Weighing the risk of major surgery

Alicia Colombo

Older adults contemplating major surgery may be unsure of whether to proceed with an operation. In many cases, surgery can improve an older person’s quality of life or be a lifesaving procedure. But advanced age coupled with the need for major surgery sometimes increases the risk of unwanted outcomes, such as a recovery with difficulty performing daily activities, re-hospitalization, problems with mobility and the loss of one’s independence.

How does one determine if the potential benefits from major surgery are worth the risks? Kaiser Health News features several health experts with suggested questions that older adults should ask their surgeon if an invasive procedure is proposed. Here are some recommendations. It is important to discuss all options with your health care provider so you can make an informed decision and not delay treatment if recommended.

What’s the goal of this surgery?
Ask your surgeon how the procedure will make things better for you. For example, it could reduce pain, extend your life, improve your quality of life, and/or prevent you from becoming disabled.

You should also ask what impact the condition will have on your daily life if you do not have surgery. Just because an abnormality, such as a hernia or gallstones, has been found doesn’t mean it has to be addressed. If you don’t have bothersome symptoms and the procedure comes with complications, your doctor may advise against surgery unless or until the condition worsens.

What are the alternatives to surgery?
Major surgery normally involves opening the body, allowing the surgeon access to the area where the problem exists, and surgical work needs to be completed. It involves trauma to the tissues, a high risk of infection and an extended recovery period. Make sure that your physician discusses non-surgical alternatives. Older men with prostate cancer, for instance, might want to consider ongoing monitoring of their symptoms, rather than risk invasive surgery. Women in their 80s who develop a small breast cancer may opt to leave it alone if removing it poses a risk, given other health factors.

What is the best possible outcome?
You should find out what exactly the procedure or surgery will entail, how long you’ll be in the hospital, and if rehabilitation will be required after you are discharged.

Among other things, people might ask their surgeon: What will my daily life look like right after surgery? How long is the typical recovery period? Will I need care at home and for how long? Will tubes, drains, catheters or other medical supplies be used in the recovery process? Will they be inserted during surgery? How long does equipment used in recovery following surgery? Who takes care of post-surgical care to prevent infection or complication?

It’s important to consider your health, age and functional status when considering the most likely outcome. Research suggests that older adults who are frail; have cognitive impairment; or other serious conditions, such as heart disease, have worse experiences with major surgery. Also, people in their 80s and 90s are at higher risk of complications. That being said, the benefits of surgery may outweigh the potential risks.. Be sure to discuss the risks and benefits with your physician.

You may want to have a family member or friend in the room for these conversations, especially if the surgery is high risk. Older adults with some level of cognitive impair ment may need assistance working through complex decisions.


Source: Kaiser Health News

Categories: Health Milestones eNews

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