INFORMATION
FOR NOMINATED
CARERS/COMPANIONS

Joint replacement surgery

If you are supporting a friend or relative who needs to have joint replacement surgery, you will probably have lots of questions about what’s involved, how it may affect them in the future and how you can help them so that they recover as quickly as possible. We hope you will find this information helpful in dealing with some of the issues that you may face.

As a friend or carer, there are a number of ways that you can help someone who is planning to have joint replacement surgery and to make life easier for them before, during and after their hospital stay.

Being well informed
Being well informed is a good first step to supporting someone who is planning to have surgery.

  • Look through the information about what’s involved before, during and after the operation
  • Find out more about the Enhanced Recovery Pathway including ‘prehabilitation’
  • Encourage the person having surgery to take an active part in their own recovery and to work with their healthcare team; this can help them to feel more positive and in control of their health, resulting in a faster recovery time
  • Support and encourage them when carrying out their exercises before they go to hospital, as well as while they are there and when they return home
  • During the pre-admission appointment you’ll have a chance to meet some of the healthcare team. It can help to write down any questions beforehand; make notes during the appointment; and, if necessary, follow these up with any further questions later via the links on this site.

Keeping track
It can help to:

  • Keep all personal information, emergency contact numbers, medical letters, appointments and other information together in a folder
  • Write a list all the patient’s medications, along with dosage instructions (if your relative/friend has a dossette box, their GP should be able to supply a list of medication)
  • Keep a diary of appointments along with comments about how your friend/relative is feeling
  • Prepare questions in advance of appointments/surgery
  • Make notes on any advice or information you receive

Managing expectations
It’s important to manage the expectations of your friend or relative so that they understand the limitations they will face in the early weeks following surgery. They may need to make practical arrangements and adjustments at home and to arrange for other people to carry out some tasks. It can be helpful to:

  • Make a list of short and long-term post-operation goals and help your friend or relative to achieve these
  • Work with them on exercises to increase overall muscle strength before surgery; doing the exercises together may help them stay motivated
  • Download the My to-do list’

The pre-admission appointment
At the pre-admission appointment, you’ll have an opportunity to meet the healthcare team involved with every aspect of your friend/relative’s care. It can help to make a note of names/roles/contact details so you can contact them directly if you think of questions afterwards. It’s also important to understand the options for anaesthesia and pain relief.

In some cases, your friend/relative may be given advice about losing weight, cutting down/quitting smoking, reducing alcohol or carrying out particular exercises. This type of advice is often easier said than done and the person having surgery is likely to need your support if they are going to be successful. Please ask us for more advice/information if you need it.

Getting ready for surgery

Top tips:

  • If the person having surgery needs a flu vaccination, please arrange this to be done at least a month before surgery
  • Arrange a visit to the dentist a few weeks before surgery to check for loose teeth and cavities as these can lead to infections after surgery
  • Try to avoid coming into contact with infections in the weeks leading up to surgery and let us know as soon as possible if the person having surgery is unwell
  • Please let us know – and also ask your GP for advice – if the person having surgery has:
    • Any skin conditions such as eczema, psoriasis, rashes or ulcers
    • High blood pressure
    • Diabetes or any other long term condition
    • Is a smoker
    • Drinks more than the recommended amount of alcohol
    • Is worried about any aspect of their treatment
  • Encourage your friend/relative to carry out any exercises they have been given to prepare for surgery

There’s more information about preparing for surgery within this site.

A few days before your friend/relative’s admission to hospital, we’ll give you a call to confirm all the arrangements. We may ask you to help reduce the risks of surgery by making sure that the person having surgery has followed the directions given by the pre-admissions team including:

  • When to stop eating/drinking before surgery
  • Advice about taking their medication
  • Having a bath/shower before coming to hospital to reduce the chances of infection

There is more information about what to expect on the day of surgery on this site.

What to take to hospital
There is a downloadable list of suggested items here. Please remember to bring your friend or relative’s medication and to leave any valuables at home although a small amount of cash is useful for magazines etc.

