Expected social support and recovery of functional status after heart surgery.

Purpose: We investigate if expectations of social support prior to heart surgery are consistent with received support from family and friends in the post-surgery period, and whether expected social support predicts improved recovery of functional status.Methods: The analysis included older adults from the Health and Retirement Survey (1996-2014 waves; N = 702). Receipt of social support was compared to expectations of social support using the Kappa statistic. Logistic regression models were fitted for short- and long-term functional status.Results: Expectations of social support aligned poorly with actual support received after surgery (κ < 0.32). Expecting future social support was associated with lower odds of post-surgery functional limitations (short-term recovery: OR = 0.53, 95% CI: 0.37, 0.78; p = 0.001; long-term recovery: OR = 0.63, 95% CI: 0.40, 0.99; p = 0.048). However, in multivariable analysis, this association was explained by the persistence of pre-surgery functional status limitations among people who were not expecting future support.Conclusions: This study demonstrates that older adults may overestimate the support they could receive for functional limitations after major surgery. Clinical implications of this finding include better planning for long-term care among older adults presenting for heart surgery.Implications for rehabilitationOlder adults presenting for major surgery may have limited social resources to help with post-surgery recovery.Rehabilitation professionals should consider that patients' pre-surgery expectations of support from friends and family may be inaccurate, leading to unmet need for help with activities of daily living.Formulating a specific plan for obtaining help with activities of daily living, with the involvement of family or friends who are willing to provide this help, may improve pre-surgery planning for rehabilitation after surgery among older adults.