When older adults undergo major surgeries like hip or knee replacements, they often face a frightening period of confusion called postoperative delirium. It can be scary for both the patient and their family. New research highlights that we can reduce these instances by moving away from standard care toward a more holistic approach.
A specific bundle of non-drug strategies, known as eCASH, shows promise. This includes early movement, mental stimulation, enough sleep, social support, and keeping the room feeling like home. When these pieces are combined with a team that works together across different medical roles, the results are much stronger than if one person tried to manage it alone.
While this review of 20 high-quality articles shows a clear pattern of success for the eCASH bundle, there is some variation in how different studies were designed. Because this was a narrative synthesis rather than a single large trial, we cannot see specific numbers or percentages yet. However, it points toward a clear path: using risk screening and team collaboration to keep patients safe and clear-headed.
