Why Older Adults Need Specialized Care Before and After Surgery

Surgery can cure disease, extend life, and ease symptoms. But surgery can be risky for older adults. 

Many older adults have more than one health problem. About 20 percent of adults age 65 and older have three or more long-term health conditions, such as diabetes, heart disease, or cancer. Because of this, doctors who specialize in caring for older adults play a key role in care before and after surgery.

Primary care doctors, such as geriatricians (doctors who specialize in older adult health), check the health of older adults before surgery. This check-up can:

• Help older adults, their families, and the surgeon decide if surgery is the right choice.
• Help create a plan to get the older adult ready for surgery and for recovery after surgery.

Geriatricians may also work with the surgery team to help manage the older adult's care while they are in the hospital. Research shows that older adults do better when doctors and other health care professionals work together to address their health needs before surgery.

Advance Care Planning: What Matters Most?

Surgery can be risky for many older adults. Before surgery, the doctor needs to talk with the older adult about their health care goals and advance care planning. Two key steps are: 

1. Choosing a health care proxy (a trusted person who can speak for the older adult if they cannot make decisions), and 
2. Writing an advance directive (a document that says what types of life-saving care the older adult wants or does not want).

Patient and Care Partner Education

The doctor should counsel and educate the older adult and their family or care partners. Topics to cover include:

• The risks of surgery. This includes common risks like heart attack, but also risks that are talked about less often, such as delirium, trouble with daily activities, or having to move into a care facility.
• Any health problems, disabilities, or support needs the older adult has.
• If the older adult cannot agree to surgery on their own, a surrogate decision-maker (health care proxy) must be involved. The health care professional must include this person in the process.
• The importance of advance care planning and the chance to complete the needed documents.
• What care will be needed after surgery, such as wound care, managing a colostomy (an opening in the belly for waste), drain care, or round-the-clock help.
• The importance of physical therapy and other types of therapy during recovery.

Prehabilitation

Prehabilitation means improving an older adult's health and strength before surgery. The goal is to help them recover as quickly and fully as possible after surgery. Many research studies show that prehabilitation can shorten hospital stays, reduce problems after surgery, and improve health outcomes.

Last Reviewed and Updated: October 2026
By: AGS/HiAF Public Education Committee, HealthinAging.org Content Reviewers