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How To Wipe Your Bottom After A Hip Replacement ?

You, just like my mom and I, will have lots of questions about how, and what, you can do after a hip replacement, and some of those questions are rather more embarrassing to ask than others, but nonetheless they still need answering.

To wipe your bottom after a hip replacement without bending forwards you have two options  –

  • using an extendable wiping device
  • using a handheld bidet

This will not be a problem for everyone.

My mom had no issues with her personal care after her posterior hip replacement, but that may be because she is small and slim.

 

Assistive devices for toileting after a hip replacement

If you are having trouble with wiping yourself and not bending forwards, there are a number of devices, along with certain models of raised toilet seat, which will give make it easier to do this without leaning forwards and hurting yourself –

 

Open Front Seats

Both safety frames with raised toilet seats and bedside commodes have models with open front seats, which allow access and more room for personal care.

Toilet Aids for wiping

There are a number of plastic, long handled devices with a gripping mechanism at one end, to which you can attach your toilet paper or wet wipes, and then clean your self without bending more than your precautions allow –

  • “Freedom Wand” is one example, and has a number of extensions which extend the device up to 30″ in length. You can make it  7″, 14″, 21″, 25″ or 30″ long, which should be long enough for most people.
  • “Comfort Wipe” is another wiping device.
  • The gripping system is somewhat different, but it will hold toilet paper and wet wipes.
  • Not as long as the “Freedom Wand” the length of the handle extends a person’s reach by 15 “, but that is still far enough for a lot of people

Both of these devices allow you to wipe your private parts from the front, so you do not have to lean forwards. You simply pass the device between your legs and clean yourself in the upright sitting position.

 

Handheld bidet sprayer

This is my preference, as a bidet will wash you clean, and you don’t have to wonder if you have really got yourself clean.

Handheld bidet sprayers can be easily attached to your toilet water inlet pipe with a T-valve, which of course comes with the kit.

Once you have relieved yourself, you can take the handheld spray and clean yourself.

If you have an open front raised toilet seat, it can be a little easier, but it’s not like you are washing a car.

There is a shut-off on the T-valve, so you can turn that on and off each time before you use it if you are worried about water leaking out of the connection.

There are many, many models to choose from, and you can find them all lover Amazon and at large retailers like Walmart.

 

If you like the idea of a bidet, and you want one for the long haul, you can also get units which –

  • are incorporated into a toilet seats, replacing your existing seat, and which just require bolting to the toilet, and then attaching to the water inlet pipe
  • can be attached under your existing seat toilet seat, and then attached to the water inlet pipe

 

You can get more elaborate models, which are electric and offer a choice of water temperature.

But there is something to suit pretty much every budget.

Sitting on a toilet seat after a hip replacement

If you have to take precautions sitting on the toilet after a hip replacement (typically with posterior or lateral approach replacements), you have probably fitted a raised toilet seat of some kind, and now you are going to get used to sitting on in the right way, so that you don’t hurt your hip replacement.

Should you have a caregiver, you will both need to know how the sitting on the toilet, and the getting up from the toilet, are done.

If you haven’t yet fitted your raised toilet seat, and you don’t know anything about raised toilet seats, I have an article you can look at, “Types Of Raised Toilet Seats: All You Should Know Before You Buy”, and which explains about all the types, with lots of different examples of each, and to what situations, and for whom, they are best suited. In all, I discuss 13 different types of seats which you can use.

How to sit down on a raised toilet seat with armrests

 

If you want a fully illustrated guide on how to sit down using a walker after a hip replacement, I have an article all about that, which you can find here  – “How To Sit On A Toilet After Hip Surgery: A Detailed Illustrated Guide”

To sit down

 

Step 1

With the aid of your walker, slowly back up to the toilet.

 

Step 2

Stop when you feel the seat against the back of your legs.

 

Step 3

Carefully lower any garments that you need to, with your hand on the side of the non-operated hip.

Take hold of the frame with the same hand again, once you have done this.

Next, stretch out your leg with the hip replacement slightly out in front of you.

