Ambulatory Surgery for Seniors: More Common, Higher Readmission Rates

Today, health care providers are looking for ways to cut costs. One way this is being accomplished is by eliminating hospital stays wherever possible. Indeed, patients are increasingly being scheduled for ambulatory surgeries—surgeries where the patient goes home the same day. Many of these surgeries, which now include hysterectomies and spinal surgeries, would have required a hospital stay in the past. In fact, according to a study by Northwestern University, 70 percent of surgeries today are being done in out-patient settings.

What this means for seniors: The study found patients 65 and older who have ambulatory surgery are much more likely to be readmitted to the hospital within 30 days than younger patients, regardless of their health before surgery. Contributing to the problem are poor health literacy in general, cognitive impairment and the difficulty in understanding and following directions for the often complex care that is needed at home.

This trend in health care is not likely to reverse; therefore, seniors have to learn to be better prepared. Here are some things to keep in mind if you or someone in your family expects to go for ambulatory surgery.

  • Bring someone with you when you see your doctor prior to surgery so they can help you remember all the pre-surgery instructions;
  • Have someone with you when you are getting your discharge instructions so that they can help you remember all the post-op instructions;
  • Make sure you have arranged for all the prescriptions, medications and supplies you will need when you go home;
  • If a home health nurse will be coming to see you make sure those arrangements are in place;
  • If you live alone ask a family member or friend to stay with you—certainly for the first day and preferably for a few days. They can pick up prescriptions, prepare a meal, remind you to take your medications, help with wound care and just be there to support you.
  • Consider hiring a caregiver for few days to help with your care if you don’t have family nearby to assist you.

No person in your circle to help? Can’t afford a caregiver? Make sure that you tell your doctor and the discharge planner. If there is a question about whether you can safely manage your care at home, your provider may find a way to keep you in the hospital for a day or so.

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