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

Summary

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).

Conditions

• Delirium
• Alteration of Cognitive Function
• Incompetence, Functional

Interventions

BEHAVIORAL

Early and Intensive Occupational Therapy

Intervention group:Standard non-pharmacological prevention plus early and intensive OT. Begin in the first 24 hours in CCU admission. OT areas:1)Multi-sensory stimulation:Intense external stimulation, increase alertness,2)Positioning: Fixtures like dorxi-flexion splints, devices for preventing edema,etc,3)Cognitive Stimulation: Awareness, orientation, attention, memory, calculation, praxis and language,4)Training Activities of Daily Living (ADL): Keep a daily routine and independence in hygiene, grooming and feeding,5)Upper Limb Motor Stimulation (ULMS): Activate functional movement and strength ,6)Family involvement. General Guidelines for intervention: Visit of an OT twice a day, 40 minutes each time, for 5 days; meeting of family training for promote strategies during the daily visit.

BEHAVIORAL

Standard non-pharmacological delirium prevention

Non-pharmacological strategies are the first line of approach in the prevention of delirium. It is recommended to implement some of these strategies, which are: Reorientation protocol, including information 4 times a day about time, date, place and reason for hospitalization; early mobilization by physical therapist 3 times a day, corrected sensory impairment (use such as eyeglasses, hearing aids); environment management, use clock and calendar in the patient´s room, promote supervision of a professional or family to avoid physical restraints; sleep protocol, like lower light, noise and nighttime drug administration and finally, reduction of any anticholinergic drugs and minimize the use of benzodiazepines.

Sponsors & Collaborators

• Fondo Nacional de Desarrollo Científico y Tecnológico, Chile

  collaborator OTHER_GOV

• National Fund for Research and Development in Health, Chile

  collaborator OTHER

• University of Chile

  lead OTHER

Principal Investigators

• Evelyn Alvarez · University of Chile

• Maricel Garrido · University of Chile

• Eduardo Tobar · University of Chile

• Rolando Aranda · University of Chile

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

60 Years

Max Age

95 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2011-04-30

Primary Completion

2012-07-31

Completion

2012-12-31

Countries

• Chile

Study Locations