Arthritis and care at home: pain, stiffness, and staying independent

Osteoarthritis is the most common type of arthritis in the UK, according to the NHS. It causes pain and stiffness in the joints themselves, most commonly the knees, the hips and the small joints of the hands, and it can make them harder to move. The NHS lists age, being a woman, being overweight and an earlier joint injury among the things that make it more likely. It is managed rather than cured, and the NHS says that with the right support people can lead a healthy, active life with it and that it does not necessarily get worse.

Rheumatoid arthritis is an autoimmune condition: the immune system, which usually fights infection, attacks the cells lining the joints by mistake. It usually affects the hands, feet and wrists. It can also cause tiredness, a lack of energy and weight loss. It is treated by a hospital rheumatology team with long-term medicines, which the NHS says ease the symptoms and slow the condition down, and with physiotherapy, occupational therapy and podiatry alongside. Some of those medicines need regular blood tests, which is one reason appointments matter.

The timing matters as much as the room. The NHS says stiffness in rheumatoid arthritis is often worse in the morning or after a period of inactivity, and that morning stiffness in rheumatoid arthritis often lasts longer than the half hour typical of other kinds. In osteoarthritis, the NHS describes pain and stiffness that increase when a joint has not been moved for a while. So for one parent the worst hour is getting up, and for another it is standing up after a long sit in the afternoon. Ask your relative when their hardest time of day is, and plan around that.

The route to most of this equipment is an occupational therapist. The NHS advises asking the council's social services for an assessment for equipment or home adaptations, which you can do by phone or online, and says equipment and small adaptations are provided free if your relative is assessed as needing them. The care needs assessment explains how that assessment works and what to say. Home modifications for an older parent covers rails, ramps and bathroom changes in more detail, and the right equipment to aid the elderly goes through the smaller gadgets. If stairs are the problem, stairs, stairlifts and moving downstairs sets out the options.

A walking stick or frame should be the right type and the right height, and walking aids and how to choose explains how. NICE's osteoarthritis guideline says walking aids such as sticks are worth considering for arthritis in the hips, knees or feet. For bathing, bathing and toileting an elderly parent covers doing it safely and with dignity.

Arthritis UK, the national charity formerly called Versus Arthritis, has information on living with arthritis at home and a free helpline. For rheumatoid arthritis, the National Rheumatoid Arthritis Society also gives information and support.

NICE's guideline on osteoarthritis (NG226) says the core treatments are therapeutic exercise and weight management where appropriate, along with information and support. It asks clinicians to explain that joint pain may increase when somebody starts exercising, and that regular, consistent exercise will benefit the joints in the long term. The NHS treatment page calls exercise one of the most important treatments, whatever a person's age or level of fitness.

At home, that means doing the exercises the physiotherapist sets on most days, even when your relative would rather not. Physio at home explains how to get NHS or private physiotherapy at home and how a carer supports the exercises between visits. Exercise for older people covers safe activity more widely.

The advice in this timeline comes from NICE's guideline on rheumatoid arthritis (NG100), the NHS page on living with rheumatoid arthritis, and the rheumatology service at Harrogate and District NHS Foundation Trust. NICE also says adults with rheumatoid arthritis should have a named member of the team, such as the specialist nurse, who coordinates their care. If your relative does not know who that is, ask at the next appointment.

A flare changes what a day looks like. The NHS says simple daily tasks may become difficult or take longer with rheumatoid arthritis, and in a flare that can include getting dressed and cooking. You may want an extra visit, or a longer morning, for as long as a flare lasts. If a flare follows an infection or a hospital stay, hourly care after a hospital stay covers the first weeks home.

1. 1

   The GP considers a referral

   When other treatment has not worked

   NICE says a referral for joint replacement should be considered when pain, stiffness or reduced movement is substantially affecting quality of life and exercise, weight loss and pain relief have not helped or are not suitable.
2. 2

   An orthopaedic surgeon assesses the joint

   Hospital clinic

   The surgeon talks through the benefits and risks. NICE says nobody should be ruled out because of age, other conditions or their weight alone.
3. 3

   Plan the first weeks home before the operation

   Before the date

   Walking aids, a raised toilet seat and a clear route through the house, and somebody to help with washing, dressing and meals while the joint heals.

NICE's osteoarthritis guideline says clinical judgement, not a numerical score of how bad the joint looks, should decide the referral. For rheumatoid arthritis, the NHS says surgery may be needed if medicines have not prevented damage to a joint.

The weeks after the operation are when practical help counts most. Recovery at home after a hip replacement and recovery at home after a knee replacement set out the first six weeks, the exercises, and the help with washing and dressing your relative will need while the joint heals.

A visit of an hour gives enough time for getting up, washing, dressing and breakfast without hurrying somebody whose joints are stiff. The standard visits, and what each covers sets out what fits in a morning call, and how many visits a week does my parent need? helps you work out the hours. If your relative finds washing and dressing the hardest part, personal care explains what help with it involves. If you want someone to help with the stiff start to the day, you can search for carers near you and compare their rates.

Every carer on PrimeCarers has had their identity and right to work checked, holds an enhanced DBS check (or PVG in Scotland, Access NI in Northern Ireland) issued within the last 18 months, and has been interviewed online. Every visit booked through PrimeCarers is insured, by the carer's own policy or by cover PrimeCarers arranges where they do not hold one. We do not check qualifications, training or references. What a carer says about their experience with arthritis is their own account on their profile, for you to ask them about. PrimeCarers is an introductory service, not an agency or a care provider: carers are self-employed, and you agree the visits and the rate with them directly.

If your relative has savings below the council threshold of £23,250, the council may contribute to the cost of visits after a needs assessment, and local authority funding explains how that works. We do not give financial advice, so for a decision about savings or property, speak to a regulated financial adviser.