Background: Delirium is a geriatric syndrome that presents in 1 out of 5 hospitalized older patients. It is also common in the community, in hospices, and in nursing homes. Delirium prevalence varies according to clinical setting, with rates of under 5% in minor elective surgery but up to 80% in intensive care unit patients. Delirium has severe adverse consequences, but despite this and its high prevalence, it remains undetected in the majority of cases. Optimal delirium care requires an interdisciplinary, multi-dimensional diagnostic and therapeutic approach involving doctors, nurses, physiotherapists, and occupational therapists. However, there are still important gaps in the knowledge and management of this syndrome. Main body: The objective of this paper is to promote the interdisciplinary approach in the prevention and management of delirium as endorsed by a delirium society (European Delirium Association, EDA), a geriatrics society (European Geriatric Medicine Society, EuGMS), a nursing society (European Academy of Nursing Science, EANS), an occupational therapy society (Council of Occupational Therapists for European Countries, COTEC), and a physiotherapy society (International Association of Physical Therapists working with Older People of the World Confederation for Physical Therapy, IPTOP/WCPT). Short conclusion: In this paper we have strongly promoted and supported interdisciplinary collaboration underlying the necessity of increasing communication among scientific societies. We have also provided suggestions on how to fill the current gaps via improvements in undergraduate and postgraduate delirium education among European Countries.

Meaningful occupation is a frequently stated part of person-centred care, but that need is often unmet in long-term care (LTC) settings. There is little in literature about the perspective of people with moderate and severe dementia on their identity construction and social roles. This study deals with the following question: how do men and women with moderate to severe dementia living in long-term care maintain aspects of their identities and social roles? It also gives insight into the application of a narrative-in-action approach with people with advanced dementia. Using a qualitative research design in the ethnographic tradition, observations, interviews and informal talks whilst doing occupations with people with dementia and their carers were used for data collection in two institutions. A narrative analysis based on a narrative-in-action approach was applied. The findings show the efforts of people with dementia doing “identity work” in a confining environment. They used narratives, objects, and occupations to express their identities despite their cognitive or physical impairments. The narrative-in-action approach offers the potential to better understand the perspective of people with dementia who have problems expressing themselves verbally. Even though they are fragmented, repeated stories have an important function in constructing identity and should not be regarded merely as a symptom of dementia. This study allows for a better understanding of the relationship between occupation, its symbolic meaning, and identity in people with advanced dementia.

Background: Delirium and dementia are two of the most common geriatric syndromes, which requires innovative rehabilitation approaches. Aim: We aimed at determining which occupational therapy and physiotherapy interventions are applied with older people with delirium and dementia in different care settings. We also identified the assessment tools that were used. Materials and methods: We conducted a literature search for scientific articles published from 2012 to 2022 (PubMed, MEDLINE, AMED and CINAHL) with adults aged >65 years including experimental study designs with randomized or non-randomized intervention, exploratory studies, pilot studies, quasi-experimental studies, case series and/or clinical cases. Studies that did not use interventions that could be classified as occupational therapy or physiotherapy were excluded. Results: After applying the exclusion criteria, 9 articles were selected. The most widely used assessment to define dementia was the MMSE (N = 5; 55.5%), whereas the CAM (N = 2; 22.2%), CAM-ICU (N = 2; 22.2%) and RASS (N = 3; 33.3%) were the most widely used to define delirium. The rehabilitation interventions that were most frequently performed were early mobilization, inclusion of the caregiver during treatment, modification of the environment to encourage orientation and autonomy, the interprofessional systemic approach and engaging persons in meaningful activities. Conclusions: Despite the growing evidence on its effectiveness, the role of physiotherapy and occupational therapy interventions in the prevention and treatment of people with dementia and delirium is still emerging. More research is needed to investigate if effective occupational therapy programs known to reduce the behavioral and psychological symptoms in people with dementia are also useful for treating delirium and specifically delirium superimposed on dementia. Regarding physiotherapy, it is crucial to know about the amount and timing of intervention required. Further studies are needed including older adults with delirium superimposed on dementia to define the role of the interprofessional geriatric rehabilitation team.

The need for integrated, accessible and person-centred care for people with dementia to foster quality of life and facilitate life in the community has been voiced by health policy. Pharmacies have the potential to provide easily accessible information and support for people with dementia, caregivers and the public. The ‘Dementia-friendly Pharmacy’ programme aimed at re-orienting community pharmacy in Austria, focusing on stronger inclusion of professional counselling into core services. It followed principles of health promotion and person-centred care, aiming at empowering all actors involved, and at fostering quality of life. Methodologically, the programme was based on participatory health research, thus involving all relevant actors and consolidating their perspectives on issues related to dementia care. In the course of the programme, a workshop series covering topics relevant for dementia care in community pharmacy, as well as prototypes for small-scale projects were developed, and measures were taken for securing sustainability. Findings related to programme development and implementation encompass pharmacy staff’s motivation to participate in the programme, counselling knowledge and skills development, experience with building community partnerships and cross-organizational development and sustainability. Furthermore, effectiveness of the programme has been established. These findings are discussed against the background of re-orienting pharmacies.

This article presents the life stories of four older women in Vienna in order to better understand the role of occupation in the course of ageing. A qualitative life-story method in the narrative tradition was used as a design of this multiple case study. The stories presented extend beyond an illness or deficit narrative and contribute to a more multifaceted narrative of the subjective experience of ageing in occupational terms in connection with identity. The women did not perceive themselves as old or sick despite problems in mobility, the presence of chronic disease and advanced age. This was associated with their engagement in occupation that was meaningful and linked to their identity. Engaging occupation is the means to continue, test, and adapt to the ageing self. Because occupation is like a litmus-test of one's identity and capacities, the women used it as a measure of change while ageing. Using Atchley's continuity theory, the attempt of the four older women to maintain a balance between adapting and struggling to continue their occupations is discussed in relation to their identity. The results expand Atchley's continuity theory by adding an occupational perspective.