Things You Didn’t Know About Post-Operative Care for Elderly People
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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. Older age, having surgery, dementia, and strong pain medicines such as opioids are all risk factors for 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 sudden changes or increases in the severity or frequency of their confusion after the procedure, and tell the care team right away if you notice them.
Keep An Eye Out For Long-Term Cognitive Effects
The strongest effects of anesthesia usually wear off within about a day, and lingering grogginess often fades over the following days. However, some people will continue to experience cognitive issues long after the operation, a condition known as Postoperative Cognitive Disorder (POCD, also called postoperative cognitive dysfunction). Advanced age is one of the most common risk factors.
In some people, these problems can last for months after surgery. 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.
Ask the surgical team before using ice. If they approve it, cold therapy in the early stages can help 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 pad or brace around the surgery site. Always keep a layer between the cold source and the skin, and check fragile skin often, because older adults can get cold injuries more easily.
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 often eases within a day or two after the procedure. If it lasts longer, or your loved one keeps vomiting or can’t keep fluids down, 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. Uncontrolled pain can make nausea worse, so your loved one should take pain medicine as prescribed and not change the dose without talking to the surgical team.
As for keeping food down, follow the diet instructions from the hospital. Many people start with clear fluids, then move on to other drinks. 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
This nausea can contribute to another serious issue: dehydration. Older adults are more likely to become dehydrated, partly because some people lose their sense of thirst as they age. Dehydration can add to confusion, dizziness, and other post-op problems, so staying hydrated is 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 an electrolyte drink. Ask the care team first if your loved one has heart or kidney disease or has been told to limit fluids.
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 fever, redness, warmth, or drainage around the wound, and pain or swelling in one leg, which can signal a deep vein thrombosis.
Call the doctor right away if you notice any of these. Call 911 for chest pain, sudden shortness of breath, or severe confusion, since these can signal a blood clot in the lungs or another emergency.
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!
Sources
- Delirium, MedlinePlus
- Dehydration, MedlinePlus
- Deep Vein Thrombosis, MedlinePlus
