As a growing number of the estimated 78 million
Baby Boomers transition into their senior years, an
increased focus is placed on the health of this
important group of Americans. According to the United
States Census Bureau, more than 12 percent of the total
U.S. population is over age 65
and, of that segment, more than half will undergo at
least one surgical procedure as senior citizens.
Research indicates that seniors are at an increased risk
for experiencing complications both during and after
surgery. In an effort to ensure
that senior patients have the best possible outcome, the
American Society of Anesthesiologists (ASA) has
developed a set of tips to help prepare senior citizens
and their caregivers for surgery.
“Surgical procedures are understandably intimidating and
it is a central role of the anesthesiologist to inform
and care for the senior patient, before, during and
after surgery,” said Terri Monk, M.D., M.S., Duke
University Medical Center. “The driving force behind
these tips and the additional information found on
LifelinetoModernMedicine.com was to create a central
resource for seniors having surgery.”
According to the Society for the Advancement of
Geriatric Anesthesia (SAGA), “the elderly are more
sensitive to drugs, and often in an unpredictable way.
It is more difficult to find the right amount of drug to
use, and it is easy to have more dramatic undesired
effects of a drug. There are many reasons for the
increased sensitivity, including the fact that the older
brain is more sensitive to some drugs than young people.
In other words, the same amount of drug has a bigger
effect in the elderly. Some drugs achieve higher
concentrations in the blood in elderly patients than in
young patients, so more drug gets to the brain and heart
and so the effects are greater. Lastly, most drugs are
eliminated from the body more slowly in the elderly so
the drug effects last longer in older people.”
“Two complications that may occur in elderly patients
following surgery are postoperative delirium, a
condition that causes some patients to become confused
and disoriented for up to a week after surgery, and
postoperative cognitive dysfunction (POCD), which is
defined for patients as having long-term problems with
memory loss, learning and the ability to concentrate,”
said Dr. Monk. “In an effort to help minimize the
likelihood of cognitive problems after surgery, seniors
are encouraged to undergo a cognitive exam before
surgery and avoid taking certain drugs.”
Additional information and resources are available at
LifelinetoModernMedicine.com, the ASA’s Web site
dedicated to educating and empowering the public about
Tips to Help Seniors and Caregivers
Prepare for Surgery
1. Get to know your physicians
When considering whether or not to have surgery,
find out if the surgery is really necessary and
what benefits it will provide. You should also
talk to the anesthesiologist prior to surgery
and consider scheduling a consultation with a
geriatric specialist, particularly if you are
taking multiple medications. A geriatric
anesthesiologist specializes in treating the
geriatric patient, and he or she has specific
experience caring for the elderly both
preoperatively and postoperatively. Lastly, if you may be depressed, please see a
psychiatrist and seek treatment prior to surgery.
This is extremely important because depression has
been tied to higher mortality rates in surgical
patients. The psychiatrist, in consultation with
other members of the surgical team, may also
recommend minimizing the use of sedatives,
especially long-acting drugs such as
2. Don’t be afraid to ask questions
about the procedure
Having a surgical procedure can bring up a lot of
questions, and it is important to bring that list of
questions to your preoperative appointments in order
to ensure you are as educated and confident as
possible. Important questions to ask include:
- Can you tell me more about the procedure?
- Where will the surgery be conducted?
- What do I need to do before the procedure?
- At what point in the procedure will
anesthesia be administered? What type of
anesthesia will I receive?
- Who will be my anesthesia provider?
- When can I speak with my anesthesiologist?
- As a senior citizen, are there any specific
complications associated with anesthesia and
this procedure that I should be aware of?
- How long will the entire surgery take?
- Will the anesthesia make me nauseous after
- Will I be in pain when I wake up from the
- When will I be discharged from the
- When will I be completely healed?