  • Ice can be used for about 20 minutes every hour to control pain, in the first 3 to 5 days.
  • 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 crossing the legs, twisting and bending the hip past 90 degrees in the first six weeks.
  • Infection: can be identified by redness, swelling, increased local pain, or leaking of old blood or pus. Your surgeon should be notified immediately.
  • 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 regular exercises, elevation, blood thinners and small amounts of walking. Your surgeon should be notified.
  • 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 occasionally confusion. An ambulance should be called and emergency transfer to an emergency centre should occur.
  • Heart attack: this can be identified by severe chest pain, sweating, collapse. An ambulance should be called and emergency transfer to an emergency centre should occur.
  • Australian Orthopaedic Association
  • American Academy of Orthopaedic Surgeons
  • Australian Society Of Orthopaedic Surgeons
  • AOA Medico-Legal Society
  • American Board of Independent Medical Examiners