Postoperative Delirium: What You Need to Know

We all have our assumptions about what increases as we age. More aches and pains? Sure. Higher eyeglasses prescriptions? Undoubtedly. Statistically, you're more likely to go under the knife too. Adults 65 years and older receive the most non-elective (emergency/acute) surgeries. With increasing surgical rates, there are also increased risks.

In our last post, we dived into the costs and benefits of anesthesia for seniors. Briefly, we touched on something called postoperative delirium, a serious reaction to anesthesia that predominantly affects older adults. In this post, we'll go over everything you need to know about postoperative delirium.

What are the Symptoms of Postoperative Delirium?

Postoperative delirium is a sudden state of mental confusion and memory trouble occurring after an anesthesia treatment. Postoperative delirium can present as early as 10 minutes after anesthesia or as late as 7 days post-surgery. Typically, it's a temporary state and resolves itself in 24 to 72 hours. Caregivers should monitor for symptoms of the condition during recovery in the week after surgery.

Symptoms of post-operative delirium include:

• Hallucinations

• Confusion and disorientation

• Agitation

• Lethargy

• Slurred speech

If a postop patient starts experiencing these symptoms, the individual's medical team should be contacted immediately. This may include their pharmacist, who can confirm if the patient's combination of prescriptions isn't causing or exacerbating the issue.

Who is at Risk for Postoperative Delirium?

Postoperative delirium affects 50% of older adults (65+) post-surgery. Beyond mere age, certain risk factors make one vulnerable to postoperative delirium. Patients with existing memory issues, such as dementia or Alzheimer's, are at the highest risk. According to notable neurologist Dr. Matthew D. Gold, it's more common after age 60. It's also most likely after orthopedic and cardiac surgeries.

When Postoperative Delirium Evolves: Postoperative Cognitive Dysfunction

For most people affected by postoperative delirium, it passes within days. Unfortunately, for some, it can linger for weeks or months. In rare cases, it has been permanent. If lasting, it is called postoperative cognitive dysfunction, or POCD.

It isn't clear what causes some to develop POCD over others. Some experts speculate it's related to body inflammation. Other factors seem to increase the likelihood of POCD, like prior alcohol abuse, a history of cardiac surgery, and certain genetic markers.

Can Postoperative Delirium Be Prevented?

Postoperative delirium can't be prevented completely, but you can take steps to reduce its likelihood. Being in good health, physically and cognitively, before surgery is the best prevention tip.

Of course, "being healthy" is a hard bar to reach sometimes, especially if a person needs surgery in the first place. There are steps to take after the surgery that can help stave off delirium as well. Fostering a calm environment, reorienting the patient, and keeping up routines can help.

Early movement is important, so try to get the patient moving as soon as they are allowed and able. Keep up meal schedules so they stay hydrated and nourished. Take all medicines as directed. Encourage ample sleep with low lights and a quiet room.

A certain level of confusion is expected after any surgery, so make sure to reorient the patient often. Remind them of their name, the date, and the time. Keep familiar objects around, like a favorite blanket or framed family photos. If they utilize any aids related to vision, hearing, or mobility, reintroduce them as soon as possible.

Conclusion

Postoperative delirium, along with postoperative cognitive dysfunction, can be distressing. It can ease fears to take prevention steps and be informed. As always, bring up your concerns with your doctor or surgeon.

If your loved one requires home healthcare during recovery, Seniors Fix can provide a caregiver. Call 240-744-0674 for a free consultation.