With recent advancements and new models of post-surgery care, people now have plenty of options for recovering outside of a hospital.
While post-operative care can still carry risks, it is common to have complications after surgery and discharge. Sometimes your body might react in a way that requires experienced personnel to identify and quickly recommend the course of action so you do not put yourself at risk.
Orthopaedic surgeries and post-stroke recoveries should also always be followed up with physiotherapy on a daily basis for the initial period. This actually gives you the best chance of recovery possible and reduces the risk of complications or non reversal of certain conditions.
In stroke recovery especially, a recent study done by Dr Brian Doctrow in 2021 titled “Critical Time Window for Rehabilitation After a Stroke” seems to suggest that the “golden window” would be between 60 to 90 days after stroke onset.
Most seniors that have been hospitalised for days or weeks also usually tend to not be able to walk after that. This is where physiotherapy is highly needed to get them strengthened and back on their feet again so they do not fall and end up in hospital again, or experience other worse-case scenarios.
Typically, on post-surgery or post-hospitalisation discharge you would choose between two alternatives – home care and post-hospitalisation/post-op care facilities. Some might wrongly select “old folk’s homes” or nursing homes where the primary clients are there for palliative or end-of-life care and do not have a proper physio facility with robotics or specialised technology for proper recovery.
The best way to approach post-op recovery or post-surgery care and the respective costs is to know that it should be a very short period instead of a prolonged one in order for it to be successful, because a long recovery time could mean more risk for complications to develop. When the body experiences progress and healing, the person undergoing recovery is also at less risk of depression, which is to be avoided at all cost! This of course is dependent on the person undergoing the surgery or hospitalisation. So while there might be a base rate, post-op care providers usually need to understand the condition before they are able to offer a quote. An example of what the post-op care providers needs to know would be:
Are they healthy and young?
Are they older and have other medical conditions?
Have they been immobile prior to the hospitalisation?
Do they have other underlying conditions that need to be addressed?
The whole recovery process for the person undergoing discharge should be approached as someone who needs observation and assistance from an experienced team of nurses and caregivers, physiotherapy to strengthen, correct, address pain and range of motion with the relevant technology available and for some, possibly a special diet that changes from the time of discharge to recovery (this is not just for stroke recovery but especially so for those undergoing stroke recovery). It might be someone coming off or requiring tube feeding and transiting to soft food with the help of a dietitian, to ensure sufficient nutrition, and a speech therapist for someone who might have lost their ability to speak or swallow.
Depending on the assistance they need, if you choose home care, you might need to be prepared to engage a number of professionals to the home, rent equipment or even make daily trips to the physiotherapist and encourage the senior to keep regular with their physiotherapy appointments. We recommend physiotherapy in a centre instead of at home as manual physiotherapy provides a very slow progress. If your aim is to recover as soon as possible (which it should be), robotics and technology is certainly the way to go and cuts your recovery time significantly!
In ReU Living, our experience (and with a combination of our protocols and care) with orthopaedic recovery (total knee replacement – TKR, total hip replacement – THR and spine surgeries) for a healthy person can be as short as a few days, and by 3 weeks, you can definitely see signs of the road to recovery, or certified fit for discharge to go home and back to daily living. For stroke recovery, our milestones are monthly, with 2 months as a good indicator of what to expect in the 3rd month. You could read more about our methodology and approach here.
Whichever your option, we recommend that if you have the means, you MUST spend it on your recovery, not just a surgery. A surgery might provide a pathway to recovery but post-operative rehabilitation care is the vehicle/insurance to take you there with a high certainty, given the technological advancements in rehabilitation machines and robotics nowadays.
That’s us, but let’s dive into the home care option, shall we?
Cost of Home Care
The first question everyone has when it comes to home care is – how much would it cost? When it relates to an individual person’s wellness and body, it’s not as simple as a fixed menu pricing, but typically, here are some costs that you should be aware of, and benchmarks you can consider.
First and foremost, you’ll have to consider the time taken to source for the right caregiver. This means looking for an agency which provides caregivers or an independent caregiver, interviewing them, allowing them to meet the person they will be caring for, agreeing on how many sessions are required or the family’s requirements for flexibility and only then would you know roughly how much you would need to pay daily or even monthly.
The time cost here is significant because the selection process can be very long, the longer the requested items get. You might also need to account for the possibility that the caregiver might not be available as frequently as you’d like, and you might therefore need to hire two caregivers to rotate between to make sure you receive adequate care. There is also the possibility that with more complicated requests, the agency might not even be able to find your caregiver or fulfil your requirements.
In terms of monetary cost, it would typically cost between RM4,500 – RM6,800 per month or a market average of RM30-35/hour for the caregiver to go to your home. It is usually costlier for live-out caregivers who come and go due to additional transportation costs. You could hire a live-in caregiver but food costs are not included in the rates above – that’s additional cost you have to factor in (we will discuss cost of food for the patient/client in the next segment). Perhaps that might amount to another RM600-750/month so you might be looking at a minimum of RM5,000-7,500+ at the top end, and you need to provide a proper place for them to sleep. Sleep is necessary for them to function properly in giving care.