 

Step 4

Using your hand on the side of your hip replacement, reach back for the armrest of the raised toilet seat on the same side.

Once you have the armrest firmly in your grip, you can let go of the walker with your other hand, and take hold of the armrest on that side of the raised toilet seat.

Carefully lower yourself towards the raised toilet seat, making sure to take your weight with your arms and your good leg, keeping your back straight, and without leaning forwards.

 

Step 5

Sit down towards the front of the raised toilet seat, without attempting to sit down as far back as you can at first.

 

Step 6

With your arms, lift yourself a little and to scoot back deeper into the seat, so you are sitting properly on it  – no leaning forwards, and use your good leg to help your arms a little, if you need to.

To stand up

 

Step 1

Push your operated leg, so it is stretched a little out in front of you.

With your back straight, using the armrests, lift yourself up a little, and scoot yourself to the front edge of the raised toilet seat.

 

Step 2

Before standing, you want to position your good leg slightly further back than usual, as it will be able to provide more force, without causing you to lean forwards.

 

Step 3

With your arms and good leg, push up vertically, with a straight back, and not leaning forwards.

Remember, your leg with the hip replacement should not be taking any weight.

 

Step 4

Once your arms are straightened, using your hand on the side of your hip replacement, take hold of the walker, while you still have the armrest of the raised toilet seat in your other hand.

 

Step 5

Then, with your other hand, let go of the second armrest on the raised toilet seat, and take hold on to the walker on that side.

 

Step 6

Now you’re holding on to the walker with both hands, and your weight is on your good leg, you can bring your hip replacement leg back to a normal standing position. You will put the amount of weight on it, that you have been told to do by your medical team.

Sitting on a toilet seat or raised toilet seat without armrests

 

To sit down

 

Step 1

With the aid of a walker, back up to the toilet until you feel the seat against the back of your legs.

 

Step 2

Using the hand on the opposite side from your hip replacement, undo any garments you need to lower, and then put your hand back on the frame.

Stretch your leg which has the hip replacement slightly out in front of you, and be careful not to do it in a way that you get caught up in your undergarments and trip.

 

Step 3

Now with that same hand that you just used, reach back to the raised toilet seat.

Your other hand on the side of the hip replacement is still holding the walker.

 

Step 4

Sit back on to the raised toilet seat when you have your hand on it, using your hand to take a lot of your weight, lower yourself to the seat.

Once your backside is on the seat, you can let go of the walker.

 

Step 5

Placing your hands on either side of the raised toilet seat, you can push up, to lift yourself slightly, and then scoot back further into the seat.

You need to place your hands towards the back if you can, but not on the front as raised toilet seats can sometimes tip forwards, depending on the quality of course.

 

To stand up

 

Step 1

First, you need to scoot to the front of the seat to make standing easier.

Place your hand on the side of your hip replacement, on the walker, and place your other hand, on the non-operated side, on the raised toilet seat slightly behind you, and push up a little and forwards, and scoot to the edge of the raised toilet seat.

You place your hand a little towards the rear of the raised toilet seat is to avoid it tipping.

 

Step 2

Now push your operated hip leg hip slightly out in front of you, and try to pull your good leg in under you, closer to the toilet.

The hand, on the side of your operated hip, is still holding on to the walker.

Step 3

Now with your hand, on the side of your operated hip, holding on to the walker, use your other hand, to push up from the raised toilet seat, along with your good leg.

Again, the hand on the raised toilet seat must be as far back as when you push up. If you place it too far to the front of the seat, when you push up, you can make the seat tip.

Step 4

To stand up, you are using your good leg, and your arm pushing up from the raised toilet seat to give you all the power, and the hand on the walker is just there to stabilize you.

Step 5

When you are standing, you can put the hand that you used to push up from the toilet, on the walker as well, and stand using the walker.

Step 6

You can now stand in a normal way normal standing position, and bring your operated leg back into a normal posture. The amount of load bearing you are doing when standing will depend on where you are timewise in your recovery, so I can’t comment on that.

