OLDER adults with frailty often faced prolonged functional recovery and unmet care needs after major elective noncardiac surgery.
Older Adult Recovery After Surgery
Older adult recovery remained incomplete for many patients in this multicenter mixed methods cohort study of adults aged 65 years or older who underwent major elective noncardiac surgery. Among 204 older adults, 64% had at least one impairment in instrumental activities of daily living at 1 to 2 months after surgery, and 42% still had impairment at 6 months. Basic activities of daily living were also affected, with 33% reporting at least one impairment at 1 to 2 months and 19% still impaired at 6 months.
The study focused on older adults living with frailty, with a median Clinical Frailty Scale score of 4, and found that recovery extended well beyond the immediate postoperative period. Most patients lived at home before surgery, and many returned home after discharge, yet functional limitations and ongoing support needs remained common. These findings suggest that older adult recovery after surgery may be more prolonged and disruptive than patients and families anticipate.
Caregivers and Recovery Experiences
Caregivers also played a central role in recovery. Most were spouses, and many were managing their own chronic conditions while supporting patients after discharge. Interviews with older adults and caregivers identified four main themes: inadequate education and preparation for surgery and discharge, reduced independence during recovery, mental health effects associated with surgery, and the importance of postoperative support from the healthcare team.
Participants consistently reported that they felt poorly prepared for what recovery would involve. They wanted clearer preoperative counseling, more practical discharge teaching, and better communication after leaving hospital. The findings suggest that caregiver inclusive discharge planning, including wound care instruction, complication recognition, and guidance on where to seek help, could improve both patient and caregiver experiences.
Overall, the study shows that older adult recovery after major elective noncardiac surgery is closely tied to functional status, caregiver support, and the quality of perioperative communication. More targeted preoperative education, earlier follow up, and stronger postoperative support may help reduce uncertainty and improve recovery in this high-risk population.
Reference
Toledano N et al. Recovery Experiences of Older Adults and Their Caregivers After Major Elective Noncardiac Surgery. JAMA Netw Open. 2026;9(3):e260692.
