Delirium isn’t an expected part of recovery, and it’s more than just “confusion after surgery.” It’s a serious medical condition where brain function becomes impaired due to surgical stress, anesthesia, or illness. It can appear suddenly and affect memory, attention, and awareness.
Recognizing delirium as a medical emergency—not just confusion—helps families act quickly and find the right care to support recovery and prevent long-term damage.
A new study led by the University of Rochester Medical Center reveals that postoperative delirium is more common than previously thought, and it’s more serious than many realize. Experts once thought that delirium was a short-term effect of surgery. Now, researchers link it to long-term health problems, including lasting cognitive decline.
The good news: it’s often preventable.
Hospitals and healthcare providers can take steps to reduce the risk, and families play an important role, too. We asked URMC anesthesiologist Heather Lander, MD, and geriatrician Annie Medina-Walpole, MD, how patients and caregivers can protect brain health before and after surgery.
What can patients and families do before surgery to lower the risk of delirium?
Delirium occurs more often in older, frail patients. People who have multiple health conditions (especially cognitive issues) or those facing complex surgeries are also at higher risk. But preparation can make a big difference. Steps include:
- Be open with the surgical team about all health issues and medications.
- Improve nutrition and physical strength, if time allows.
- Keep chronic conditions like diabetes, heart disease, or lung disease well-managed.
- Make sure to have assistive devices like hearing aids, glasses, and familiar items ready. They will help with reorientation after surgery.
- Ask the care team about anesthesia choices and the plan to support brain health post-surgery.
What are the warning signs of delirium to watch for in the hospital or after going home?
It’s normal to be groggy after anesthesia, but delirium is different. Warning signs include:
- Sudden confusion or trouble focusing
- Trouble recognizing familiar people or places
- Changes in alertness, such as unusual drowsiness or restlessness
- Rapid mood swings or hallucinations
These symptoms can come and go. If they last more than a few hours or if they worsen, let the care team know immediately. Early action can speed up recovery.
What one strategy would you recommend to improve brain recovery after surgery?
Sleep. Quality rest before and after surgery is one of the most effective and overlooked tools. Families can help by:
- Asking staff to reduce nighttime noise and interruptions.
- Encouraging regular sleep-wake cycles.
- Supporting a calm, quiet environment for rest.
What should families ask if delirium prevention isn’t being discussed?
Before surgery, ask:
- “What steps are you taking to prevent delirium?”
- “How will pain and medications be managed to lower the risk of confusion?”
- “How can we support delirium prevention?”
After surgery, ask:
- “Are you watching for signs of delirium?”
- “What symptoms should we monitor at home?”
- “What can we do to support full recovery?”
These conversations ensure the care team is keeping brain health top of mind.
If delirium does occur, what follow-up care should families insist on?
Recovery doesn’t end at discharge. Ongoing monitoring is crucial. Families can:
- Schedule follow-ups focused on cognitive health.
- Let all healthcare providers know about the delirium episode.
- Watch for ongoing memory problems, confusion, or behavior changes.
- Create a predictable, calm home environment to support brain recovery.
Taking these steps can help reduce the risk of lasting cognitive decline and improve the chances of a full recovery.
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