How long do you have to use a raised toilet seat after a hip replacement ?

 

If you have to use a raised toilet seat after a posterior or lateral hip replacement surgery, you will typically have to use it for between 6 and 10 weeks following your surgery, before you can start using a regular toilet seat again.

The exact time will, of course, depend on your age, state of health, your type of surgery.

Only your surgeon knows exactly how long he thinks you need it, and he will usually let you know at the 6-week post-operation assessment.

For those who have had an anterior hip replacement none of this is relevant, as only a handful of cases will require a raised toilet seat, and any precautions to be taken for bending or sitting.

 

 

When can I sit in a normal chair after a hip replacement ?

 

After a posterior, or lateral hip replacement, you typically cannot sit in a “normal” chair for up to 6 to 8 weeks, and have to wait until your surgeon tells you it’s okay, which will most likely be at your post operation assessment which should be 6 weeks after surgery.

Even once you have had the okay to sit in a normal chair, it is a good to use one with armrests until 3 months after your surgery, as this will help you to use your arms to push when you stand, not letting you lean forwards, so placing less stress on the joint.

Up until you are told it is okay to sit in whatever chair you would like, you need to sit in a chair –

  • with a straight back
  • with armrests, a solid seat
  • with a seat level, which means that your hip is either level with your knees or slightly higher, but not below

During the recovery period, post surgery, while you are observing all the precautions, it is best to avoid rocking chairs, low stools, chairs on wheels, recliners, sofas, all chairs lower than the height of your knees, and those without armrests.

 

If you have had an anterior hip replacement you should be able to disregard all of the above for the reasons I have already mentioned multiple times.

 

What’s the best chair after a hip replacement ?

 

If you had an anterior hip replacement, you really don’t have to worry about this, unless of course your surgeon has told you to take some precautions involving chairs.

It is wise to avoid any really low chairs, and if the chair has armrests that can make it easier for you to stand up in the early stages of your recovery.

 

For patients who had a posterior or lateral hip replacement, you want to get a chair with –

 

  • armrests – you need these to help you when standing up
  • a straight back
  • a seat which is higher from the floor than the back of your knees, so you are that your hip does not bend more than 90 degrees – if your hip is higher than your bottom that is fine
  • you should be able to place your feet flat on the floor when you are seated – no dangling, or even half up in the air – this is for safety when standing
  • a firm but comfortable seat

 

You should sit on any low seats, puffy seats, sofas and seats without armrests.

If you are finding the chair you are using a little too firm, you can always add a wedge cushion or a square cushion of dense foam, 2 to 4 inches thick, to make things a little more comfy.

It is completely unnecessary to spend a fortune on a chair, that you will only be using it for 6 to 10 weeks, in most cases.

For my mom, we had a very basic upright wooden chair with a slightly padded back and seat, and armrests.

The seat height was about 1 inch higher than her knees, so she was sitting with her hip at a very good angle.

Any time she found the seat was getting a bit too much, she would lie on her bed for a while.

Lifetime Precautions after a hip replacement

 

The temporary precautions that hip replacements patients are advised to take, relate mainly to the surgical procedure that was used, whereas the lifetime precautions relate to the material that the implant was made of.

The range or type of activities you will be able to do, once you have been through the recovery period, does not appear to depend on which method was used to implant your hip replacement, as once your soft tissues have recovered and strengthened, they should be able to stand up to most normal activities.

In general, surgeons recommend that patients can return to sports activities 3 to 6 months after surgery.

You will be advised on what types of activities and sports, you can take part in depending on the type of materials your implant is made of – metal, ceramic, polyurethane –

Typically, a person will be advised that swimming, bowling, stationary biking, dancing and walking are allowed – often referred to as low-impact activities.

Some patients with “experience”, will be advised that it is okay to do downhill skiing, cross-country skiing, weightlifting, ice-skating and Pilates.

High-Impact sports, such as racquet ball, squash, football, soccer, rugby, baseball, softball, jogging and sprinting, are totally advised against.

