Social rehabilitation of the elderly after surgical intervention.

Post-surgical elderly patients always present multiple medical needs and social problems, which require management by a multidisciplinary team. There are many alternatives to institutionalisation and they should be sought to contribute the maintenance of independent living. Following the previous studies, the social rehabilitation will be better: if clinical results are good and surgical techniques appropriate, if patients are under 75 years, when coming from and discharged to home, and finally, when they are able to perform activities of daily living. The pre-surgery social dependence influences the mortality to a greater extent than the age and sex. Furthermore, the placement in a long-term institution after discharge from hospital, increases threefold the mortality rate. To improve the social outcome, several authors made different suggestions: early home visits by a rehabilitation team, the multidisciplinary geriatric assessment unit, the joint orthopaedic-geriatric rehabilitation approach, assessment apartments, reiterate trials home discharge which is our usual type of intervention.