Nonpharmacological intervention in the management of delirium: an integrative bibliographic review

Abstract

Introduction: Delirium is a complex clinical condition characterized by a neuropsychiatric expression organic disease, in which the individual has a sudden change in cognitive capacity, possible fluctuations in sleep, awareness, and attention. The treatment of delirium must be carried out using a multicomponent and interdisciplinary approach. Objective: Learning about non-pharmacological interventions for the management of delirium by a multidisciplinary team and those conducted specifically by the occupational therapist. Method: Integrative bibliographic review on Lilacs, Pubmed, Scopus and Web of Science database and SciELO. Results: The interventions aimed at the empowerment and participation of all agents involved in the treatment of patients with delirium. We highlight strategies focused on: increasing patient autonomy and independence; adequacy of environmental conditions, promote safety, comfort, familiarity, and temporal-spatial orientation; adaptation of the routine to favor the sleep-wake cycle; physical, cognitive, and sensory stimulation; improving occupational performance and encouraging significant activities; prescription of assistive technology resources and complementary therapies, when indicated; constant evaluation and monitoring of the patient; control of pain, emotional symptoms and clinical conditions that predispose to delirium; improved communication of the patient and his bonding with the team and the support network; and health education. Conclusion: Interventions aim at integrality of care and therefore, must be carried out by the different professionals that compose the team, highlighting the role that occupational therapists play in the management of delirium.