Elderly adults facing the need for high-risk surgeries may feel that their only choice is to take their chances and go ahead with a procedure to extend their life, but few seniors and families are educated about what could be the quality of life for patients who experience serious complications. And the risk for complications increases significantly among frail, elderly patients.
Older adults need to be included in shared decision-making conversations; they may value their ability to live independently or with minimal help over the risk of life-extending surgery that could leave them significantly impaired. And new standards for the surgical care of older adults have been endorsed by the American College of Surgeons, creating more opportunities for elderly patients to discuss their health goals and expectations for recovery with their surgeon. Understanding what an older surgical patient hopes for in terms of quality of life in the period of time following surgery is crucial in the decision-making process.
An elderly patient who needs surgery to extend life but could wind up in nursing care, with chronic pain or unable to return home may decide they value their ability to live well, for a shorter period of time rather than risk complications that could significantly compromise their quality of life. And as the population over the age of 65 continues to grow, by 2050 seniors will comprise 21 percent of the population. As the number of seniors rises, so will the demand for surgical services. New standards will help improve communication before surgery and focus on what goals are most important to older patients. They will also better screen for geriatric vulnerabilities, including improved medication management and provide senior-friendly hospital and rehabilitation rooms and staffing.
Recent research, published in the JAMA Surgery, found that surgeons who use a Best Case/Worst Case framework with patients and their families can help foster the decision-making process for a good outcome in the eyes of the elderly adult. Learn more about communication between surgeons and elderly patients by following this link to the Wisconsin study.