Total hip replacements and Occupational Therapy

I have a vested interest in this post. I am about to have a total hip replacement. I decided that it was time to get up to date with the latest does and don’ts and to see what online advice is out there. I was interested to see how well occupational therapy was using the internet to advise those needing surgery. What have I found?

Interesting there is little change in the advice since I trained 30 years ago.

What did I find and what did I expect to find:

1. I expected to see a more occupation focus to the occupational therapy information. Most information talks only about ADL’s and related equipment. In living with a hip that needs to be replaced there seems to me to be a lot more that could be talked about. It was even difficult to find concepts such as energy conservation and work simplification.  
2. I expected that there would be presurgery advice. I don’t mean information given out a week or two before surgery and associated with preparing for surgery and the weeks after, but rather advice to assist from the time the possibility of surgery is identified.  Advice that includes priniciples of joint protection on both the affected and unaffected side and that helped you keep in the best shape physically before surgery and helps you keep engaged and participating as things get harder to do (as of yet I haven’t found any info that would cover this).
3. I found that there is an assumption in the information that if you are having surgery you are in the older age group and  not it seemed doing a lot! e.g. only needing to dress, shower, eat prepared meals for one, sit a lot (in the same chair) and occassionally drive a car!. Yet I know that  there are many very busy active 60 plus’s, and then there are the people like me I meet who are working, paying mortgages, engaging in a wide range of activities, some with young families,  all heading towards a hip replacement.
4. That occupational therapists would have got together with consumers and worked up some really good information that all occupational therapists could use, after all there is no sense everyone reinventing the wheel. 
5. That the advice would be consistant. There seems to be differences in some advice and no rational given for why the advice may differ e.g  whether you should sleep on the operated side or the nonoperated side, the precautions associated with internal and external rotation, and moving the operated hip backwards.
6. Occupational therapy advice seems hooked on equipment, rather than techniques  e.g. what happens after the first week or so when the person get more active e.g what do you do if away from home and needing to go to the toilet and there are no high seats?

Therefore…

If you are heading towards a total hip operation what do you need to know in relation to the tasks and activities you want and need to do? Perhaps then occupational therapists will take up the challenge to design information that helps you.

and occupational therapists what are the best examples of information from occupational therapists already online? and why? and what evidence is there that should we be calling on in the information we put online?

I look forward to hearing your thoughts.