Post Operative Cognitive Dysfunction

[plipplop1]

Mam had a second hip replacement in March ,she's 85 and came through the op physically very well but she is now very confused especially after she's had a nap and wakes up.She doesn't have much idea of days and times and her personality is different. We have had her to the GP who has said give it nine months,the renal specialist said 'we should have realistic expectations as she is 85' but she wasn't confused before the op. Mam has various other disabilities diabetes,glaucoma, renal failure but all being managed. I've made her a calendar so that when she wakes she can see what day it is and what going to happen.Has anyone any advice on what I can do

[rowanwitch]

Did they eliminate other causes like a mini-stroke... only most cases I saw when nursing resolved a lot more quickly than that usually days rather than months and strokes are sadly not uncommon in elderly people either during or immediately after surgery

[plipplop1]

Thank you for your prompt answer no one will investigate anything at present but I think you are right about the mini strokes she had a couple of episodes when she came out of hospital that I think were mini strokes I am holding out hope that she is going to come back to us but I think I am being unrealistic.

[Sqad]

Aged 85years...post operative confusion.........only too common in the elderly, it often seems the "final straw".

Diabetes, renal failure, could be investigated but for what purpose? Kidney transplant? She would never survive and kidneys are in short supply.

Mini-strokes? what could be done?

plipp....she is on old woman who has done very well despite all her problems and I cannot see a silver lining.........sorry.

[plipplop1]

I know what 's being said is right but I can't give up hope yet I also still have Dad 89 with multiple health problems all of which we manage. All I am trying to do is keep them both as happy as possible and perhaps what I need are tips on how to manage the confusion so it doesn't upset her. The diabetes and renal failure are under control and I give her injections for the renal failure. I think I having been living in false hope........

[woofgang]

okay practical stuff. can you get here a daily paper delivered? The calendar you have made is key and will help the most of anything you can do. With the personality change, it does actually sound like a stroke which might explain the doc's 9 months comment. TIA's (transient ischaemic attacks,) resolve as far as they will very quickly. "ordinary" strokes resolve more slowly, a good rule of thumb is not to expect any further recovery after a year. It is very important to keep her eating and drinking, both for her kidneys and to ward off urine infections which will make the confusion very much worse. I have been where you are and its a hard horrible place to be. I think your goal of keeping your Mum and Dad happy si praiseworthy and the most realistic one you can have ((hugs))

[boxtops]

Plipplop, my mum was 93 when she had her final operation on her leg, she was most definitely confused when she was on the ward for a couple of weeks. It felt like dementia but wasn't, she was so muddled up, she told me there were fishermen with ropes on the ward. I was told at the time that it was connected to the anaesthesia, taking longer to work through the system of an older person (though I bow to Sqad's clinical expertise in this topic). When she was discharged back to her nursing home, she did recover her equilibrium and knew who we were and conversed well. (Sadly she was very old and had had a good life, and died not long after, but she had heart failure so the operation and confusion did not appear to have direct connections.)

[RATTER15]

This is something I deal with on a daily basis in the dementia unit I work in, I think the best you can do is try to distract your Mum when getting confused, give her plenty of mental stimuli, lots of photographs and sit with her and do lots of reminiscing, plenty of reminders of what she used to do when she was younger, you may well find its recent issues that are confusing her but she may well remember her past quite clearly, this will be reassuring to her.

[plipplop1]

To everyone that replied Thank You for your help and advice I am very grateful It is good to know there are such kind and generous people out there many thanks