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

Pozzi, Christian; Lanzoni, Alessandro; Lucchi, Elena; Salimbeni, Isabella; L, DeVreese; Bellelli, Giuseppe; Fabbo, Andrea; Morandi, Alessandro

doi:10.1007/s40520-019-01422-0

Cited by 16 publications

(9 citation statements)

References 31 publications

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“…Nurses are involved in the everyday assistance of the patient at risk of delirium whereas OTs are specialists in restoring the patient's independence in basic and instrumental activities of daily living, on the basis of patient's preferences. 49 For example, Alvarez and colleagues 50 recently reported the results of a feasibility study promoting the previously mentioned intervention with technology in older patients admitted to acute hospital wards. The intervention includes different activities via the interaction with a tablet, which prompt the patient to wear glasses and hearing aids.…”

Section: Discussionmentioning

confidence: 99%

Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study

Morandi¹,

Inzitari²,

Udina³

et al. 2021

Journal of the American Medical Directors Association

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Objective: Sensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium. Design: Cross-sectional study nested in the 2017 "Delirium Day" project. Setting and Participants: Patients 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes, and hospices in Italy. Methods: Delirium was assessed with the 4AT (a short tool for delirium assessment) and sensory deficits with a clinical evaluation. We assessed the association between delirium, hearing and visual impairment in multivariable logistic regression models, adjusting for: Model 1, we included predisposing factors for delirium (ie, dementia, weight loss and autonomy in the activities of daily living); Model 2, we added to Model 1 variables, which could be considered precipitating factors for delirium (ie, psychoactive drugs and urinary catheters). Results: A total of 3038 patients were included; delirium prevalence was 25%. Patients with delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium. In the multivariable logistic regression analysis, the presence of bi-sensory impairment was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval (CI) 1.2e2.1; P ¼ .00] and in Model 2 (OR 1.4; CI 1.1e1.9; P ¼ .02), whereas the presence of visual and hearing impairment alone was not associated with delirium either in Model 1 (OR 0.8; CI 0.6e1.2, P ¼ .36; OR 1.1; CI 0.8e1.4; P ¼ .42) or in Model 2 (OR 0.8, CI 0.6e1.2, P ¼ .27; OR 1.1, CI 0.8e1.4, P ¼ .63).

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Section: Discussionmentioning

confidence: 99%

Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study

Morandi¹,

Inzitari²,

Udina³

et al. 2021

Journal of the American Medical Directors Association

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“…Rousseau and Métivier [43] proposed an intervention based on imitation for emotional management. Adaptation and compensation interventions, as described in our study, such as using a pillbox or a dispill for medication management, highlighting essential information, stimulating the person to start the activity, using a checklist, verbalizing the steps of the task when achieving the task, or establishing a routine, are interventions that are widely documented in the literature as effective in optimizing independence and safety of older adults with NDs in their BADL and IADL [44][45][46]. Finally, the interventions proposed by the participants allow a better understanding of what types of assistance would meet the needs identified for this population, which would help computer scientists to better design features of HMD intended to help older adults with NDs accomplish BADL and IADL.…”

Section: Comparison With Prior Workmentioning

confidence: 99%

A Mixed Reality Cognitive Orthosis to Support Older Adults in Achieving Their Daily Living Activities: Focus Group Study With Clinical Experts

Yaddaden¹,

Spalla²,

Gouin-vallerand³

et al. 2022

JMIR Rehabil Assist Technol

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Background Mixed reality is an emerging technology that allows us to blend virtual objects into the actual user’s environment. This can be realized using head-mounted displays. Many recent studies have suggested the possibility of using this technology to support cognition in people with neurodegenerative disorders (NDs). However, most studies have explored improvements in cognition rather than in independence and safety during the accomplishment of daily living activities. Therefore, it is crucial to document the possibility of using mixed reality to support the independence of older adults in their daily lives. Objective This study is part of a larger user-centered study of a cognitive orthosis using pure mixed reality to support the independence of people living with NDs. This study aimed to explore (the difficulties encountered by older adults with NDs in their daily life to ensure that pure mixed reality meets their needs, (the most effective interventions with this population to determine what types of assistance should be provided by pure mixed reality technology, how the pure mixed reality technology should provide assistance to promote aging in place, and the main facilitators of and barriers to the use of this technology. Methods We conducted a descriptive, qualitative study. A total of 5 focus groups were completed with occupational therapists who had expertise in the disease and its functional impacts (N=29) to gather information. Each focus group met once for a 1-hour period. All sessions were held over a 3-month period. A semistructured interview guide was used. All group interviews were audiotaped with the consent of each participant to facilitate the data analysis. We conducted inductive qualitative analysis in four stages using a thematic analysis approach: full transcription of the audio recordings, first-order coding of the transcribed data, second-order coding from the first-order code list, and data reduction and matrix development. Results The results suggested that the main difficulties encountered by this population were in remembering to complete tasks, initiating the tasks, and planning the tasks. Several interventions are used to improve the independence of this population, such as prevention, simplification or facilitation, adaptation, and compensation. The use of pure mixed reality in older adults with NDs to promote independence and safety at home is promising and may respond to several clinical functions identified by the participants. Finally, pure mixed reality has good potential for use in this population and involves certain facilitators and obstacles, such as resources, technical aspects, and social considerations. Conclusions The cognitive orthosis that will be developed in light of this study will act as a proof of concept for the possibility of supporting people with NDs using pure mixed reality.

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“…The delirium episode is, by definition, an acute change that could have a significant impact on the friends and family, and an ability to receive care. An occupational therapist should have a critical role in training and informing the carer 9 .…”

Section: Initial Difficultiesmentioning

confidence: 99%

Delirium in nursing homes: the continued case of B.M.

Rahman

2023

JGG

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This is an open access article distributed in accordance with the CC-BY-NC-ND (Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International) license. The article can be used by giving appropriate credit and mentioning the license, but only for non-commercial purposes and only in the original version. For further information: https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en Geriatrics and GerontoloGy elsewhere -hypothesis papers Delirium in nursing homes: the continued case of B.M.

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

Cited by 16 publications

References 31 publications

Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study

Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study

A Mixed Reality Cognitive Orthosis to Support Older Adults in Achieving Their Daily Living Activities: Focus Group Study With Clinical Experts

Delirium in nursing homes: the continued case of B.M.

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