In June 2018, Julia Herzenberg learned that her 73-year-old father was scheduled to have his gallbladder taken out and stones removed from his pancreas. So she flew from her home in northern California to New York to be at his side and serve as his advocate in the hospital.
The surgery went well and her dad seemed fine afterward, so Herzenberg and her brother slipped out for lunch while a friend stayed with their dad. When she got back an hour later, she noticed her father's shoes were up on the windowsill rather than on the floor.
"He was convinced that ants were crawling in his shoes and that the nurses were lying to him,” recalls Herzenberg, a project manager at Kaiser Permanente in Oakland, California. “He had become argumentative with them, which was unusual for him. His behavior was a little scary to me.”
Herzenberg quickly realized that her father was experiencing delirium, a potentially serious condition that involves a sudden change in thinking and behavior; it is the most common surgical complication for older adults, according to a just-released Global Council on Brain Health (GCBH) report. She immediately let the nurses know and they decreased his pain medication. She also gave him his glasses to help him become better oriented to where he was and what was happening around him. Within a couple of hours, her father was back to his usual self.
As Herzenberg discovered, having a family member experience delirium can be an upsetting experience — and one that requires prompt action. Fortunately, she knew the signs to look for, which experts say is crucial, especially because hospital staff members may not recognize delirium right away. Caregivers know their family members far better than anyone on the health care team does, so it's important for loved ones to be attuned to early signs of delirium.
Know the signs, know how to respond
"What you want to look for are changes in your relative's alertness, ability to focus and pay attention, and track with you in a conversation, compared to how they usually are,” says geriatrician Jason Karlawish, a professor of medicine at the University of Pennsylvania School of Medicine and codirector of the Penn Memory Center.