Postoperative Confusion in the Elderly
When older folks undergo medical procedures requiring anesthesia, post-surgery confusion or delirium may occur. The older person may have been totally independent and lucid prior to the procedure, but in the days following surgery they may be so disoriented and agitated that the family starts to panic as concern over how to manage care grows. Though postoperative confusion is not a given, it is not uncommon, especially in the elderly. It may last a few hours or much longer. Thankfully, the confusion often clears up on its own. Anyone, especially the elderly, facing surgery should discuss the possibility of postoperative confusion with their physician. The literature reveals that it is not uncommon for doctors to prescribe sedatives. And yet, recent studies indicate that like in many other situations, less is better. In fact, one study suggests that the use of very light anesthesia during hip surgery significantly decreases incidences of postoperative delirium in the elderly. Another study emphasizes the importance of looking for underlying causes, many of which are easily treatable and might go undetected if sedatives are given.Some individuals may be at higher risk for post-surgery confusion than others. As always, communication is paramount. Be sure treating physicians know your complete history. Discuss risk factors, medications you are taking (don't forget to mention over-the-counter medications or dietary supplements), alcohol intake history, general mobility issues, etc.
Be proactive by preparing for the best postoperative outcome. Remember that the best defense is a good offense! Be sure to get adequate nutrition and hydration. Have a contingency care plan in place in case more than expected recovery time is needed. Finally, be sure to have appropriate legal documents (advance directives) in place well before surgery. Recovery goes best when no one has to sweat the details should postoperative difficulties develop.
