When an older loved one suddenly stops recognizing people, sees things that aren't there, or stays restless and sleepless for nights within days of a major operation, families are often frightened. This state is called postoperative delirium. Delirium is a sudden clouding of attention and awareness that tends to come and go through the day and often worsens at night.
Delirium is not a sign of weak willpower or a fragile mind. It appears more often with advancing age and in people who have had a prior stroke or already-declining memory and thinking. When a brain that is already vulnerable meets anesthesia, the stress of surgery, pain, lost sleep, an unfamiliar ward, the many tubes and a new ostomy attached to the body, certain medications, dehydration, or infection, these strains can pile up until the brain becomes temporarily confused.
Fortunately, most postoperative delirium eases gradually as its causes are sorted out. It can take days, sometimes a few weeks, which feels very long to a watching family. Delirium is not the same as dementia suddenly worsening; after recovery most people return to their earlier selves, though those with pre-existing cognitive decline may recover a little more slowly.
Families can help. Put on the person's glasses and hearing aids so they can see and hear; open the curtains for daylight and keep nights quiet and dark to protect the day-night rhythm. Gently remind them of the date and where they are, and keep familiar photos or objects nearby for comfort. Staying calmly present and reassuring works better than restraining or arguing, and telling the care team what the person is normally like and when the change began is a great help for diagnosis and treatment.
When the difficulty of accepting a new ostomy is layered on top, both patient and family tire easily. That is a separate adjustment that takes its own time, so there is no need to accept everything at once. However, if the delirium suddenly worsens or is joined by fever, breathlessness, reduced urine, or a red, swollen wound, a hidden infection or other problem may be present, and the care team should be told right away.
This article is general information and does not replace diagnosis or treatment for any individual patient. Please always discuss symptoms and how to respond with your doctor or care team.