Some startling statistics to consider: Adults over age 65 make up 16% of the US population yet account for 33% of all out-patient surgeries and 40% of all in-patient surgeries. That’s a lot of older people going under the knife, and not always with successful outcomes. As Paula Span recently documented in The New York Times, older patients are now getting surgeries previously deemed too dangerous for seniors. Given the increased risk of complications, longer hospital stays and increased mortality rates for older surgery patients, it’s no wonder that senior surgeries are now coming under increased scrutiny. In fact, the American College of Surgeons, in collaboration with the John A Hartford Foundation, has developed new standards for geriatric surgical patients so as to promote better outcomes and surgical care for older patients, including improved pre-surgery communication between care providers and patients, and more geriatric-friendly hospital rooms. The goal is for patients and families considering surgery to be able to assess how geriatric patients fare in particular hospitals.

So how do you determine whether you or a loved one should go through with a proposed surgery and whether sufficient caution and care are being taken, given the patient’s age and medical status?  A recent story on NPR has a good checklist of considerations you should think about, including tips for getting second opinions, surgeon shopping and questions to help guide your thinking. And do you know about “pre-habilitation?” That’s a strategy of getting you or a loved one in the best shape possible prior to undergoing surgery. And what about your hospital? Does it have sufficient experience performing the type of surgery you are considering? A recent report detailed that most hospitals, especially in rural areas, have not met minimal volume requirements to successfully perform high-risk surgeries.

Finally, anesthesia is a frequent concern for geriatric patients. There is fear that cognitive changes may result after general anesthesia- which is why a new study out of Brussels is so intriguing. Researchers substituted general anesthesia in geriatric patients with local anesthesia and the use of hypnosis via virtual reality to distract from the procedure. The results? Patients using this method reported a more calm experience with less pain and fewer of the side effects associated with general anesthesia. So strap on that virtual reality headset and read more here.