Date of Award

2026

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Dr. Kelly Dornbier

Abstract

Purpose: Hospitalization presents significant risks for individuals with dementia, including increased behavioral and psychological symptoms (BPSD), delirium, functional decline, and reduced occupational engagement (Boltz et al., 2023; Teichmann et al., 2019; Zwingmann et al., 2020). Acute care environments are often overstimulating, unfamiliar, and task-oriented, which can exacerbate cognitive impairment and contribute to caregiver distress. Despite strong evidence supporting nonpharmacological, occupation-based interventions, structured engagement opportunities are rarely integrated into acute care workflows (Burgdorf et al., 2023; Faeder et al., 2023). This doctoral capstone project aimed to develop occupation-based dementia activities for use during hospitalization while equipping formal and informal caregivers with practical strategies to support meaningful engagement during and after discharge.

Methods: A comprehensive literature review addressed dementia care in acute settings, nonpharmacological management of BPSD, delirium prevention, and caregiver support. A structured needs assessment was conducted through personal communication with occupational therapists, nurses, physicians, certified nursing assistants, activity directors, family caregivers, and individuals with dementia. Guided by the Person-Environment-Occupation (PEO) model and the Cognitive Disabilities Model (CDM), 12 themed activity kits were developed. Each kit included graded materials and caregiver instruction guides outlining setup, safety considerations, and modification strategies. Activities were designed for bedside use to promote engagement and support delirium prevention. An additional educational handout was created to guide caregivers in developing individualized activity boxes for home use, supporting continuity of care.

Conclusion: Cognition-matched, occupation-based activities offer a feasible and clinically relevant approach to enhancing engagement in acute care. By integrating individualized activity design, environmental adaptation, and caregiver education, this project supports patient participation and caregiver confidence. This approach addresses a critical gap in acute dementia care and promotes continuity of meaningful engagement strategies across settings, with implications for improving patient outcomes, reducing caregiver burden, and supporting nonpharmacological management of behavioral symptoms.

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