Delirium after hip surgery

[Pinklady81]

We are all very worried about my grandmother who is 92 and fell and fractured her femur last week. Prior to this she was of sound mind, lived in her own flat and cooked and went shopping for herself. After surgery a few days after she has rapidly changed into a different lady she is hallucinating , not making sense, ringing relatives up and asking where they are and just general confusion. It's so upsetting and we are at a bit of a loss. She has had all the standard checks done eg bloods, urine and they have come back clear so leaning towards the trauma of the injury and delirium taking hold ? Has anyone got any advice as doctors don't seem too worried and just think she's a frail old lady with dementia when she was not before entering the hospital ..... many thanks for reading

@Thighdentitycrisis she seems to just be sleeping lots and very confused when she appears to be awake still we are nearly into a week of this and the doctors have now said no this delirium and very common and that she may or may not come round it's so so sad . She doesn't seem to know where she is at all

I wrote a similar thread myself. In fact I had to check that you weren't a relative of mine. My mum is the same age and fell four weeks ago exactly. For the first three weeks she was exactly how you describe your grandmother. Over the last week though she has changed back into the person she was. She now wears her own clothes, eats big meals, can talk sensibly and is learning to walk again, though it does hurt her. She isn't interested in things like crosswords or reading, which she used to be, and we are hoping that comes back. She was absolutely exhausted for the first three weeks. It was very upsetting to watch her sleep constantly.

She is now in a rehab place and they are preparing her to return home in the next few weeks. I really hope your grandmother has the same experience.

Regarding delirium, my mum was just the same and is now okay. She still insists that very strange things happened on her ward and that we will hear about it all on the 10 o'clock news!

its been a good 3 weeks since the fall and still getting gradually more settled

@Thighdentitycrisis @EmergencyHepNeeded it seems for your relatives time has been the factor we've tried doing all the suggestions mentioned eg clock, speaking to her about where she is and bring in some familiar home things which she remembered straight away. It's just the conversation part she remembers people and events that have happened but then in the next breath talking about some random made up event that she's part of . Each day is different some days she's very alert and out of bed others she's very lethargic and just sleeps majority of the time.

@Pinklady81
it’s been very like that I agree but we are still not out if the woods and realistically she will return to how she was. It’s great to see she has improved somewhat but I think when we are not there she’s distressed. Hope your grandmother makes som progress soon

Meant won’t return!

This was like my great granny, she was totally independent and lived by herself, she was a bit forgetful but we just put it down to old age, telling you the same story she told you last time or forgetting she’d told you. She then fell and broke her hip and things got gradually worse, she was eventually diagnosed with vascular dementia and we were told the trauma of the injury and surgery had made it more pronounced and sort of sped it up almost

But of course it may not be this and could be pain relief, alot of our patients are on PCA machines (self administered push button pain relief) sometimes they push the button too much thinking it’s not doing anything which can knock them off, sometimes it just doesn’t agree with them

Is she dehydrated? My Dad is 82 and has had Covid in the last two weeks. He went from fully independent to not knowing where he was, not being able to take his tablets or insulin. He's still not fully right, and it's been horrible but the main factor was him was a temperature and not enough fluid.

It's really awful to stand and watch, OP, I hope she's better soon.

It’s been 3 weeks since DM fell and had a hip replacement. She has been back in her care home for 3 days and seems more settled and alert. I also don’t think she will get back to how she was. She is hardly eating anything and says she is not hungry. I hope appetite returns because. She needs strength to try and get some mobility back. She is very weak

My OH had Parkinsons and was just about coping with my support - he sometimes said and believed strange things and his mobility was dodgy. He fell and fractured his hip - he was a GP and diagnosed it himself - and he lay there on the floor and said "This is the beginning of the end." After the surgery he never recovered. He was mad as a hatter and living in a state of terror because of his paranoid beliefs. He died about 10 months later, never having emerged from what they described as delirium. The combination of his underlying brain disease, the trauma of the fall, the fracture, the surgery and the hospital stay were too much for him.

Sadly it is not unusual for this sort of trauma to trigger a mental decline. I am sorry that this has happened to your grandmother and hope that she will be one of the ones who recover - but her age is against her. My OH was not old.

I'm sorry to hear about your grandmother. Has she been checked for a urinary tract infection? A relative of a similar age had hip surgery (after a break) & was not delirious but lethargic & unwell following. I told hospital staff she wasn't normally like that, they checked for a UTI (because it can cause people to feel really ill. I think maybe it can happen after surgery like that). It turned out she did have a UTI & improved quickly after being given antibiotics. So maybe it could be worth asking about this? Anyway, I hope she feels better soon

Same thing has happened to my 87 year old father who had spinal surgery in June. He has changed from being a bit forgetful to someone who seems as if he has severe dementia. It really varies from day to day but at its worst he believes that he is the victim of some kind of conspiracy and the staff in the nursing home are all out to trick him, or worse. I spoke to an elderly care consultant when he was in hospital and she said they won’t assess for dementia until three months after the onset of delirium. It’s very sad to see him like this and it’s definitely impeding his recovery.

Hello everyone

Many thanks for all your replies, well it looks like my grandmother is coming out the other side . Been a couple of days but she is now coherent , recognising us all and chatting away . It's the pain now that's bothering her whereas in her delirious state she wasn't in pain and hopping in and out of bed! It really has been a rough few weeks but there is some hope now and she is hopefully having all the assessments down before she goes into respite which she isn't keen on at all!! Fingers crossed for you all in similar situations as we never thought this would happen ! 🙏

That’s really good news. I had a hip op and the pain killers caused nightmares and I felt awful, I’m a lot younger as well.

I came on here to post a similar story, found this thread and feeling so much better.

Same thing happened to my 99-year-old grandma who fell on her way to market (where she would happily haggle with stallholders), breaking her arm and jaw.

She went from being completely “with it” to seeing black elephants (cars!) through her hospital windows.

Two months on, she’s now settling in her new care home, which seems excellent. She’s with it most of the time but will suddenly tell us that my grandpa (who died 20 years ago) has called to get a new telephone line installed. We keep having to remind her that she can’t cook for herself as there’s no kitchen in her small bedroom etc, only for her to ask us to take her to the market five minutes later.

After reading this thread, I’m hoping that she’ll be back to her usual self soon.

I really wish hospital doctors and nurses had talked to us about delirium and how common it is.

I’m glad your grandma is better, OP, and wish her well.