It’s often that seniors experience conditions that put them in a situation where surgery might be the only option. Before making the decision of surgery, it’s important to weigh out all the alternatives available.

Weighing Out the Options of Surgery

A common complaint is surgeons not helping older adults and their families to understand the impact of surgery in terms that people can comprehend. Older patients face a higher risk of complications after surgery and this needs to be taken into consideration.

It’s not so often that surgeons routinely engage in shared decision making, which includes finding out what’s most important to patients and discussing a surgeries potential to affect their lives before setting a course of treatment.

Older patients, it turns out, often have different priorities than younger ones. More than longevity, in many cases, they value their ability to live independently and spend quality time with loved ones.

New Standards For Improving Care

Now new standards meant to improve surgical care for older adults have been endorsed by the American College of Surgeons. All older patients should have the opportunity to discuss their health goals and goals for the procedure, as well as their expectations for their recovery and their quality of life after surgery.

Surgeons should review their advance directives, such as instructions for the care they want in the event of a life-threatening medical crisis or offer patients without these documents the chance to complete them. Surrogate decision-makers authorized to act on a patient’s behalf should be named in the medical record.

If a stay in intensive care is expected after surgery, that should be made clear, along with the patient’s instructions on interventions such as feeding tubes, dialysis, blood transfusions, cardiopulmonary resuscitation and mechanical ventilation.

How to Decide if Surgery is Right for You

Generally, surgeons explain to an older patient the physical problem, how surgery is meant to correct it and what complications are possible, backed by references to scientific studies.

Questions should be asked like….. What does living well mean to you? What do you hope to be able to do in the next year? And what should I know about you to provide good care?

Surgeons can help guide discussions that require complex decision-making by asking five questions, such as:

• How does your health affect your day-to-day life?
• When you think about your health, what’s most important to you? What are you expecting to gain from this operation?
• What health conditions or treatments worry you most?
• What abilities are so critical to you that you can’t imagine living without them?

Make your own Decision

Sometimes surgeons make the misguided assumption that older patients want to follow recommendations rather than having input into medical decisions. With 97% of seniors preferring that their doctor offers them choices and asks their opinion.

A tool has been developed called “best case/worst case” to help surgeons communicate more effectively with older patients. The idea is to tell the patient story in terms they can understand.

Instead of citing statistics on the risk of pneumonia or infection, for instance, a surgeon would explain what might happen if things went well or badly. Would the patient be in pain? Would she need nursing care? Would he be able to return home and do things he liked to do? Would she land in the ICU? Would he be able to walk on his own?

A similar range of possibilities is presented for a treatment alternative then the surgeon identifies the most likely outcomes for surgery and the alternative, based on the patient’s circumstances.

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Reno Valley is an assisted living and retirement community that makes living independently, while at the same time feeling safe and secure, a reality. We strive to provide the best quality of life for all residents including those suffering from loneliness and depression.
We offer a comprehensive activity program that includes both physical and social activities to encourage emotional well-being. Our staff is trained to assist those with depression. If you or a loved one are considering assisted living, contact Reno Valley today to learn more about our services or tour our community.