The investigators studied that swallowing function of patients receiving the Early Recovery Accelerated Swallowing (ERAS-W program) training will recover fast than that of patients in the control group. The ERAS program training will be initiated before surgery and continue to after surgery.

The older patients (≥65 years old) with OFI-8≥4 undergoing elective orthopedic surgery requiring tracheal intubation will be recruited. Patients will be randomized into an intervention and a control group. Patients in the intervention groups will received the ERAS-W program, while those in the control group will receive the swallowing education video.

Inclusion Criteria:

• elective surgery
• general anesthesia with endotracheal intubation

Exclusion Criteria:

• major organ dysfunction, ex: chronic kidney disease, hear failure
• bleeding tendency

due to ethical problem

Data manager knows whether the patients are in the intervention or control group. However, the patients, caregiver, investigator, and outcome assessors do not know whether the patients are in the intervention or control group.