Home Health Staff Knowledge and Experience of Delirium and Delirium Superimposed on Dementia in Older Adults

Abstract

Previous studies have shown delirium is common in the home setting and can indicate a medical emergency. Many older adults come into the hospital or ER with delirium. However, little is known about the recognition of delirium by home health workers and community nurses. The purpose of this study is to explore the experience of home health (HH) staff caring for an older adult with delirium or delirium superimposed on dementia (DSD), with a focus on capturing rich details of these experiences and their knowledge of recognition and management of delirium. Utilizing story circle methodology, this qualitative study recruited 18 home health care workers from rural Pennsylvania to share their personal experiences in caring for older adults with delirium or DSD. Participants highlighted six key themes: (i) Noticing delirium as a sudden change in behaviors, (ii) Knowing the person with dementia, (iii) Potential causes of delirium, (iv) Fear of delirium and lack of protection for HH staff, (v) Lack of specific protocol and barriers, and (vi) Managing delirium collaboratively with HH staff and family. The findings emphasize the critical role of HH staff in early delirium detection and the necessity of family involvement in patient care. However, the study also highlights the need for improved training and standardized protocols to enhance HH staff’s ability to manage delirium effectively. Addressing these gaps is essential to improve patient outcomes and the quality of care provided in home health settings.