They’re also not maids, so do not attempt to make your money’s worth by getting them to cook for the family and clean the whole house while they’re there. It might indicate that you have hired a maid for the home instead of a specialised caregiver.
Assuming you have a live-in caregiver but you need lots of care, you could hire a maid to cook, order food/catering or meals from specialised providers so the caregivers can have more time for care. Nutrition is a huge factor to recovering well as the body needs proper nutrition to heal itself. Do not stinge on nutrition at this time. You might have a dietician advise you on food options, but you’d have to be disciplined to stick to your diet and have it properly prepared.
Normal meals are already estimated at around RM30/day or about RM1,000/month as a conservative guess, and this is not for customised food cooked for you. Let’s just say RM1,500 to also cover the cost of delivery for days you don’t feel like going out or want a break from catering. If special senior-friendly or soft diet meals are required, it is approximately RM150/day or RM4,500/month.
With just a live-in caregiver and cost of meals for both the client/person receiving care and the caregiver, it can easily cost anything from RM6,000 (basic standard food with little nutritional value, e.g. noodles, porridge etc) to over RM10,000 for proper care and nutrition + the cost of basic meals for the caregiver.
Social Life & Security
If you live alone, recovering at home can get extremely tough. We know people going through their post-op recovery or post-hospitalisation recovery experience bouts of depression not just from the fact that their body may not feel like how it used to, the person taking very long to recover or they’re just drained from all the extra strength they need to go about their day trying to manage staying at home with a maid.
Security concerns are also a big issue, especially when your mobility is affected. It’s known that elderly who have compromised mobility and try to continue with daily living routines at home put themselves at risk.
When it is just you and the caregiver at home, there is no peer support or encouragement from anyone else on bad days or to soften the long journey. Often, it is also difficult to communicate with the foreign caregiver or oftentimes, the maid. Security also comes in the form of peace of mind, something that might be missing when you get care at home from a non-professional.
Cost of Another Person’s Quality of Life
Usually when a senior couple goes home, it is assumed that the other senior spouse will take care of them. This is a risky gamble and quality of life is often compromised during that period for both. It could end up costing the family more in many instances. One must think carefully if it is worth saving that money and taking that risk.
Firstly, it’s unrealistic to expect the other person to know exactly how to provide recovery care overnight. We have seen cases where medication was mixed up or the other senior lacks the strength to lift the spouse, resulting in injuries to the one that was well. Their bodies are also not in the condition to assist, it really puts an unnecessary strain on both as this role is usually done by a team of trained nurses or caregivers, even in a hospital environment.
The duty of care somehow also usually falls on the unmarried spouse, women, or the youngest of the family is “sacrificed”. Some also have to take leave from work or quit their jobs altogether. For senior management, getting the same role again later in life might not be possible, so you might have just ended up saving some costs upfront, but losing a long-term career prospect of earnings. All this sacrifice could lead to caregiver burnout.
Cost of Readmission
To extend the previous point – family members are not professional caregivers. It is unfortunate when it happens, but sometimes an untrained family member does not know what to look out for in terms of symptoms or even understanding vitals and sudden turns for the worse go undetected.
We understand the mindset of “the safest hands are our own”, hence why some families opt out of recovery care and instead choose to recover at home and have family tend to the person’s needs. But we urge you to rethink this because sometimes good intentions lead to more issues down the line, or catching the issue too late.
Some complications might require readmission into the hospital and more costs to be borne while extending the recovery period of the patient. This also means family would need to travel to and from the hospital, the hidden costs are usually undetected and costly.
Please, do NOT attempt to provide care without proper training.
Cost of Not Following Through on Physiotherapy and Rehabilitation
Oftentimes, expensive surgeries go wasted when people choose to opt out of physiotherapy to self heal at home or select to have the occasional manual physiotherapy from a home physiotherapist.
It is almost a certainty that once a senior heads home, they will not complete their required physiotherapy sessions. We have seen many seniors go for expensive orthopaedic surgeries only to go home and sit in a wheelchair and never walk again. Orthopaedic surgery deals with bones and the correction of, while physiotherapy focuses on muscles to give the body strength. They are not disjointed and need to both happen for the person undergoing surgery so they can be mobile once more.
When you’re at home and need professional help, imagine the cost of asking the renowned specialists to do home visits. Naturally, it will cost a lot more for them to forgo the clients in their centre to come over for one client. You might have to arrange Physiotherapists, Dietitians, Doctors and Traditional Chinese Medicine (TCM) practitioners separately so someone needs to be coordinating all of this. House calls typically cost anywhere from 5-10 times their usual hourly rate.
