An occupational therapy delirium pathway reduces hospital re-presentations in older adults with delirium: A before and after observational study

Abstract

Introduction: The hospital environment can exacerbate symptoms of delirium; as such there is a move to promote early supported discharge for patients with delirium. However, the occupational therapy role and impact of intervention is not well known. Our study evaluated an occupational therapy delirium pathway facilitating early assessment, intervention and supported discharge to home compared with hospital-based care. Method: A before and after, observational study design. Data was collected regarding hospital use, patient function (Functional Independence Measure/Functional Assessment Measure) and the carer experience (Preparedness for Caregiving Scale). Results: Ninety patients (43 control and 47 intervention group patients) were recruited with a mean patient age of 82.8 years (SD 7.6). There was a significant difference in hospital re-presentations ( n = 3 in the intervention group compared to n = 10 in the control group ( p = 0.026)). Hospital length of stay did not significantly differ between the groups ( p = 0.534). The mean score for the Preparedness for Caregiving Scale was 3.3 indicating that most carers felt ‘pretty well prepared’. However, patients continued to experience significant functional decline ( p = 0.006). Conclusion: An occupational therapy delirium pathway reduced hospital re-presentations and could be implemented in clinical practice to better support patients recovering from delirium as they transition from hospital to home.