When your patient needs surgery: How planning can avoid complications

Delirium, depression, malnutrition, and functional decline represent potentially serious complications of surgery that are more likely to occur in older patients. Preoperative functional, cognitive, and nutritional screening of older surgical candidates can identify those at increased risk for these complications, allowing aggressive perioperative management to prevent or mitigate their occurrence. A frank appraisal before surgery of the potential caregivers, home environment, and available community resources allows the physician to determine the probable discharge destination. Knowledge of the level of medical and functional status that must be attained before the patient can be discharged to a selected destination should guide the perioperative treatment plan and may prevent premature discharge.