Confusion After Surgery: Delirium Risk Screener

Delirium is a sudden, fluctuating state of confusion that can follow an operation, especially in older adults. People may be disoriented, drowsy or agitated, see or believe things that aren't real, or seem 'not themselves'. It usually comes on over hours to days, often worse at night, and in most cases it's temporary and improves over days to a couple of weeks.

Risk is higher with older age (especially over 75), existing memory problems or dementia, a previous episode of confusion in hospital, heavy alcohol use, poor hearing or vision, taking many medicines, frailty, and bigger or emergency surgery. Things like infection, pain, dehydration, constipation, and disturbed sleep can trigger or worsen it.

A lot. Bring glasses and hearing aids and make sure they're worn, visit often and bring familiar faces and objects, gently reorient them (day, place, why they're here), encourage daytime activity and good sleep at night, help them eat and drink, keep a clock and calendar in view, and make sure pain and constipation are treated. Flag any sudden change in alertness to the nurses early.

Usually not. Most delirium settles over days to a couple of weeks as the person recovers. A small number of people, particularly those with existing memory problems, take longer or don't fully return to their previous baseline — which is why prevention and early action matter. Tell the team if confusion is new, sudden, or getting worse.

Tell them if the person has any memory problems or dementia, has been confused in hospital before, drinks alcohol regularly, or takes sleeping or anxiety tablets. This lets the team plan anesthesia and pain relief to lower the risk and watch for early signs.