Preventing Delirium After Surgery: A Qualitative Study of Patients, Caregivers, and Providers

Jennifer O'Brien, Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaFollow
Maria Cruz, Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaFollow
Heather Dyck, Saskatchewan Center for Patient Oriented Research, Saskatoon, SK, CanadaFollow
Hassan Yassin, School of Public Health, University of Saskatchewan, Saskatoon, SK, CanadaFollow
Una Goncin, Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaFollow
Lei Xia, Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaFollow
Huma Aftab, Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaFollow
Lilian Thorpe, Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada AND Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada Follow
Peter Hedlin, Department of Anesthesiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaFollow

ORCID

Jennifer O'Brien: https://orcid.org/0000-0001-5826-5245

Abstract

Post-operative delirium is the most common complication in older adults following surgery. Symptoms include agitation, difficulty focusing, sluggishness, hallucinations, slurred speech, restlessness, rapid mood swings, and uncooperative or aggressive behaviour. It can result in longer hospital stays, increased mortality, loss of functional independence, increased need for a higher level of care post-surgery, and an increased risk of readmission to hospital. We aimed to understand and describe the experiences of patients, families, and healthcare providers with postoperative delirium, and to identify targeted initiatives to support patient and family centered care for high-risk patients. We conducted a qualitative descriptive study using interviews and surveys with two patients with lived experience, five family caregivers, and 11 perioperative healthcare providers between June 2023 to September 2024. Interview transcripts and open-ended survey responses were analyzed deductively according to expert recommendations. Participants reported that preoperative screening for delirium risk factors was uncommon and suggested risk factors be discussed with patients and families. Participants shared that no formal anesthesia protocols were in place intraoperatively, but anesthesiologists aim to use fewer high-risk medications in at-risk patients. Healthcare providers asked basic reorientation questions after surgery, but patients did not undergo formal delirium assessments. Four main suggestions to improve care for patients at risk for postoperative delirium included standardizing protocols, sharing information about cognitive risks with patients and families, focusing on environmental and behavioural interventions, and conducting ongoing evaluation. These findings will inform the development of a patient-centered multi-hospital postoperative delirium prevention pathway to reduce delirium amongst older patients.

Recommended Citation

O'Brien J, Cruz M, Dyck H, Yassin H, Goncin U, Xia L, Aftab H, Thorpe L, Hedlin P. Preventing Delirium After Surgery: A Qualitative Study of Patients, Caregivers, and Providers. Patient Experience Journal. 2026; 13(1):33-42. doi: 10.35680/2372-0247.2081.