Activity-based occupational therapy intervention for delirium superimposed on dementia in nursing home setting: a feasibility study
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).
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.
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.
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.
KeywordsOccupational therapy Delirium Dementia Nursing home Tailor-made activity
Study conception and design—all the authors. Acquisition of data—AL, IS, LPD. Statistical analysis: EL. Interpretation of results—all the authors. Drafted manuscript—CP, AL, AM. Critically revised the manuscript—all the authors. Final approval of manuscript—all the authors.
Compliance with ethical standards
Conflict of interest
The authors declare no conflicts of interest.
All procedures performed in the study were in accordance with the ethical standards of the Ethical Committee Val Padana (Protocol 34788/17) and with the 1964 Helsinki declaration.
Informed consent was obtained from patients’ authorized surrogates at study enrollment.
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