Things You Didn’t Know About Post-Operative Care for Elderly People

increased confusion

Caring for any loved one after surgery is a big responsibility, but since elderly people are so vulnerable already, they require extra consideration. Besides all the usual post-surgery advice — like having comfortable post-surgery clothing for the ride home — here are six things you need to know when caring for an elderly loved one after a procedure.

Watch Out For Increased Confusion

Even young adults in perfectly good health often suffer from grogginess, confusion, and short-term memory loss after undergoing anesthesia. They usually don’t remember getting ready for surgery and may be “out of it” for several days afterward, struggling with simple recall or tasks such as putting on hospital socks.

This effect is often magnified in seniors, who are already vulnerable to memory problems because of their age. It even has a name: postoperative delirium. Unfortunately, it can be tough to figure out if your loved one has postoperative delirium if they were already experiencing periods of confusion and memory loss prior to the surgery. Look out for increases in the severity or frequency of their symptoms after the procedure and let your doctor know if you notice an uptick.

increased confusion

Keep An Eye Out For Long-Term Cognitive Effects

The strongest effects of the anesthesia will wear off in about 24 hours, and the lingering grogginess and confusion should be gone in about a week (or less). However, some people will continue to experience cognitive issues long after the operation, a condition known as Postoperative Cognitive Disorder (POCD) — and advanced age is one of the most common risk factors.

These symptoms can linger for up to 12 months after surgery and may precipitate further mental decline. If your loved one is older or already vulnerable to cognitive decline, talk to the surgical team about what they are doing to lower the risk for POCD, as well as what you can do at home to help. 

Be Ready For Excessive Bruising

Bruising after surgery is normal, both around the surgical site itself as well as any other areas of your body that had to be braced during the procedure. While this is to be expected, the bruising can be quite alarming, especially in fragile elderly people who are already prone to bruising easily. The bruises should fade in color in a few days and be completely gone in a few weeks.

Using ice therapy in the early stages will help lighten the bruises and also reduce pain and swelling. While you can use a good old pack of frozen peas, many people find it beneficial to buy or rent ice machines for post-op care. These machines continuously pump ice cold water through a brace that is wrapped around the surgery site, which improves both efficacy and comfort.

prepare for potential nausea

Prepare For The Potential Of Nausea

Another unpleasant side effect of anesthesia is nausea, and your loved one may even vomit a little bit after the procedure. This can also be exacerbated by certain medications that your loved one may be prescribed to take after the surgery. Nausea should subside in 24-48 hours after the procedure. If it lasts beyond this, or your loved one throws up more than twice, call the surgical team to let them know what’s happening.

The surgical team may be able to switch them to different medications (if that seems to be the cause of the nausea) or prescribe anti-emetic pills to reduce the nausea. Pain makes vomiting more likely, so your loved one should not skip or reduce their pain medication dosage unless specifically instructed to do so by the surgical team.

As for keeping food down, start by drinking clear fluids and then having some milk or juice. If that stays down, try soft, bland foods such as applesauce, pudding, and oatmeal. Slowly reintroduce bland, solid foods until your loved one is able to tolerate regular food. Keep in mind that they may need to stay away from certain foods that are known to irritate the GI tract, even after they are eating solid food again.

stay vigilant about dehydration

Stay Vigilant About Dehydration

This nausea can contribute to another serious issue: dehydration. Dehydration can contribute to pain, confusion, grogginess and other post-op issues, so staying hydrated is absolutely essential. While your loved one is in the hospital, they will be given fluids intravenously, but once they get home and out of their hospital gown, you will need to monitor their fluid intake. You will probably need to remind them, especially if they are still out of it.

Start with plain water to avoid contributing to nausea. Encourage them to take small sips more frequently, as opposed to large gulps, which might cause their stomach to feel sloshy. If they struggle to drink from a regular glass, get them a bottle or lidded tumbler with a straw, which will be easier to drink from and also help prevent spills. Once their stomach settles, you can try a flavored drink or adding electrolyte powder to the water to further contribute to hydration.

Look Out For Uncontrolled Pain

Very fragile elderly people may not be able to communicate if they’re having complications or if their pain medications aren’t working, especially if they already had cognitive issues prior to the surgery. Look out for warning signs besides vomiting, including trouble breathing, signs of infection around the wound, and signs of a pulmonary embolism or deep vein thrombosis. Call the doctor immediately if you notice any of these symptoms and be prepared to go to the emergency room if necessary.

Keep these things in mind as you care for your loved one after surgery to make things easier for both of you. We wish them an easy and speedy recovery!