Dubai, United Arab Emirates (CNN) — Seniors who are considering major surgery often feel uncertain whether or not they will.
In many cases, surgery can be life-saving or can improve an elderly individual’s quality of life.
However, advancing age puts people at greater risk of experiencing unwanted outcomes, including difficulty carrying out daily activities, a prolonged recovery period, movement problems and loss of independence.
So how do you determine if the potential rewards of a major deal are worth the risk? And what questions should older people ask as they try to find out?
Here’s what the experts suggested:
What is the purpose of the intervention?
Dr. Margaret Schwartz, assistant professor of surgery at the University of Wisconsin College of Medicine and Public Health, recommends asking your surgeon, “How will this surgery make things better for me?”
Will you extend your life by removing a rapidly growing tumor? Or would it improve your quality of life by making it easier to walk? Will it protect you from disability?
And if your surgeon indicates the need to remove a specific lump growing in your body or remove a specific blockage, ask how that affects your daily life.
The discovery of an abnormal condition, such as a hernia, does not imply the need to treat it, especially if you have no bothersome symptoms and the operation was accompanied by complications.
If everything goes smoothly, what can I expect?
Schwartz, a vascular surgeon who specializes in vascular surgery, often treats patients with abdominal aortic aneurysms, enlargement of a major blood vessel that can be life-threatening when it ruptures.
Here’s how Schwartz described the surgical “best-case scenario” for that case: “The operation takes 4 to 5 hours. When it’s done, you’ll be in the intensive care unit with a breathing tube overnight for a day or two.” After that, you’ll be in the hospital for about another week. It may be needed later.” Undergo rehabilitation to regain strength, but I think you can go home in 3-4 weeks, and it may take 2-3 months to feel like before the operation.”
What can I expect if things don’t go well?
According to Schwartz, this could be a “worst-case scenario”: “You will be operated on, you will go to intensive care with serious complications. You will have a heart attack. And after 3 weeks you will be admitted to the intensive care unit with most of your strength exhausted and no chance to go back.” Back home, or you could go through this even if the surgery didn’t work.”
“People often think, ‘I’m going to die on the operating table if things go wrong,'” said Dr. Emily Finlayson, director of the UCSF Surgical Center for Seniors in San Francisco.
But he explained: “We’re very good at saving people and we can keep you alive for a long time. The truth is, there could be a lot of pain, suffering and surgeries like feeding tubes and ventilators if things don’t go as we hope.”
Given my health and age, what is the likely outcome?
Once your surgeon has explained the different scenarios to you, Finlayson recommends asking these two questions: “Do you think I really need this operation?” and “What are the most likely outcomes for me?”
Research indicates that frail older people, or those with cognitive impairment or other serious conditions such as heart disease, have worse experiences when they undergo major surgery.
What are the workarounds?
Finlayson advised checking out the nonsurgical options available.
Older men, for example with prostate cancer, may want to consider ‘watchful waiting’, i.e. constantly monitoring their symptoms rather than incurring significant practical risks.
Women in their 80s with mild breast cancer may choose to leave the tumor alone if removal poses a risk when other health factors are taken into account.
