Post-Operative Delirium- What it is, Who it Affects, and How it May be Prevented

posted by Laura Armstrong on Thursday, May 24, 2018

Have you ever experienced something similar to the following scenario?

“Grandma had surgery, everything seemed to be going well, then she became confused and had a difficult time managing even the simplest tasks or answering simple questions. We were scared something was seriously wrong. She ended up having to stay in the hospital a little longer, but eventually she was back to her normal self.”

This phenomenon is known as Post-Operative Delirium, and when it does occur, it typically affects those aged 65 and older who have undergone a surgical procedure.

What is post-operative delirium and how can this affect you?

Post-operative delirium is a condition that, following surgery, can cause a patient to have temporary disorientation or confusion.  A hallmark sign is the patient will have difficulty paying attention and will be unaware of their surroundings. The timing varies, for some it can be immediately following surgery or a few days after surgery.  It may come and go, and can last several days and sometimes longer. Interestingly enough, scientist don’t have a great explanation of why this occurs in the brain, but we do know some key causes and know in some cases, post-operative delirium can be prevented.

So, what can be done to prevent this?

The nurses and providers caring for you during your hospital stay work hard in preventing, detecting, and then treating delirium if it arises. You, the patient, and your family members can help play a big role in prevention.  The American Society of Anesthesiologist Perioperative Brain Health Initiative offers 6 tips for you to prevent delirium after surgery:

  1. Ask your physician to conduct a pre-surgery cognitive test — an assessment of your mental function. The physician can use the results as a baseline for comparison after surgery.
  2. Be sure your caregiver, a family member or friend stays or can visit with you as you recover, carefully observes your physical and mental activity after surgery and reports anything troubling to your physician.
  3. Check with your physician before taking medications after surgery that can affect your nervous system, such as those for anxiety, seizures, muscle spasms or certain sleep aids.
  4. If you wear hearing aids or glasses, ask that they be made available as soon as possible after the procedure.
  5. Request a hospital room for recovery with a window if possible, so you can tell whether it’s day or night. All patient rooms at Spencer Hospital have a window.
  6. If you will be staying overnight in the hospital, pack a family photo, a clock and a calendar, or other familiar objects from home, to help you readjust.
I would also add some additional key prevention measures during your hospital stay:
  1. After surgery, be up and ambulating as soon as possible and as frequent as possible, as your condition allows.
  2. Keep your mind active. Consider your favorite hobbies and try to incorporate them into your hospital stay: reading a book or magazine, doing cross-word puzzles, knitting or needle-work, bring your laptop, play cards or other games.
  3. Request to have the window shades open during the day. At night, request lights be dimmed and noise reduced so you may get appropriate sleep.
  4. Can’t sleep during your hospital stay? Let your nurse or provider know.

If you would like more information regarding post-operative delirium here are a few websites:

The American Society of Anesthesiologist

About The Author

Laura Armstrong is a Hospitalist Nurse Practitioner here at the Spencer Hospital. A Hospitalist Nurse Practitioner provides direct medical care to patients requiring hospitalization. They assess health statuses, diagnoses any potential issues, and work with physicians and other health professiona ... read more