What to Do in the 48 Hours Before Surgery
A Room-by-Room Home Prep Guide
When someone told me they were going home from joint replacement to a second-floor apartment with no elevator, I knew immediately what that meant. It meant an unsafe discharge. It meant that the surgery went fine, the recovery started fine, and then everything got hard.
Most people put all their energy into preparing for the surgery itself. The drive there, the check-in, what to bring. What they don't prepare for is coming home.
Coming home is where recovery actually happens.
I've spent years watching patients do this well and watching them struggle. The difference, almost every time, comes down to how prepared that home environment was before surgery day. Not after. Before.
Here's what I want you to do in the 48 hours before your surgery.
What You'll Learn
- The one thing in your home most likely to cause a fall in the first week of recovery
- What three bathroom items make the biggest difference in post-surgical safety
- Why you should call the pharmacy before surgery, not after
Start with the floors
Walk through every room you'll be using in the first week home. Your bedroom, your bathroom, the path between them, and wherever you spend most of your waking hours.
Look down.
Are there area rugs that could slide under a walker? Extension cords stretched across a hallway? Thresholds between rooms that stick up even a little? Small pieces of furniture you automatically step around because you know they're there — but might not notice when you're tired from surgery and navigating with a walking aid for the first time?
Remove all of it. Put it somewhere it won't be in your path for at least two weeks.
A fall in the first week after joint replacement isn't just painful. It can undo what your surgeon worked to repair. This is the single most important thing you can do for your physical safety, and it takes about twenty minutes.
Set up the bedroom
Your bed height matters more after surgery than it does on any other normal day. Getting in and out of a bed that sits too low is painful and awkward after hip or knee replacement. If your bed is low, a bed rail attached to the frame or a bed riser under the legs can help. Ask your surgical team what height they recommend for your specific surgery.
Put the things you'll reach for most at arm's level — phone charger, glasses, medications, a water bottle, the television remote. You won't want to be bending down or reaching overhead repeatedly when you're sore and trying to rest.
If you share a bedroom, think in advance about which side of the bed makes it easiest to get in and out given your specific surgery. Your physical therapist can guide you on this, but it's easier to figure that out and rearrange furniture before surgery than after.
Don't forget the bathroom
This is where most falls happen after surgery.
If you don't already have a shower chair or a transfer bench, get one before surgery day. Get a handheld showerhead if you don't have one. Get grab bars if your shower or tub doesn't have them — many hardware stores carry grab bars that install without drilling. These are safety equipment, not optional accessories. They protect a recovering joint that deserves to be protected.
Your surgeon will tell you when you can shower after surgery. When that day comes, you need to be stable. Set the bathroom up now so stability is built in.
A raised toilet seat is also worth considering seriously. Getting up from standard toilet height after hip or knee surgery requires more joint movement than most people expect. A raised seat with armrests makes a real, meaningful difference in the first two weeks.
Prepare the kitchen
Cooking is not on the agenda for the first several days home. That's normal and expected. What you need is food that's easy to access without standing at the counter for long stretches.
Cook and freeze meals ahead of surgery if you can. Stock simple, grab-and-go foods: yogurt, cheese, ready-made soups, pre-cut fruit. Put the things you'll reach for most at counter height or at the front of the refrigerator, so you're not bending and searching when you're tired.
If someone is staying with you to help, be specific about what you need. "I'll need meals for the first five days and help getting in and out of the shower" is far more useful than "can you just check in on me." People who love you want to help — give them something concrete to do.
Confirm what needs to be ready before you leave
Before you walk out the door for the hospital, these things should already be done:
- Walker or other mobility aid fitted to your height — ask physical therapy to fit it at your pre-op appointment
- Ice packs or cold therapy unit if your surgeon recommended one
- Your blood thinner prescription filled and at home — not waiting at the pharmacy for when you get back
- Your discharge instructions and your surgeon's after-hours contact number somewhere you can find them
- A specific person confirmed to drive you home and stay with you the first night
That last one isn't a suggestion. You won't be in shape to be alone the evening after surgery. Even if you feel okay, you shouldn't be.
If your home situation is complicated, say so before surgery
If there are stairs involved and no alternative. If you live alone with no one to help. If your bedroom is on a different floor from your only bathroom. If you're not sure you can manage any of this on your own.
Tell your surgical team before surgery day. They can connect you with a case manager, arrange for home health visits after discharge, or adjust the plan based on what's actually true about your life.
You are the most important piece of information your care team has. Give them what they need to take care of you well.
Shira Graham, RN, BSN is a patient advocate with 34 years of nursing experience.
Shira's Patient Advocacy Services was created to help patients and families navigate the healthcare system with confidence.
