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August 15, 2019

Surgical Decision-Making Tips for Older Adults

If your medical team is recommending surgery, then you have some decisions to make — including whether you want to move ahead with the operation. To help, this post will provide guidance into how to make the best decision for your specific situation.

First, it’s true that surgery in older patients can be riskier than with young patients because of an increased risk of complications and post-surgical quality of life changes. 

Having said that, Jennifer Whitlock, RN, MSN, FN, says older adults should not “expect the worst during or soon after surgery just because they are no longer in their youth.” There are better healthcare services for older patients now, including with surgery.

As with most events in life, how you should handle your surgical decision-making process is unique to your health and overall situation in life.

Four Step Surgical Decision-Making Process

JAMA Network lays out a four-step process, which starts with establishing your own health-related priorities. Is the goal to prolong your life? Maintain quality of life? Remain independent? Once you’re clear about what your priorities are, you can then talk to your surgeon about how the recommended operation will fit in with your overall health goals.

Typically, older patients have a longer recovery time than younger patients, and usually need more support during that time frame. As part of your decision-making process, it’s recommended that you ask what yours is anticipated to be like. Will you, for example, need to recover at a skilled nursing facility or it is likely that you can recover at home?

Also discuss what your quality of life is anticipated to be after you’ve recovered. Is it reasonable to expect that you could return to your previous health status? Or will you need a walker? Oxygen? Although no one can predict the future, your surgeon should be able to give you guidance about your quality of life after recovery.

Armed with this information, it should now be easier to make the right decision for your circumstances.

Preparing for Surgery

If you decide to move forward with the operation, know that older adults can benefit significantly by doing what they can to improve their health before the surgery takes place. What this means depends upon your situation. If you smoke, then stopping may be your goal. Or if you have diabetes, it may be to work with your doctor to get your blood sugar levels at optimal levels. When you maximize your health before surgery, this helps to reduce the amount of stress on your body during and after your operation.

This is also the time that, if your medical team believes you’ll need to stay at a rehabilitation facility after the surgery, to prepare for that stay. It can be helpful to visit the center ahead of time, to know what your recovery may be like.

After the Surgery

Statistically speaking, older patients have longer recovery periods and need to work through more postoperative complications than younger patients. It’s more common to need rehab, to experience sleep disturbances, as well as the postoperative complication of delirium.

This means that, typically, you’ll need more support from your healthcare team, as well as from family and friends.

Finally, attitude matters. One study of older adults in Ohio, published by the American Psychological Association, showed that positive perceptions about the aging process can actually help to extend life’s longevity.

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