Surgical Decision Making for Older Adults

Before deciding to undergo an operation, patients should establish their health care–related priorities, such as the importance of prolonging life, preserving independence, or maintaining quality of life. Once these are determined, patients should discuss with their surgeon how the proposed operation will influence those priorities. For example, a patient considering hip replacement surgery whose goal is to improve pain and function may decide to proceed with the operation in order to meet that goal. In another example, patients who have rectal cancer needing surgical resection must consider the risks of postoperative complications and not being able to care of themselves at home for a very long time. If your personal priority is maintaining a certain quality of life and being independent (for example, living at home) rather than living longer but depending on others, you may decide not to proceed with surgery.