To send the immobile and frail senior out to various clinics multiple times a week would cost everyone time away from work, and not to mention the lethargy from constantly planning your schedule around their appointments, and the backbreaking work of carrying them around. There are better ways to demonstrate love, such as engaging professional assistance, and by that we don’t mean having a maid to care for them. That is just a show that something is being done without actual results of recovery being the objective.
Factoring all the costs above and based on getting proper care on the schedules required to have real recovery, the total cost would come close to or exceed RM10,000/month depending on the combination of factors. But it won’t be unrealistic to expect the homecare costs to exceed any other options available if one were to engage the best professionals over in the frequency proposed. There are significantly more hidden costs than one is aware of, as they’re not paying in a lump sum and often feel it is “cheaper”.
Post operative and post hospitalisation care facilities usually charge based on a package customised to your specific needs. Each package would usually include 24/7 care by a professionally trained team, room and board (all meals), laundry service, access to amenities & activities, and physiotherapy plans for optimal recovery These can range between RM6,500 upwards but is convenient as you can estimate costs better vs home care.
Food is covered for the price and world-class facilities like ReU Living have dietician-endorsed halal menus as well. Some facilities even cater for special dietary needs and ours comes from a 5-star hotel kitchen, so it tastes good while providing the best nutrition for post-op recovery.
Absolutely no hospital or basic food here. Your body needs proper nutrition to recover, not something you would be able to get at home unless you pay for premium catered meals from a specialist.
Social Life & Security
Almost all facilities will offer 24/7 security, and some may even have ambulances on standby just in case of emergencies. There are also teams of people working to ensure your stay is comfortable. You don’t have to do housekeeping or laundry or cook. There would also be social activities planned which helps with combatting post-operative depression and a community of like-minded or similarly aged people for companionship – people who would understand and empathise with what you’re going through and is also an encouragement as they recover together, or see others get better. This supportive community truly helps the experience become a positive one. The activities are also run by professionals and come without additional cost as part of the package.
One unspoken thing about care in specialist recovery centres vs an old folk’s home or nursing home is that the latter focuses on end–of-life-care. It gets really depressing for the person recovering being amongst people who are there for a different reason and often, they don’t even want to be there.
Cost of Physiotherapy and Other Specialists
Post-operative and post-hospitalisation care facilities offer a more comprehensive place for recovery. Look for one that has a proper in-house physiotherapy facility, the equipment and technology is key as it aids in faster and better recovery – this is one thing you cannot get at home, which is why we encourage those who can to visit a proper physiotherapy centre. Because there is a larger demand for specialist services such as TCM, OTs, dietitians and speech therapists for eg, these places are able to offer most cost effective packages. It also usually comes with doctor visits already, for those who happen to need one and for attending doctors, these can also be arranged.
The costs can range, but If not already included in the package the costs for such specialists for example would range from RM120-250.
Costs Less, Better Quality & Faster Recovery
For around RM10,000 (or less if recovery is in days), it’s a massive cost savings from say homecare (which usually drags on for months as less specialists go to the home and no technologically advanced equipment can be carried over). If you take 6 months of recovery at home, one is looking at close to RM20,000 for a caregiver and meals alone for 3 months. This doesn’t even include manual physiotherapy. If you go to an old folk’s home/nursing home to save money instead of focusing on the objective of recovery, chances are 3 months later, the person has not recovered and the cost of care for the rest of their lives is going to be costly. The long term cost is often forgotten and neglected and most just focus on the initial cost.
Recovering faster and earlier also means the family members (you) are not prolonging the whole care timeline, having to take time off from work to chauffeur them to and from appointments and upsetting your own life schedule. There is also a significant cost for this. Furthermore, many have more peace of mind knowing their loved one is given the best standard of care, with all the specialists under one roof. Specialist post-operative care facilities such as ReU Living are also now very comfortable so the family also feels relaxed visiting and spending time there.
In general comparison with many of our clients of whom we perform a baseline measure, when they are given the best care right out of the hospital, they typically recover faster and better with fewer long-term complications reported as opposed to home care or a nursing home.
Convenience & Comfort
Less time is taken away from family who would sometimes need to take leave to check up on them, or have to deal with the discomfort of having a stranger in your home with your loved one while you’re at work.
Recovery is a short period, it is not a permanent check-in, it is an investment in long-term health. Time away allows your loved one, or you to focus on recovering well instead of having to stay at home and feel the pressure of going back to be a parent or a fully-working adult who needs to take care of their seniors or spouse while still in the recovery phase.
At the end of the day, the decision is yours. Some families prefer home care and there’s nothing wrong with that, but you need to be aware that in order to get proper care, you need to have the whole specialist team on hand.
We would encourage you to think long-term – the quality of life you’d want to have daily if you make a full recovery. Pick the option that gives you the best chances of recovery so you can have the best quality of life for you or your loved one. And think of the long-term savings of a well-recovered person.
We wish you a speedy and smooth recovery journey, and if you are curious about what we can offer, you could reach out to us here.