Early Occupational Therapy for Delirium Prevention in Older Patients Admitted to Critical Care Unit

Early Occupational Therapy (OT) for Delirium Prevention in Older Patients Admitted to Critical Care Unit (CCU)

This is a randomized, controlled trial to compare the efficacy of two strategies of non-pharmacological prevention of delirium in critically non-ventilated older patients:

• standard non-pharmacological prevention
• intensive nonpharmacological prevention (standard non-pharmacological prevention plus early and intensive occupational therapy).

Delirium is a complication in older, with incidences 70-87% in CCU. This increases mortality, hospital stay, hospital cost, and cognitive impairment. Occupational Therapy (OT) improves independence at discharge, and reduction in delirium in patients undergoing mechanical ventilation. This study compares the efficacy of non pharmacological standard prevention (control group) versus intensive nonpharmacological prevention (experimental group) in the delirium duration in older admitted CCU.

Inclusion Criteria:

• Age over 60 years.
• Admission to CCU for monitoring by acute or chronic illness, expected more than 24 hours
• Informed consent of patient or family related.

Exclusion Criteria:

• Cognitive impairment before to admission (measured by Test Reporter-TIN).
• Severe disorder of communication and cultural constraint of language (inhability of properly communicating in Spanish)
• Delirium at CCU admission or at the beginning of the intervention
• Need for mechanical ventilation
• Early limitation of therapeutic efforts and greater comorbidity with expected mortality within 90 days (in the opinion of the treating team).