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Helping Seniors Prepare for Surgery

March 01
10:30 2018

Image result for seniors preparing for surgery

No one that I have ever met wants to have surgery, unless it is necessary to fix or treat the body for a specific situation – like cancer, a broken bone, ruptured appendix, cataract or other vision correction.

Other than eye surgery, without which I would be blind by now, or having my tonsils out when I was 4, the only major surgery I have ever had was to repair a chronic foot condition that caused a great deal of pain. At the time I was a meter reader for an electric company and walked an average of 12-15 miles per day, sometimes of rough, uneven or rocky terrain. I was in fairly good condition at the time for a 40-year-old, but it still took a number of months before my foot was completely healed and the pain gone.

I have avoided knee replacements since 1975, for several reasons, one of which is that I have a genetic immunity to most painkillers, so there is very little that helps after surgery, as I found out after my foot surgery.

Unfortunately, the older we get, the more likely we are to need some form of surgery. It can be surgery to remove a tumor or for cancer, it can be to remove a gall bladder, or set a broken hip or some form of heart surgery.

In many cases, we are not fully prepared to face surgery or the recovery, which can be long and grueling. Research has shown that with many of us, not being fully prepared for surgery can lead to complications and even increase our risk of dying.

Several hospitals are working to change this for many seniors needing surgery:

“Innovative hospitals such as Duke University Medical Center, the University of California-San Francisco Medical Center and Michigan Medicine are working to change that. In the weeks leading up to surgery, they prescribe exercise to seniors, make sure they’re eating healthy foods and try to minimize anxiety and stress, among other initiatives.”

There is a good reason for these initiatives:

“Research suggests these interventions can enhance seniors’ readiness for surgery and potentially lead to improved outcomes. ‘Changing how we approach older patients is really an imperative,’ said Dr. Emily Finlayson, director of the Center for Surgery in Older Adults at UCSF…”

“New evidence from Duke’s POSH (Perioperative Optimization of Senior Health) program demonstrates the value of prepping at-risk seniors for surgery, a strategy endorsed by the newly published standards.”

“In January, researchers reported that older adults who went through the POSH program before major abdominal operations spent less time in the hospital (four days versus six days for a control group), were less likely to return to the hospital in the next 30 days (7.8 percent vs. 18.3 percent), and were more likely to return home without the need for home health care (62.3 percent vs. 51.1 percent). They also had slightly fewer complications.”

“POSH is an interdisciplinary model of care, bringing together surgeons, geriatricians, anesthesiologists and social workers while actively engaging older patients and their families. Seniors referred by surgeons attend one- to two-hour appointments at Duke’s Geriatric Evaluation and Treatment Clinic, where they receive a comprehensive geriatric assessment focused on their functioning (what they can do, with what degree of difficulty), mobility, cognition, medications, nutrition, existing medical conditions and support at home from family or other caregivers, among other factors.”

The impact is proving to make such a difference on the recuperation and survival of seniors having surgery, that the American College of Surgeons have been looking at programs like that at Duke and hope to kickoff an effort to get similar programs throughout the country.

If you or a senior loved one or friend are facing surgery, you may want to look into what the POSH program is about. You can do so by clicking POSH. If possible, get more physically active, exercise eat a healthy diet and find ways to relive the stress and anxiety that many face when approaching surgery.

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HLA Staff

HLA Staff

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