Facing surgery — whether it's your own or a loved one’s — can feel overwhelming and bring up a lot of worries. As we age, the chance of needing surgery increases: Adults 65 and older account for more than 40% of inpatient surgeries in the U.S. each year. And there are risks that come with age, especially for people who are frail or have multiple health conditions.
Thankfully, there are clear steps you can take to prepare for surgery. Tools like the Geriatric Surgery Patient Checklist developed by the American College of Surgeons (ACS) can help you ask the right questions, share your goals, and work with your surgical care team for the best possible outcome.
Age-Friendly Surgery: What It Is and Why It Matters
The ACS checklist is based on an approach to health care called “age-friendly care.” This is care that addresses your unique needs. It's based on what research shows are the most important things to pay attention to as we get older — the 4Ms: What Matters, Medication, Mind, and Mobility. All of these are especially important when it comes to surgery:
- What Matters: Your health goals and what you want from surgery
- Medication: Ensuring your prescribed and over-the-counter medicines are safe before, during, and after surgery
- Mind: Screening your memory and mood to prevent confusion after surgery and support your mental health
- Mobility: Planning to stay active and independent after surgery
Planning ahead and partnering with your care team can help ensure your surgery experience supports your needs and goals.
Before the Appointment: What to Prepare
The checklist helps you prepare for your first appointment with your surgeon and care team. It covers key areas to discuss with them — and to review with the people close to you who will help you before and after surgery.
- Goals for surgery. Think about what you hope to gain from the surgery, and find out if the procedure fits with your health goals.
- Support system. Who will help you after surgery? Make a plan with trusted family, friends, or a caregiver. Choose a medical proxy who can make decisions if you're unable to.
- Medications. Bring a list of medications you take, including prescriptions, over-the-counter medications, supplements, nicotine, cannabis, and alcohol.
Filling out these parts of the checklist before your first appointment will help guide the conversation with your care team — and your support system.
At the Appointment: What to Ask
The checklist also includes key questions to ask during your appointment before surgery. You and your caregiver can use them to guide the discussion with your care team:
- What is the surgery and why is it needed? Are there alternatives?
- What are the risks based on my health?
- What do I need to do to prepare?
- What will recovery look like — timeline, activity restrictions, support needed?
- How will pain be managed, and are there non-opioid options?
- Will I need rehab, home care, or a nursing facility afterward?
Ask About Presurgery Screenings
Your care team may check you for health factors that could affect your surgery and recovery. These include:
- Cognition (thinking)
- Delirium (confusion) risk
- Functional status (daily activities)
- Mobility (walking or moving)
- Nutrition
Talk to your providers about which screenings are right for you.
Hospitals Are Embracing Age-Friendly Surgery
Surgery is a big step, but you don’t have to navigate it alone. More hospitals are adopting age-friendly approaches to surgery. The ACS Geriatric Surgery Verification (GSV) Program helps hospitals meet high standards of care for older adults — and it’s working. Hospitals in the program report fewer complications, shorter hospital stays, reduced hospital readmissions, and higher patient satisfaction.
To find a GSV-certified hospital near you, visit the Find a Hospital map from the ACS.
With tools like the Geriatric Surgery Patient Checklist — and the support of your care team and loved ones — you can feel more confident, informed, and ready for a safe and healthy recovery.
The Geriatric Surgery Verification Program is supported by The John A. Hartford Foundation, a nonprofit organization dedicated to improving care for older adults.
Show Sources
Photo Credit: DigitalVision/Getty Images
SOURCES:
American College of Surgeons: “American College of Surgeons Releases Checklist to Help Older Adults Prepare for Surgery.”
American College of Surgeons: “Geriatric Surgery Verification.”
American College of Surgeons: “Geriatric Surgery Patient Checklist.”
Annals of Surgery: “Implementation of a Multi-specialty Geriatric Surgery Pathway Reduces Inpatient Cost for Frail Patients.”
Annals of Surgery Open: “Making a Financial Case for the Geriatric Surgery Verification Program.”
Diagnostics (Basel): “Comprehensive Peri-Operative Risk Assessment and Management of Geriatric Patients.”
