Avoiding Surgery in the Elderly

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On June 21, 2012, Posted by , In Caregivers, By ,,, , With Comments Off on Avoiding Surgery in the Elderly

Avoiding Surgery in the Elderly

It may take members of our parents’ generation (and our own) a long time to get over thinking of hospitals as refuges of safety and operating rooms as harbingers of better days ahead. But it’s gradually becoming clearer that for the very old and frail, and for nursing home residents in particular, hospitals are places to avoid whenever possible, and surgery can become a source of danger in itself.

Even operations considered fairly routine in younger patients, like appendectomies, become high-risk for nursing home residents. Bluntly put, surgery is much more likely to kill them.

A substantial proportion of older people who enter hospitals will never fully regain their physical or mental capabilities, even when the illness that brought them there is successfully treated.  These interventions, which typically also keep people in bed, even though getting out of bed is critical to their recovery, may help explain why.

So here’s a key question family members can ask before the surgeon starts scrubbing, especially if their older relative is frail enough to require nursing home care: Is there any alternative to surgery we could try?

We think of appendicitis as a surgical disease — you take it out.  But if you get appendicitis in England, it’s often treated with antibiotics, whatever age you are.  Gallbladder attacks can also be treated with antibiotics, or sometimes with a drain inserted under local anesthesia. A stent inserted by a gastroenterologist can relieve a bowel obstruction.

In each case, the treatment is less of an assault than surgery with general anesthesia. And if it doesn’t work — if a 24-hour course of intravenous antibiotics, which can be administered in the nursing home, avoiding hospitalization, can’t overcome the infection — surgery remains an option.

It might take a confident surgeon (because invasive surgery can provide protection against lawsuits, even if it’s hard on patients) and a persistent family to pull off this alternative approach.

Surgeons, like most other physicians, are trained to save lives. But with older patients, there’s less length of life to protect. So the other variables become way more important: maintaining cognitive status, living independently, caring for yourself…and bottom line, quality of life.

Source:  www.nytimes.com

Contact Pure Home Care Services at (586) 293-2457 today!  If you live in Birmingham or the surrounding area, we can help you care for your loved ones.

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