Older adults who have caregivers at home or close to them who can assist them during recovery after joint replacement may recover more quickly at home than in a rehabilitation center. A study released by the Journal of Arthroplasty in 2017 found that complication rates were no different after six months between patients who remained in a rehabilitation center and those who recovered at home.
According to the study, recuperating at home after joint replacement is beneficial for certain patients. Those who elect to have the surgery and have no underlying conditions that may make recovering at home more difficult may recover more quickly if they can to do so in their own home. Doctors are concerned about patients who live alone going home after joint replacement. However, many hospitals are now assigning visiting nurses to provide assistance to those who may not have family members locally to help them.
A second study, released in March 2018 and published in JAMA Internal Medicine, reviewed 17 million patient outcomes. The research compared older adults who had undergone joint replacement, most of them hip or knee, who went to a rehab facility to those who were treated with home healthcare. Based on the second report, patients who were sent home improved at the same level as those sent to rehab. The death rate remained about the same, but costs were significantly lower for patients who went home. The study did find that there were slightly more hospital readmissions for home healthcare patients than for rehab centers. However, the researchers felt this was an indication that home health providers needed better training and not that the care at home was not to the level of a rehab center.
Patients who were interviewed indicated that recuperating at home was much better than time in a rehab center. Many stated that they were more comfortable, which also made them more willing to do the physical therapy they needed to recover. In addition, because rehab centers include patients who may have underlying illnesses, a patient who is otherwise healthy could be exposed to illnesses they would not be at home. Living alone did not seem to be an issue for patients who were studied as 90 percent of them said they would choose a home discharge over rehab.
Some researchers believe that the data may be skewed since patients who are sent to rehabs are often sicker and require special services that cannot be provided at home. But the trend has grown – 95 percent of patients who receive a hip or knee replacement are sent home to recover.