How long do you have to use a raised toilet seat after a hip replacement? By 6 to 10 weeks after reevaluation from your physician, you’ll be permitted on doing so.
But sometimes, it can take longer for elderly patients who are frail, or unable to do activities on the toilet from pain, weight-bearing status, and strength of the patient.
What is a Raised Toilet Seat anyway? It is an additional seat on the toilet used for people who are not capable of using the toilet that is lower than their height, have difficulty sitting down or getting up, and those who had undergone surgery like hip or knee replacement.
It can come as portable, nonportable, and installed. It can be a temporary solution for functional problems of an individual, or a permanent preset to a better function on toileting.
Because, it may be easier for a person to use diapers, but at what costs shall it be if they are capable of going with the bathroom with assistance, or with a walker/cane?
To avoid bending down you can raise the toilet seat to few inches which will help in decreasing the seat and the user who is standing.
Decreasing this distance can make a world of difference for people with limited strength or mobility, and even restore their full independence.
But Why Is It Important?
After surgery, precautions and limitation of movement are imposed by your surgeon to give the hip the ability to heal. Especially if it is a recent one.
Also, muscles on the area of the operated leg will definitely weaken after a few days of limited mobility from the surgery. Therefore, training on getting of bed comes first before bladder and bowel movement.
Once at home, most patients rest resort on two things: application of adult diapers, and having a bedside commode. But for those who are able to stand up and ambulate with a walker, or crutches, a practice of doing business in the bathroom is done as training. Acquiring a raised toilet modification can take a while, especially if it’s included on your insurance.
Important Guidelines Before Attempting To Use a Raised Toilet Seat
It is important to note, movements over 90 degrees of hip flexion, and raising of the knees over the chest are not permitted for the first 6 to 10 weeks of a hip replacement.
Whether that’s a cemented, or uncemented type of operation. Because displacement can occur, or loosening of the hip. It will be bothersome to undergo surgery once more, physically, and mentally.
Make sure that you have anti-slip mats in your bathroom. This is to reduce fall risk especially if the bathroom has no divided portion of bathing and toileting.
Also, if possible, install shower/toilet handles for a safer bathroom movement. Insurance companies include it as part of interventions of patients after surgery.
In addition, bathroom necessities from overhead or shall be by reach on chest level. If the patient needs to use toilet paper, it shall be in front of the patient, or upon sight to prevent twisting of the body.
And if using a soap, consider having a liquid soap rather than a hand-held one to prevent any dropping of the soap after taking a bowel movement.
A physical therapist visit at home after surgery will be vital for the strength, balance, and ability to do functional activities especially toileting.
With the collaboration of an occupational therapist, there will be modifications on activities, proper use of walker/crutches, getting up of bed, and of course sitting.
Precaution on Using A Raised Toilet Seat
Assure that you have supervision, especially if you are attempting to go to the restroom for the first time.
There are raised seats that are portable and can be installed by another individual, therefore having a companion while doing bowel or bladder movement will make navigating and sitting on a toilet easier.
Asides from that, it can keep you safe if ever the seat is not attached properly and might be displaced at any point of transferring to sit.
Strength Training Necessary For the Patient’s Use
From a physical therapist’s perspective, strengthening of these muscles and methods on how to do it will benefit the patient’s ability to sit down or have the strength to tolerate sitting positions, and getting up on it.
It is not only the legs, but also involved upper arm strength, and core/trunk stability in order to maintain the position.
Quads strength – this muscle will be useful in order to stand up and maintain leg position on sitting down. This can be done by doing straight leg raises while lying on the back of the bed. This is an initial strength training in order to move the leg in different positions as well, and getting out of the bed.
Glutes strength – often overlooked, but the hip also has the buttock muscles to maintain the position and mechanism of the leg and trunk muscles to move properly. This is one of the muscles highly affected after hip replacement, therefore, strengthening the gluteal area is necessary. The mini squat is an example of an exercise to address that.
Core/trunk strength – postural control in a sitting position will determine if the patient is capable of sitting for a long period of time. A weakened core and trunk may arise from the activities pre-surgery, sedentary lifestyle, and poor body mechanics. Therefore, addressing core/trunk strength will help the patient maintain a sitting position.
Upper Arm strength – lastly, but not the least, upper body strength will be useful in doing transfers from bed to toilet. By being able to push oneself with your arms, it will be easier to access surfaces better or gauge whether it is possible. Strengthening your arms can start from overhead activities from your physical therapist
Overall body conditioning is also added within the strength training. Tolerance training on sitting, standing, and maintaining positions for balance as well.
Education and instructions on the use of the walker, crutches, or even a cane will be given. Most of the visits will also involve an assessment of your home, and your ability to recover from a sudden incident of falls.
How To Use A Raised Toilet Seat
Here is an instruction from Youtube on how to install a portable raised toilet seat. This can be done by your caregiver, your home health aide, or someone who is able to attach it to the toilet seat.
According to the London Health Sciences Centre, if your toilet is lower than your knee level, you will most likely need a raised toilet seat.
Strength on the arms to push and pull yourself is needed to make it easier to move. But first, learning how to sit down is necessary for more activities similar to sitting, like toileting.
How To Sit Down after Hip Surgery
- Back up to the bed or chair where you want to seat until the back of your knees touch the surface of the bed/chair.
- If it is lower than the back of your knee, you can apply a FIRM cushion. It is not advisable to use a soft or overstuffed bed that can lead to folding your hips more than 90 degrees
- Reach your hands to the armrest of the chair, or if in bed, hold firm on the surface.
- Lower your body with your good leg, and sliding your operated leg until you are seated.
- This might look like an awkward position, but scooting is only necessary if the position of the operated leg remains the same.
Using A Raised Toilet Seat with Arms and Versaframe (from the seat):
- Back up until you feel the toilet seat against the back of your good leg
- From holding to your walker, hold the handle of the raised toilet seat
- Slide your operated leg forward while folding the good leg to lower down on the seat.
- Slowly lower yourself down until you’ve reached the seat to sit down. Your operated leg shall be more forward than your good leg that’s folded in 90 degrees.
So, When Can I Stop Using It?
Depending on the physician’s instruction, as mentioned above, an evaluation will be conducted. MRI and X-Ray are done to see if there are any changes in the area, like displacement or loosening.
If there are no changes, and improvement from a physical and occupational therapist is observed, restrictions will be less.
In addition, it will be a measure of whether it’s just the hip that is the problem. Oftentimes, it isn’t, especially if you’re elderly. Factors like knee pain, arthritis, or back pain can be a hindrance to the removal of the raised toilet seat.
Therefore, even easing of the precautions is permitted, it is still up for the patient’s function to know whether it is allowed to remove it.