Education and information
You’ll be given information about our patient support and education programme at the pre-admission appointment. Patient education is an important part of the Enhanced Recovery Pathway, it aims to ensure patients are healthy and well prepared for surgery, and are able to manage well when they return home. Supporting your friend or relative as they take part in this recovery programme can help them to get back to normal quickly.

Asking for advice
If you are unsure about anything either during a consultation or afterwards, or feel that something needs to be explained more clearly to your friend or relative, please let us know. And you can telephone us for advice at any stage before, during or after surgery.

After surgery
After your friend/relative has had their surgery, we’ll telephone you to let you know that everything’s OK and give you a time to visit them.

Soon after surgery your friend or relative will be helped to begin a programme of exercises designed to help them become mobile as soon as possible. They will be encouraged to get out of bed and walk using a walking aid and to carry out these exercises as frequently as possible. Encouraging them to work with their physiotherapists and follow their exercise programme will enable them to return home as soon as possible.

Going home

Most people return home after three nights in hospital, once they can wash and dress themselves, walk around without help (using a walking aid), get up and down stairs, and carry out their exercises.  We’ll discuss your friend or relative’s progress with you and agree the best time for you to collect them. Before they leave hospital, they’ll be given a follow-up appointment and the pharmacist will visit them to discuss their medication and any painkillers to take home. You’ll also be given a telephone number to call if you/they have any questions or concerns.

Your consultant will check the wound and remove any clips at the follow up appointment, and your friend or relative will be advised to continue wearing their pressure socks to help prevent blood clots.

Make sure they have the following before you set off home:

  • Discharge letter for the GP practice
  • Details about the prosthesis (the new artificial joint) to keep
  • Outpatient appointment (around six weeks after surgery)

Caring for your friend/relative at home
Everyone is different, particularly in the early days, and this can affect:

  • The level of pain relief required
  • Energy levels
  • Getting back to doing everyday activities

Your friend or relative will need to adjust their daily routine to allow more time for particular tasks or activities, including their exercises, as well having plenty of rest. They should also take extra care to prevent the likelihood of falls.

During the first few weeks, it’s particularly important for your friend or relative to carry out their exercises and to move around as much as possible to speed up their recovery, as well as to minimise swelling and stiffness and avoid the risk of blood clots.

It’s normal for patients to feel tired as well as frustrated at not being able to get on with their usual activities. Supporting them as they gradually increase what they do each day and helping them to reach their short-term goals can help them to gain strength and confidence.

There is more advice about getting back to normal on this website, including:

Diet
Bathing
Pain relief
Caring for the wound
Getting in/out of a car

Getting into/out of bed
Frequently asked questions

Returning to work
Depending on the type of work your friend or relative does, they may need at least six weeks off. However, everyone recovers at different rates and some people will need longer, especially if their work involves heavy manual tasks, commuting, or walking/standing for long periods of time. Your Consultant will be able to advise you about this.

Supporting their recovery
Sometimes patients can feel under pressure as they see others who’ve had similar surgery walking sooner/better than they can and seeming to recover at a faster pace. You may need to remind your friend or relative that their recovery isn’t a competition; everyone is different and this means that others may:

  • Be experiencing less pain
  • Have been fitter before surgery
  • Have had fewer complications

It’s important to understand that measuring themselves against other patients isn’t helpful and can affect their confidence.


Looking after yourself
When you’re caring for someone else, it’s easy to forget that you need to look after yourself as well. So do make sure that you arrange to take breaks away from caring and look at what you can do to make life easier for yourself while you’re caring for your friend or relative.

Fortius Joint Replacement Centre
at Bupa Cromwell Hospital

164 -178 Cromwell Road
Kensington
London
SW5 0TU


E: info@fortiusclinic.com

Appointments: +44 (0)203 693 2119

Copyright ©2017 Fortius Group Powered by Fortius Digital | Registered in England and Wales. 12345678