Needs of the older patient in the intensive care unit following heart surgery

Cardiac surgery among older people is becoming commonplace in Australia. However, there is little evidence that critical care nursing management has addressed the unique needs of this patient population during the postoperative recovery stage. Their specific physiologic and psychological differences identify them as having particular needs in regard to nursing care. For many years, cardiac patients were carefully screened and only those who had reduced risk factors were considered for surgery. Now there are increasing referrals of older patients with a range of conditions and increased risk factors. These people present with more difficult surgical problems and tend to have a complicated postoperative period. As a result they are proving to be a clinical management challenge. In light of the evidence presented, clear examination of the unique needs of the very elderly during the immediate postoperative phase is suggested to provide the basis for a comprehensive overhaul of patient management with positive implications for standards of care.