216 ENABLING THE DELIRIOUS PATIENT TO REMAIN AT HOME: TWO CASE STUDIES FROM THE EDITH (EMERGENCY DEPARTMENT IN THE HOME) SERVICE

Abstract

Abstract Background The EDITH service brings emergency department care to the older adult thus negating the need for hospital presentation. There is an emerging body of literature regarding optimal treatment for patients with delirium suggesting care takes place in a familiar/ home environment. Methods Patient A: an 86 year-old lady with a UTI. She had a CFS:6 and a 4AT:7. She lived with her husband and her daughter who was a nurse lived nearby and provided care. She had a hypoactive delirium presentation. Patient B: an84year old gentleman with a chest infection. He had a CFS:5 and a 4AT:7. He lived with his wife and had a home care package. He had a mixed delirium presentation. Results In both cases, the Occupational Therapist (OT) provided education to the family regarding delirium and the recovery process of same. The OT provided advice regarding modifying and optimising the home environment for the delirious patient. The OT provided advice on the therapeutic use of activity and functional engagement. Medical input involved antibiotics and ensuring adequate nutrition and hydration. Safety netting was completed by onwards referrals to community services (PHN, COT, GP etc) and providing additional EDITH in-person reviews and phone-calls during the period of recovery. Conclusion Delirium type, level of family support and their understanding of delirium may impact on the success of a delirious patient remaining at home. The OT has a specialised role with regards to the treatment and management of the delirious patient. This is an emerging area of practice that OTs can lead as older adult services evolve and there is a move towards caring for patients with delirium within the familiar home environment.