Activity-based occupational therapy intervention for delirium superimposed on dementia in nursing home setting: a feasibility study.

Abstract

OBJECTIVE:

Multi-component interventions can reduce delirium incidence. Occupational therapy (OT) has been effective in the management of dementia. We designed a real-world feasibility study of an OT intervention in the management of delirium superimposed on dementia (DSD).

METHODS:

We included a convenient sample of 22 patients older than 65 years of age with delirium and moderate dementia admitted to a nursing home (NH). The OT procedures were standardized according to the level of agitation or sedation of the patient and based on a structured OT evaluation. The Canadian Occupational Performance Measure (COPM) was used to evaluate the proxy perception of performance in the daily activities at baseline and at delirium resolution.

RESULTS:

The mean age was 86.45 ± 6.46 years. The first daily treatment was delivered in the entire sample, while the second was delivered in 63.46% on day 1, 72.72% on day 2, 25% on day 3, 66.67% on day 4, 100% on days 5 and 6. The main time of the first daily treatment varied, day 1 through day 6, from 14.8 ± 8.5 to 20 ± 0 min; while the second daily treatment, in the same period, from 3.9 ± 6.7 to 20.1 ± 0 min. The mean time of the first treatment varied day 1 through day 6 from 14.8 ± 8.5 to 20 ± 0 min, while the second treatment from 3.9 ± 6.7 to 20.1 ± 0 min. The COPM proxy performance and proxy satisfaction increased from delirium onset to delirium resolution.

CONCLUSIONS:

This is the first study to report the feasibility of an OT intervention for the management of DSD in a NH setting. The results are important to support future trials on delirium management in a setting often understudied and underrepresented.

• Authors: Christian Pozzi, Alessandro Lanzoni, Elena Lucchi, Isabella Salimbeni, Luc Pieter DeVreese, Giuseppe Bellelli, Andrea Fabbo, Alessandro Morandi
• Journal: Aging clinical and experimental research (Aging Clin Exp Res) Vol. 32 Issue 5 Pg. 827-833 (May 2020) ISSN: 1720-8319 [Electronic] Germany
• PMID: 31768877 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Delirium (etiology, therapy)
• Dementia (complications)
• Feasibility Studies
• Humans
• Nursing Homes
• Occupational Therapy