Innovation in delirium care: A standardized intervention to reverse inattention using touch and movement

Abstract

Delirium is a complex neurocognitive disorder characterized by an acute disturbance in attention, awareness, and perception. It is a dangerous syndrome that is independently associated with higher rates of morbidity and mortality, inpatient complications, and is a predictor of long-term cognitive dysfunction. Although delirium can occur in persons of all ages, the prevalence among and impact on older adults is particularly significant. Current gold standard approaches for delirium include treating medical precipitants and physiological perturbations and optimizing the environment using multicomponent nonpharmacological interventions. Although these approaches are proven effective in preventing delirium, evidence has not shown them to significantly improve delirium once it occurs. The need for a safe, effective, and specific treatment for the phenotype of delirium itself is an urgent priority worldwide. The intervention described in this article, Attention and Awareness Through Movement technique followed by Movement To Capacity (AATM/MTC), targets cortical dysfunction through sustained sequential touch, cranial nerve stimulation, and muscular movement. It raises the tantalizing possibility that a specific method to reduce inattention and normalize arousal levels may not only be feasible but also safe and inexpensive. For these reasons, preliminary observations are described in the hope of stimulating interest in further exploration of this novel approach to delirium therapy.