Introduction

While joint replacement surgery experiences are as varied as the individual patients themselves, their hospital stays all share two common experiences-checking in and checking out. It's important to prepare for the day you leave the hospital as diligently as you did for the day you checked in.

Going Home: The Night Before

If your surgeon says "I think we can release you on Wednesday," Tuesday is the time to get serious about going home. If you didn't pack "going home" clothes, have your caregiver bring something for you. You'll want something loose fitting and easy to pull on over your wound, and you'll need comfortable shoes with non-skid bottoms. Ask about the weather - you may need to have your caregiver bring a sweater or coat.

If you have received flowers and gifts during your stay, ask your caregiver to remove the items the night prior to your expected dismissal. You'll have enough to do in the car supporting your joint replacement limb without having to worry about how to keep flower arrangements from falling over.

The day you are released, your joint replacement surgeon will visit and provide going-home instructions. Once your surgeon says you can go home, the hospital staff will initiate release procedures. If your caregiver is not present, you'll need to call him or her with the good news that you can go home.

• If you have an IV in, it will be removed and a bandage applied.
• Your dressing will be changed. Pain medication may be administered for your comfort on the ride home.
• Your nurse may suggest you have a sponge bath or a shower before going home, and will help you with other personal grooming needs before helping you get dressed.
• Your physical therapist may visit you to review your exercise program, or your surgeon may instruct you to continue with your therapy as prescribed.

The surgeon's instructions will be repeated by either a surgery or floor nurse, who will provide the instructions in writing. If you have questions, or if you are not clear about any part of the instructions, ask for clarification. Take notes or have your caregiver take notes for you. The American Academy of Orthopedic Surgeons recommends asking the following questions before leaving the hospital:

• When will you need to see the doctor again?
• Dates and times home nurses or therapists may come to your home.
• What to do about bandages.
• When bathing is permitted.
• When it is OK for you to be left alone in the house.
• When you will be allowed to drive again.
• Advice about elevation, weight bearing (on a leg) and pushing, pulling or lifting (on an arm).
• What medicines are being prescribed, why, and whether the prescriptions will be filled at the hospital.
• Be sure to pack your notes and all the instructions given with the rest of your personal items.

Someone from the billing department may come to your room to verify insurance information and to arrange for payment of any charges over the deductible. Or, you may be given a phone number to call after you return home.

The floor nurse will let you know when all of the paperwork is in order and you have been officially released. The nurse and your caregiver can help you pack your personal items, and many hospitals provide a "going home" bag for the personal care items they provide during your stay. When you're packed and ready, a volunteer or other hospital staff member will bring in a wheelchair to take you from your room to the hospital exit. Most hospitals have a policy requiring patients to be transported by wheelchair out of the hospital. The hospital staffer will wait with you at the hospital exit while your caregiver brings the car around to the exit. The hospital staffer will then help you into the car, assist you in adjusting your car seat, buckle your seat belt and will close the car door for you, too.