Preparing your Elderly Loved one for Surgery

Ask your Doctor (NIA)

Surgery can be Life-Saving

While surgery and anesthesia pose risks for the elderly, it is estimated that more than half of seniors over age 65 will undergo at least one surgical operation. Surgery can be life-saving and can prolong life when it is successful.

Will the Benefits of Surgery Outweigh the Risks?

The major question to ask your doctors is to find out if the surgery is really worth taking the risk, since complications for seniors are more common during and after surgery than for younger adults.

Second Opinion

By all means you should also seek a second opinion from another qualified doctor and Medicare may pay for it.

Other Questions to Ask the Surgeon and Doctors

• Is the surgery necessary to do now or can it be done at a later time?
• Are there other non-surgical treatments that could be tried first?
• What kind of anesthesia will be used? What are the risks of the anesthesia? Is it possible to do the surgery with local rather than general anesthesia since local has less risks for the elderly?
• What are the possible physical and mental complications associated with this kind of anesthesia or surgery in the elderly?
• How will the surgery affect the health and lifestyle of your loved one? Will it improve quality of life?
• Will your loved one be in pain following the surgery and if so how long is this pain expected to last?
• How much time will be spent in the hospital?
• How long will it take for your loved one to fully recuperate?
• Will rehabilitation be necessary after the surgery?
• What will happen if your loved one does not have the operation?
• Is there anything else to know about this kind of operation?

Insurance Questions

You and your loved one must find out exactly what private insurance, Medicare, Medicaid, etc. will pay towards the operation and the hospital stay. These may be answered by the hospital social worker or you can phone Medicare with questions you may have:

800-633-4227

Inform the Doctor about the Following:

• If your love one suffers from food or drug allergies
• Prescription drugs they are on for chronic illnesses
• Drugs that Affect the Central Nervous System. It is especially important to inform the doctors if your loved one has suffered from depression and has recently been on anti-depressant drugs, sleeping medications or anti-psychotic medicines.
• Sleep Disorders like Obstructive Sleep Apnea. This is crucial for the doctors and the anesthesiologist to know about possible obstructive sleep apnea and whether or not your loved one is being treated for it.
• If your loved one has ever had a bad reaction to general anesthesia in the past

Risks to Seniors from Surgery and General Anesthesia (GA)

• Seniors are more sensitive to drugs than younger adults and can suffer all kinds of side effects from medicines used before and after surgery.
• Some people never wake up from general anesthesia. There are cases where the surgery was successful, but the patient never woke up from the anesthesia. Local anesthesia is safer than general anesthesia, but it cannot be used for every kind of operation.
• Postoperative bleeding is another complication from surgery, but this is not limited to seniors.

Mental Problems for Seniors after Surgery

Delirium

Some seniors suffer from delirium after the surgery where they suffer from confusion and disorientation and this can last for a week.

Post Operative Cognitive Decline (POCD)

Some seniors, especially diabetics, suffer from memory loss, learning skills and attention disorders following surgery. This usually clears up in a few months, but in some cases it can lead to further decline and dementia. For more about POCD see our blog article from May 11, 2018.

Consent

Your loved one must sign a form giving his/her consent for the operation. This means that he/she has been told about the possible risks but still agrees to have the operation. It is important for the family to get answers to all the above questions before their loved one signs.

How to Prepare your Loved One for the Operation

• Double check that the doctors know about any food, drug or other allergies your loved one has, what prescription medicines they are on and what chronic medical conditions they may have. Some meds may have to be stopped for a day or more before the operation.
• Check that your loved one does all the pre-surgery tests that the doctor has ordered.
• Plan for someone to take care of your loved one after he/she is discharged from the hospital. In some cases, the surgery will be done as an out-patient and your loved one may come home a few hours after the operation or possibly spend only one night in the hospital.
• Make sure you have the rehabilitative equipment your loved one will need after the operation.
• Buy any prescription drugs they will need when they are home.
• Get a phone number from the doctor or hospital where to call for help in case of any problems that come up.
• Get written instructions how to care for your loved one at home.

The Day of Surgery

• Make sure your loved one has followed all the instructions regarding fasting or other things required before the operation.
• Jewelry should be removed and left at home.
• Dentures must be removed before the operation. Make certain your doctors know if your loved one wears dentures.
• Also contact lenses should be removed.

Rehabilitation after Surgery

Some operations require either short or long-term rehabilitation following the operation. In some cases you may decide to send your loved one to a skilled nursing and rehabilitation facility. Medicare usually pays for this for a senior if they spent at least three days in the hospital.

The Van Duyn Center for Nursing and Rehabilitation in Syracuse NY can offer excellent rehabilitation care after surgical operations.

Conclusion

While surgery may be necessary and life-saving, it is not without risks, especially for seniors. Ask your doctor all the questions you need to make sure that the benefits of the operation outweigh any risks.