You’re a senior who needs a hip or a knee replaced. Or you’re considering surgery to fix a chronic neck or back problem. You’re not alone.
It’s estimated that an average of 15 million surgeries are performed on American seniors every year, for a variety of reasons. For patients over the age of 65, surgery prep may be a bit more involved than it would be for a younger person.
Today, let’s review eight things you should do before you schedule your elective surgery.
1. Ask questions.
Before you agree to any procedure, you should understand why your surgeon recommends it, what the alternative treatments would be (if any), what the procedure will do and what it will entail in terms of rehab and recovery.
Surgeries are inherently invasive. For any patient — young or old — that ups the risk of post-operative infections, blood clot development and other medical complications.
Make sure that you understand your surgeon’s plan for minimizing these risks, and that you also understand what responsibilities you will have to take on (post-operative hygiene, wound care, medications you’ll have to take, scans and checkups you’ll have to attend, etc.) to help your surgeon guard against them.
2. Inform your primary care physician and any specialists you see that you’re having surgery.
It’s not up to your surgeon to contact all of your doctors. In fact, your surgeon may not even know who they all are — especially if you see a variety of specialists. It’s extremely important that you take on the responsibility to communicate with all your doctors and let them know when you are electing to have surgery.
Your doctors may need to change the medications you’re on to minimize the risk of complications. Or, they may recommend you undergo various medical clearance tests to ensure your body can withstand the procedure — especially if you have serious chronic conditions like heart disease, lung disease, cancer, diabetes, or high blood pressure.
Make sure that everyone on your medical team is on the same page as you and your surgeon.
Many seniors will need a short-term stay in a physical rehab care center after their elective surgeries.
3. Review your medication list with your primary care physician, surgeon and anesthesiologist.
This is especially true if you are on any blood thinners or blood pressure medications. Blood thinners (i.e., Coumadin, Xarelto) decrease your blood’s ability to clot. That’s desirable if you’ve had problems with blood clots or atrial fibrillation in the past, but when you’re under the knife, it could be a problem.
Moreover, some medicines can cause adverse reactions with anesthesia drugs. Make sure that you carefully and completely review your medication regimen with your regular doctor, your surgeon and your anesthesiologist before your surgery.
4. Contact your health insurer.
Some insurers require pre-authorization for elective surgeries like joint replacements or vertebral disc repairs. And you’ll likely have copays, co-insurance, provider network restrictions and deductibles to sort through.
Does your health insurer limit the number of inpatient recovery days it will cover? How about coverage for your stay at a short-term rehab hospital? Home health care? Don’t charge into surgery without first clearly understanding what your insurer will and will not pay for.
5. Choose a short-term rehab provider.
Many seniors will need a short-term stay in a physical rehab care center after their elective surgeries. You’ll want to check with your insurer to see where and how much coverage you’ll have for short-term rehab.
Then, you should tour the rehab care centers available to you and choose the one you’d be most comfortable with as your supporter in transitioning from hospital to home.
Does your chosen rehab care center have both physical and occupational rehab on site, as does Marjorie P. Lee Retirement Community in Cincinnati? If you do choose Marjorie P. Lee, a care transition coordinator will provide an in-home assessment to prepare you and the house for a successful completion of your care. The care plan will give you confidence that every piece of your care after the hospital will be just what you need to make a full recovery and get back to enjoying your life.
Will your short-term rehab provider also arrange follow-up home care? And does it have a variety of amenities, services and fun activities for patients to enjoy while they recover? What are the options for dining? Do they have options that suit your dietary preferences and tastes?
6. Arrange outpatient rehab and home health care.
A lot of seniors who have elective joint replacement surgeries will need outpatient rehab visits and/or home health care even following their release from inpatient rehab. It can take the body a long time to fully recover.
If your outpatient or home health services aren’t going to be provided by the either the hospital or short-term rehab provider, check with your insurer to verify coverage for outpatient and home health providers in your area, then choose one you’re comfortable with.
Also, ask your surgeon or inpatient physical rehab provider what modifications or special equipment you may need at home in the weeks and months after your surgery.
Will you need a walker? Stair lift? Grab bars installed in hallways and bathrooms? Raised toilet seats? To what degree will any recovery phase equipment you need be covered by your insurance plan? Get as many answers as you can up front.
Designate a spouse, family member or close friend you would trust to make decisions on your behalf.
7. Designate your medical power of attorney and complete your living will.
This might sound a bit morbid, but complications can happen. You need to have a clear plan in place in case you are unable to make your own medical decisions after surgery.
Contact your lawyer and draw up a medical power of attorney (PoA) document. Designate a spouse, family member or close friend you would trust to make decisions on your behalf. You’ll also want to draw up an advance directive or living will document, which will make your medical wishes known in case you aren’t able to speak for yourself during recovery.
Make sure you give copies of your PoA document and advance directive or living will to your doctors, to the hospital where you’ll have your surgery, to any follow-on care providers and to the person or persons you designate as your PoA(s).
8. Get good nutrition and sleep in the days or weeks prior to your surgery.
The better rested and stronger you can be going into surgery, the better. Avoid stressors. Reduce your caffeine intake. Don’t drink alcohol. Treat your body well.