Surgical Checklist for Seniors and Caregivers

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Make sure to talk with your medical team about the following items that relate to your care pre- and post-surgery.

Pre-Procedure: Talk with your physician about:

  • Current surgery: As the patient, do you understand the necessity of this surgery and its benefits to you?
  • Past surgeries: Have you had surgery before? You should also include any history of a family member having problems with anesthesia.
  • Allergies: Do you have negative reactions to food, medicines or latex?
  • Lab tests and diagnostic results: Does your physician have these?
  • Prescriptions: Are you currently taking a prescription or any over-the-counter medications (e.g. herbals or supplements)? Have you asked your physician to recommend a geriatric specialist to help you understand the potential interaction of your existing medications and those associated with the surgery?
  • Neurocognitive disorders: Do you have any mental disorders your physician should know about? Has the physician conducted The Mini-Mental State Examination or a similar preoperative cognitive assessment?
  • Mental health conditions: Do you suffer from depression? If so, has your physician recommended a psychiatrist for you to consult with before your surgery?
  • Immune system: Do you have any immune disorders, hepatitis or excessive bleeding problems?
  • Esophageal conditions: Do you have acid reflux or a chronic heartburn condition?
  • Stomach problems: Do you have any ulcers or a history of eating disorders?
  • Teeth: Do you have any loose teeth, dentures or bridgework?
  • Heart disease: Have you ever had a heart attack, angina or chest pain, high blood pressure, or do you have a family history of any of these?
  • Emphysema, asthma, apnea: Do you have any of these conditions or other lung or breathing problems? Do you smoke?
  • Arthritis: Do you have any conditions that restrict your movement?
  • Endocrine system disorders: Do you have diabetes or a thyroid condition?
  • Concerns: Do you have any concerns or anxieties about the procedure?
  • Primary caregiver after surgery: Who should the physician contact after the surgery is complete? Who should the anesthesiologist speak with about pain management after the procedure?

Post-Procedure: Ask your physician about:

  • Side effects: Are any associated with this procedure? Am I at risk for experiencing delirium after my surgery? How can I best prevent delirium and how can my caregiver and I best cope with it?
  • Recovery comfort: Is it possible for me to be placed in a hospital recovery room that has a window? May my caregiver bring personal photographs and a calendar to my hospital recovery room? After my surgery, who will make sure I have my hearing aid, glasses and dentures?
  • Travel: Will I need to arrange for transportation after the procedure?
  • Diet: What can I eat? Is there anything I should not eat?
  • Emergency: Who do I contact in the case of an emergency?
  • Medical check-in: If needed, can I arrange for a nurse to come daily to my house after the procedure?
  • Medication: When should I take (or stop taking) any medication?
  • Bandages: When should I change my bandages?
  • Activities: When can I continue with my normal daily routine?  How long should I wait before becoming mobile again?
  • Appointment: Should I make a follow-up appointment with the physician? When?
  • Can I expect to go home after surgery?


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The ASA does not employ physician anesthesiologists on staff and cannot respond to patient inquiries regarding specific medical conditions or anesthesia administration. Please direct any questions related to anesthetics, procedures or treatment outcomes to the patient’s anesthesiologist or general physician.