What to do before, during and after the hospital stay to increase positive outcomes
Many surgeries are planned but require a hospital stay. Not all hospitalizations for older adults are the result of an accident or illness. The surgery might be as serious as open heart surgery to replace/repair a valve or a surgery to repair a hernia. Being in the hospital and undergoing surgery can take a toll on older adults if they have not prepared beforehand. Here are some healthy tips for your parent to follow during their hospital stay, and at home, post-surgery.
University of California San Francisco (UCSF) and Duke University both have programs that have demonstrated the positive results of getting ready before surgery.
Duke University’s Geriatric Program prepares older adults with a program called POSH (Preoperative Optimization of Senior Health). POSH has demonstrated positive outcomes, resulting from a sound program that is adhered to for 30 days prior to a scheduled surgery.
The POSH program is planned specifically for each patient, but typically consists of:
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Walking 20 minutes a day – five days a week.
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Doing core-strengthening exercises three times a week.
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Practicing deep breathing exercises three to four times a day.
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Stopping medications that could interact poorly with anesthesia – please ask your anesthesiologist for this directive. Do not stop medications without medical advice.
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Eating 30 grams of protein three times a day.
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Drinking lots of fluids starting three days before surgery – be sure to follow advice from your surgical team for a specific procedure.
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Practice blowing in a balloon once a day to get your lungs in shape.
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Having an advocate present in the hospital and upon returning home.
The program being developed at UCSF by Dr. Emily Finalysen includes an application for your smart phones and tablets; it is called “Prehab Pal”. The application could be helpful to patients and their families located in areas that don’t have specific preparation programs.
I have been doing client advocacy and have encouraged my clients to be as healthy as possible before surgery by eating a good diet and exercising. I would like to see these types of programs well promoted because they reduce re-hospitalizations, complications, cost to the health system and cost to Medicare. The best outcome is to take these pro-active steps to achieve a higher quality of life before surgery. These steps also help the senior return to “normal” in a shorter period of time than those who don’t prepare.
Hospitalized seniors need to be sure they have easy access to fluids and drink them often (if not restricted); they need to get out of bed and move in order not to lose muscle mass and mobility while recovering. You might need to ask for PT orders to get you up and about, but some surgeries will require bed rest for a specific amount time. You will want to start moving as soon as possible.
Those with cognitive challenges present will have separate needs. I highly recommend pre and post-surgery sitters for both days and nights for anybody with dementia. Staff changes almost daily in the hospital and familiar faces will ease anxiety and frustration in those with cognitive challenges.
The surgeon, nurses and hospitalist can do their very best, but it is possible to increase the positive outcomes through hospitalization preparation. This can greatly reduce anxiety for everyone. Personally, I had open heart surgery over a year ago; I worked for three months on health. I was back to work within six weeks and back to my old routines within three months.
Eldercare Services has professional on staff to be your advocate from the planning to the full recovery. If you want to expand your team with a professional, give us a call (866) 760-1808
