BANGOR – For many people seeking elective surgery, winter is a popular time – but with the trend of hospitals toward early patient release after surgery, much of the recuperation takes place in the home.

While the familiar setting of home enhances the recovery process, it comes with a unique set of challenges, particularly during the winter months.

Many involve issues of mobility, both inside and outside the home. Priscilla Ireland, a physical therapist with Community Health and Counseling Services based in Bangor, conducts postoperative home assessments for clients who have had surgery to help ensure a safer environment upon their return home to complete the recovery process. Preoperative visits sometimes are done for clients to inform them of some of the changes needed to make the home safer when the person returns from surgery.

Among her suggestions for physically preparing the home for a recovering patient:

. Be attentive to construction requirements if putting up a ramp before surgery, or having one built while the patient is in the hospital. The rule of thumb is that for every inch the stoop is tall, the ramp should be one foot long – so if the stoop is 22 inches high, the ramp should be 22 feet long.

. Carpeting on a ramp is pretty, but can be slippery. There is a sandpaperlike flooring material that can be tacked or glued onto the ramp to provide better grip.

. The ramp should be as wide as a wheelchair, and have a railing on each side.

. Especially at this time of year, keep the ramps and steps cleared of snow and ice. Make sure there’s a good, safe path into the home from the car.

. If a ramp is not feasible, consider building handrails on both sides of the steps.

. Inside the home, be sure all hallways are clear, making room where possible for walking space as wide as a walker. Many surgical patients must rely on a walker or crutches early in the recuperative process.

. Remove scatter rugs.

. Clean the home.

. Remember that bathroom safety is key. Tub transfer benches, shower seats, a high-rise seat for the toilet, handrails next to the toilet and grab bars near the toilet and in the shower are highly recommended.

. Develop a convenient hallway lighting system using “clapper” lights, touch lights or night lights.

. If the patient’s bedroom and bathroom are upstairs, it may be more convenient to temporarily move those living quarters to the first floor through use of a portable bed and commode.

Many of these adaptations can be made possible through the use of medical equipment. Walkers, canes, crutches, wheelchairs, beds, commodes, tub chairs and bathroom railings are among a wealth of supplies available to improve the ambulatory process. They may be borrowed from such local agencies as Penquis CAP, or purchased from medical supply stores or catalogs.

Medicare will pay for some, but not all, durable medical equipment. Some supplemental insurance policies may provide additional coverage in this regard. People should be sure to check with both Medicare and any supplemental coverage they have to learn what is or is not covered by their policies.

CHCS staff members will help clients procure needed durable medical equipment. “That’s one of my primary jobs,” Ireland said, “providing physical therapy and helping to get the needed equipment in there.”

Educating the client about recuperating in the home is another important step in the process, she said. Getting up and down stairs is something the fully ambulatory among us take for granted, but for someone suddenly reliant on a walker or crutches, a little instruction can go a long way.

Ireland said it’s also important for the patient’s loved ones to become involved in the recovery process. “If the patient’s fortunate, his family will become very involved in the person’s care,” she said. “What will happen is they’ll be there when you’re going over the person’s exercise program and later on encourage the person to do the exercises, or remind them of things they need to know and do when the therapist isn’t there.”

Adhering to a plan of care recommended by the patient’s doctor and being assisted in the home by loved ones and professional home health care providers offers the best chance for a speedy recovery from elective surgery. For information on CHCS Health Services in the Greater Bangor area, call 947-0366, Ext. 310.

Laura Fortin is Community Health and Counseling Services’ area manager for home health services in southern Penobscot County.