After Joint Replacement: Finding the Right Rehab Program

For those who suffer from joint pain and limited mobility, joint replacement surgery is an increasingly popular option. Today, about 7 million Americans are living with a total hip or knee replacement. After this surgery, most patients are eager to return home for recovery and rehabilitation (“rehab”). Yet going home is not always the best decision. In search of a faster, more complete recovery, many joint replacement patients are choosing a short-term inpatient rehab program.

“Ongoing care and therapy post-operation can be as important as the surgery itself in ensuring the best results,” says Tori Owens, the chief executive officer at Accel Rehabilitation Hospital of Plano. “Inpatient rehab centers are equipped to provide a higher level of therapy and personalized care than typical outpatient or in-home rehab programs. They’re focused on reducing the risk of complications – and helping patients make an optimum recovery, quickly and safely.”

Managing care

“A key benefit of an inpatient rehab center is 24-hour patient care and support, from medical care and monitoring to nursing care, wound care, medication management, and pain management,” Owens says. “Personal care services help lower stress, increase comfort, and speed recovery. Also, inpatient rehab facilities tend to have more top-of-the-line equipment for more comprehensive therapy than outpatient treatment programs.”

Instead of seeing one therapist for office or home visits, as is typical of outpatient programs, patients work with a physician-led, multidisciplinary care team of rehab professionals who plan and administer treatment and care. Team members may include rehab physicians and nursing staff; physical, occupational, and speech therapists; nutritionists; case managers; and others depending on patient needs and preferences. “Because all these professionals are working together onsite – with the patient at the center of care – communication is efficient, and treatment is seamlessly coordinated,” she notes.

Making strides

Inpatient rehab provides intensive physical therapy to help patients regain strength, mobility, and range of motion. “Unlike outpatient rehab, which usually involves seeing a therapist two or three days a week for an hour or so, inpatient rehab typically provides three or more hours of therapy each day,” says Anh Nguyen, MD, medical director at Accel Rehabilitation Hospital of Plano. “All therapy sessions are customized to meet each patient’s needs.

“Along with physical therapy, patients also receive occupational therapy. The therapy team teaches safe procedures for such activities as dressing, bathing, toileting, and getting into and up from a seated position. This anticipatory guidance helps patients feel well-prepared and confident when they’re ready to return home.”

Matching needs

In evaluating inpatient rehab centers for care after joint replacement surgery, Owens and Nguyen offer 10 tips:

  • Look for facilities that provide acute rehab services. Get a list of approved providers from your insurance company. Find out the requirements for precertification and how many days will be paid for. What supplemental services and amenities are offered, and which are included in basic rates?
  • Check out the facility. Observe patient rooms, physical therapy equipment, and activities. Do patients appear to be happy? How about the staff?
  • Will you be evaluated and treated by a multidisciplinary team of professionals? Will treatment plans be personalized to your needs and preferences?
  • Will care be available 24 hours a day, and will you be carefully monitored for any medical issues or complications?
  • Ask the physical therapists about their background and areas of expertise. How many knee and hip replacement patients have they worked with? What is their approach to patient-centered care?
  • How many times a day will you receive physical therapy? Are occupational therapists available to help you prepare for your transition to home?
  • Will you have free access to rehabilitation equipment between therapy sessions to work toward your recovery goals?
  • What is the dining experience like? Will you eat meals in your room, or does the facility have a central dining area? If you have special food needs, can the facility accommodate them?
  • Are family members encouraged to participate in your recovery plan?
  • Will a case manager coordinate your care after discharge, such as transportation, home care, physician follow-up visits, and medication management? Will a home assessment be conducted to make sure your home is safe for your return?

Moving forward

“One of the best things about inpatient rehab after joint replacement surgery is that it frees patients to focus fully on their recovery,” Owens says. “The comprehensive care provided relieves the stress and anxiety they’d face in going directly home after surgery. They don’t need to worry about managing essential tasks, such as caring for their surgical wound, monitoring any complications, keeping track of medications, preparing meals, and navigating medical appointments. They can focus instead on the number one priority: getting back on their feet and back in their life.”