More than a third of all surgeries in U.S. hospitals—inpatient and outpatient procedures combined—are now performed on people age 65 and over, according to the Centers for Disease Control and Prevention. That number, 38 percent, is expected to increase: By 2030, studies predict there will be some 84 million adults in this age group, many of whom will likely need surgery.
Many elderly patients have multiple chronic conditions, including diabetes, high blood pressure, and arthritis, and may have depression or dementia. Some take lots of medicines that cause side effects. After surgery, elderly people have more difficulty maintaining homeostasis, a physiological state of equilibrium, and suffer more readily than young patients from hypothermia, hypoglycemia, and anemia. Additionally, they’re more likely to fall.
Patients over 65 should talk with their doctors to assess risks and important aftercare after surgery. In fact, some hospitals are much better than others at aftercare for the elderly. Dr. John Burton of Johns Hopkins Geriatric Education Center says successful surgical outcomes for older patients require meticulous planning, pre- and postoperatively. He and his colleagues assess patients by testing for frailty, cognitive lapses, depression, shortness of breath, and poor muscle tone and balance. Specially trained geriatric nurses, pharmacists, physical therapists, and social workers also play a crucial role.
Dr. Burton says that surgical success requires strong communication between the surgical team and family members. They need to discuss strategies to prevent delirium, a common postsurgical complication, and how to manage medications. The care team also schedules “prehab”—working with a physical therapist and others to strengthen muscles before the surgery.
It’s best to ask lots of questions about how your surgeon and the team who will care for you before and after surgery. Also, look for camaraderie with your aftercare team at the hospital.