Surgery comes with risks for everyone, but it can pose serious risks for older people, who tend to tolerate anesthesia poorly and who also take longer to heal. In our culture, aggressive medical care is often sought, without taking into full consideration the various risks involved. Oftentimes, recovery time in the hospital is double and may result in a prolonged stay in intensive care. Although some elderly folks may be strong physically and even quite healthy, others may not be, and operating on someone who is more frail may not help prolong life, or even improve the quality of life.
Surgical procedures for the elderly have been in the news lately, as nearly 1 in 3 Medicare patients undergo surgical procedures in the year before they die. These surgical procedures range from major operations that require lengthy recoveries to relatively minor surgery.
Why is surgery so prevalent? Older folks often have a high regard for the medical profession, which can make them vulnerable to unwanted interventions. They agree to the procedure simply because the doctor suggests it. And why not, if insurance pays most of the cost? But problems with wound healing, length of recovery, or whether the benefits outweigh the risks may not be investigated. The patients’ overall health, their goals and values, and realistic expectations need to be considered when making these medical decisions. The best, the worse and the most likely outcomes should be laid out, for a well-advisedplan.
The baby boomer generation is aging and the population of patients older than 65 years of age seeking surgical care is increasing. Surgical services need to focus on providing safe and specialized care for this aging population. When surgery is elective, other non-surgical alternatives should be sought to improve quality of life.