Delirium occurs when there is a sudden change to an individual’s mental state that can include confusion, agitation, or complete withdrawal, which can happen after surgery.
“Post-operative delirium can impact anyone, though patients who are elderly are most at risk,” says Dr. Stephen Choi, co-director of the Perioperative Brain Health Centre. “Delirium can appear in several forms, but typically results in changes in an individual’s ability to focus, their concentration, thinking, and memory. These changes may come and go during the first few days after surgery and importantly, can occur even after all anesthetic drugs are gone.”
Dr. Choi says it is important for patients to know about delirium as it can impact their recovery. He shares some insights on delirium prevention.
What can a patient do before surgery that may help reduce the risk of delirium?
There are several things that have been demonstrated to help reduce delirium that are, in general, very good for overall health. This includes maintaining a healthy diet, getting regular physical activity, and ensuring adequate sleep.
It is important to stay hydrated right before surgery and follow guidelines about oral intake from your health-care team.
You can also help prevent delirium by doing brain exercises such as word puzzles to keep your mind active.
Before you arrive at the hospital, make sure to bring any sensory aids that are used routinely, such as glasses and hearing aids, as they can help reduce confusion after surgery.
Moving around safely after surgery, trying to maintain your routine (for example, speaking with family whether in-person or on the telephone, getting out of the hospital bed for meals), and maintaining sleep patterns, can all help reduce the risk of delirium.
Why are these actions considered to be protective measures against delirium?
If you think of delirium as the brain being disoriented, analogous to jet lag, maintaining patterns of behaviour that you are used to can be protective and be a touchstone to anchor yourself.
Each of these actions individually make a small difference, and collectively they can add up to a lot. The goal is to try to minimize disturbances to the usual environment that your brain experienced before surgery. When an individual’s actions and surroundings are familiar to them, their brain isn’t as overwhelmed processing new information, which can help decrease the risk for confusion post-surgery.
Families can also help support their loved ones achieve the goals of mobilization, nutrition, mental stimulation etc. to try and help a patient get back to their ’normal’ life and functioning, whatever that may be.