My 86-year old father has had an MRI and is being considered for knee replacement as the MRI revealed bone-on-bone. The first thing is clearance from his cardiologist as he is on a blood thinner to prevent strokes. (He has had three, none which have resulted in permanent cognitive, speech, or mobility issues.)
He has Medicare plus Part A and B supplements through AMAIA. The orthopedist has stated he might be in the hospital day of surgery and one additional day. Because of this, he indicated that any type of skilled nursing facility would be an out-of-pocket expense for my father. Is this true?
As I read the Medicare FAQ page, it appears that he would need three days admittance...but that is unlikely unless there are complications...which we, of course, hope do not arise. Am I misreading this? The orthopedist said that Medicare would only pay for home health to come in a couple of hours a week to help with housecleaning...but that isn't needed as my father lives with my husband and me.
I am very concerned about doing bed to wheelchair or bed to bedside commode transfers...both for his sake as well as my and my husband's sake. My father weighs 185 pounds. He is currently going to PT right now for upper body strengthening exercises...but he currently cannot use his upper body for self-transfers.
My Dad, who was in his early 90's, went to a doctor about his knees which were also bone on bone, and quickly the doctor said time for surgery. Thankfully my Dad refused to schedule even though the doctor [surgeon] kept insisting. Dad took his walker and walked out.
With modern medicine there is now a gel that can be placed, via needle, to help cushion the bone on bone, and one would need to go every few months to have it done. I would vote for that. My Dad never had that was it wasn't available at that time.
Don't forget, long surgeries on someone your Dad's age could result in some type of memory loss. Did the doctor warn you and Dad about that possible side-effect? And has the cardiologist given thumbs up on this surgery?
I know a few people who are half your Dad's age and they wished they never had the surgery as the rehab was grueling.
86 with no rehab, sheesh, I don't know that I would trust this doctor. It doesn't even make good sense to not plan rehab for a 86 year old with knee replacement surgery. It's a big deal.
As far as the physician treating him, I don't think there were other options discussed other than he would need to be cleared by his cardiologist and neurologist for surgery since he would have to go off his blood thinner. Perhaps once that hurdle has been cleared (or not), options will be discussed.
My aunt had knee surgery when the choice was kneee replacement or wheel chair. She was in her 90s. It was the second replacement for that knee. First one 25 yrs earlier. She didn’t go to rehab. Although I think she was in the hospital for the three nights necessary but didn’t choose rehab. Call Medicare and ask.
My aunt didn’t have a heart condition but she was on dialysis so she had extra things to consider as well.
Since he is on traditional Medicare he can get home health to come in and check on his wound, bring in a bathing aide and bring in physical therapy. They can set up his meds and make sure he is doing well. If he is homebound he can keep home health coming in. Ask them to work with his doctor for doctors orders if you find them helpful. This could be his primary doctor when the surgeon is ready to release your dad from his care. Since you work it would be helpful to you as well as dad to have them coming in.
I’m not advocating one way or the other to have the surgery. Each persons situation and other health conditions are unique. My aunt knew she wanted the replacement because she didn’t want to be in a wheelchair. Find him the best doctor available and ask for all possible choices.
Good luck with dad's surgery!