PERIOPERATIVE CARE OF THE ELDERLY: A EUROPEAN ANSWER TO EDUCATIONAL NEEDS IN THE FIELD

Appropriate care in geriatric surgery requires multidisciplinary approach combining geriatric, surgical, anesthesiological and nursing knowledge, resulting in ability of the team to manage complex situations in coordinated ways. To provide knowledge, skills, values and attitudes in the professional spheres of the surgical care of older patients, a multidisciplinary University Master on “Perioperative Care of the Elderly” is implementated at the San Marino and Ferrara University (Italy). Its aim is creating an inter-professional culture. To reach this goal, the following Entrustable Professional Activities (EPAs) of geriatric medicine become common assets for the whole team: provide patient-centered care by optimizing function and well-being, in accordance with patient’s functional status and needs, as evaluated by CGA manage the surgical care by integrating the patient’s goals and values with comorbidities and reasonably expectable prognosis assist patients and families in decision-making provide thoughtful medication reconciliation prevent and manage postoperative delirium and other geriatric syndromes coordinate post-discharge care transition. Allthesame, geriatricians will be educated in perioperative medicine and made familiar with some surgical and anesthesiological issues such as: pre-habilitation as a strategy to increase functional reserves preoperatively the endocrine-metabolic reaction to surgical aggression, its consequences on the surgical course, and ways to minimize it context-sensitive and multimodal postoperative pain management techniques of Enhanced Recovery After Surgery (ERAS). Both acquisition of competencies and capacity to perform the tasks involved in the daily work are implemented in the educational plan.