Judith Graham Reports for Kaiser Health News on new research revealing that older adults who prepare for surgery, heal faster and are discharged more quickly. They also are less likely to be rehospitalized. Some hospitals are taking the lead to help older patients best prepare for surgery.
More than anything else, you want to be sure pre-surgery that you really want surgery. Surgery is not risk-free, and many older adults end up in need of additional medical care post-surgery. Medicare data reveals that one in three older adults who are hospitalized are rehospitalized within 30 days of discharge.
If you do want surgery, there are ways you can minimize risks both during and after your hospital stay. Doctors at Duke, UCSF and Michigan are finding that older adults who exercise, eat a healthy diet and reduce their stress in anticipation of surgery, fare better post surgery than those who do not. Their aim is to highlight surgical centers that best help older adults to prepare for surgery.
Data from Duke University suggests that good preparation, including a thorough geriatric assessment, in advance of abdominal surgery significantly reduced the number of days older adults spent in hospital as well as their likelihood of readmission. The data also indicates that good preparation reduced the likelihood of patients needing home health care after discharge.
The Duke program, “POSH” (Perioperative Optimization of Senior Health,) spends time explaining to patients the benefits and risks of surgery. Patients are helped to understand the physical and emotional toll surgery can take on them and that it can lead to complications. Patients can then decide whether having surgery is in line with the quality of life they want.
Much of the advice given to patients who opt for surgery applies to everyone, regardless of whether they are getting surgery. Walk at least 20 minutes a day, do core-strengthening exercises every other day. Drink a lot of liquid. Do breathing exercises and take time to relax.
People taking medications need to beware adverse interactions with anesthesia. The POSH program advises people to stop taking benzodiazepines and antihistamines three days before surgery.
Questions patients should ask include:
- What choices do I have other than surgery?
- What are the risks and benefits of surgery or of making a different choice?
- Will surgery extend my life meaningfully?
- What will happen after surgery barring any complications? Will I be able to care for myself after surgery? If not, what kind of care will I need and how long will I need this care?
- Who should have a copy of my advance directive, appointing someone to speak for me if I cannot speak for myself after surgery?
Duke’s POSH program also offers advice that cannot be repeated too often regarding the value of having a health care buddy—someone to be with you during your hospital stay and after discharge–exercise, healthy eating and a good night’s sleep.
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