A Push to Get Older Adults in Better Shape for Surgery

Some hospitals are working to improve seniors' physical condition in preparing them for surgery by prescribing exercise, healthy eating, and minimization of anxiety and stress, reports Kaiser Health News . In 2018, the American College of Surgeons (ACS) plans to roll out a national effort to improve surgical care for seniors, after defining standards that hospitals should meet. The goal is to promote and recognize "centers of excellence in geriatric surgery" across the U.S., according to ACS's Dr. Ronnie Rosenthal. New evidence from Duke University Medical Center's Perioperative Optimization of Senior Health (POSH) program illustrates the value of readying at-risk seniors for surgery. Seniors referred to the program by surgeons attend sessions at Duke's Geriatric Evaluation and Treatment Clinic, where they receive a geriatric assessment focused on their functioning, mobility, cognition, medications, nutrition, existing medical conditions, and support at home from family or other caregivers. A study published in JAMA Surgery found older adults who followed the POSH program before major abdominal operations spent less time hospitalized, were less likely to return to the hospital in the next 30 days, were more likely to return home without requiring home healthcare, and have fewer complications. POSH participant Dr. Shelley McDonald recommends seniors walk 20 minutes a day, five days a week, and perform core-strengthening exercises three times a week, practice deep breathing three to four times daily, refrain from drugs that can interact poorly with anesthesia, consume 30 grams of protein three times a day, drink plenty of fluids starting three days before surgery, and make sure someone can sit with them in the hospital and be with them when they come home.