The recommendations above are all from a study conducted in 2005, where data from 614 surgeons were collected, to find out what was typically”allowed”, “allowed with experience” and “not allowed” after a hip replacement.

“The current recommendations of allowable or recommended activities are derived from surveys of hip and knee surgeons based on clinical experience and preference, not prospective and retrospective analyses.”

The recommendations are derived from what surgeons thought was good for their patients, not from statistics on the results of hip implant failures which occurred while partaking in sports activities. This type of data may be just as relevant, but I though that was interesting to note.

Depending on which type of material a hip replacement is made of, a person will be advised which activities it is safest to take part in.

 

“Polyethylene wear and the associated prosthetic loosening are the most common causes of post‐operative failure and the need for revision surgery. Therefore, activities that potentially expedite the wear through increased frequency or magnitude of loading (such as high impact sports) is a primary concern. To date there is limited information on the specific relationship between wear and sporting activities.”

The particular quotes above, and much of the information, come from the –  IJSPT – International Of Sports Journal Physical Therapy – Nov 2014 –

“Sports Participation Following Total Hip Arthroplasty”

 – by Erik P. Meira, PT, DPT, SCS, CSCS and Joseph Zeni Jr, PT PhD

You can read the article on the US National Library of Medicine National Institutes of Health website here –

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4223292/

 

If you read the article I have linked to above, you will see that there are also risks from different parts of the hip replacement wearing down, with small particulates being ground off, and then getting into the soft tissues, leading to pain, and other complications.

And, you will also see that there is an assumption made, that less vigorous, and a more lower-impact activities, may lead to fewer particulates coming off the implant, and ending up in the soft tissues., but no actual clear evidence.

 

Finally, there is the life expectancy of a hip replacement – (according to webmd.com)

 

“95% of hip replacements last at least 10 years, about 75% last 15 to 20 years, and just over half last 25 years or more.”

If you treat it well, it may last longer, and if you take part in regular low-impact activities, it is assumed that it will last longer !

Best raised toilet seats after a hip replacement

I have an article which goes into great detail about the best raised toilet seats for after a hip replacement, with all the reasons why I have chosen them, and for whom each seat is best suited, which you can find here – “Best Raised Toilet Seats After A Hip Replacement”

Here’s my list of the best raised toilet seats, dependent on the age and weight of the user –

 

Best raised toilet seat for the elderly after a hip replacement

 

1) OasisSpace Stand Alone Safety Frame and Raised Toilet Seat – with a hard seat

2) OasisSpace Stand Alone Safety Frame and Raised Toilet Seat – with a padded seat

3) PlatinumHealth Ultimate Raised Toilet Seat (safety frames with raised toilet seat)

4) Medline – basic 3-in-1 Bedside Commode

5) Nova Drop-Arm Padded Commode

6) PlatinumHealth GentleBoost Uplift 3-in-1 Commode and Shower Chair

 

Best raised toilet seat for larger elderly seniors (over 350 lb) –

 

1) Nova Heavy Duty Drop-Arm Commode 8583

2) Drive Deluxe Bariatric Drop-Arm Commode 11135-1

Best raised toilet seat after a hip replacement for a younger senior in good shape

 

Risers with armrests –

 

1) Nova 3.5″ raised toilet seat riser with arms  (standard), Model No. 8344-R

2) Nova 3.5″ raised toilet seat riser with arms  (elongated), Model No. 8343-R

3) Vive 3.5″ toilet seat riser with handles  (standard), Model No. LVA1071S

4) Vive 3.5″toilet seat riser with handles  (elongated), Model No. LVA1071E

Front locking raised toilet seat with armrests

 

1) Vive raised toilet seat with detachable handles, Model No. LVA10011

2) Drive Medical Premium plastic raised toilet seat with armrests, Model No. 12013

3) Nova raised toilet seat with detachable arms, Model No. 8351-R

I’m Gareth and I’m the owner of Looking After Mom and Dad.com

I have been a caregiver for over 10 yrs and share all my tips here.

Gareth Williams

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