In the rapidly evolving field of geriatrics, understanding the intricacies of pain management and delirium interventions in older patients remains paramount. A recent systematic review by Prandeh Afshar and colleagues sheds light on non-pharmacological strategies tailored to address these critical issues faced by hospitalized older adults. While pharmacological options have long been the cornerstone of medical interventions, there has been a burgeoning interest in exploring alternative approaches that prioritize the holistic well-being of patients, especially those within vulnerable populations like the elderly.
Acute pain and delirium are prevalent among older adults in acute care settings, often leading to significant morbidity, prolonged hospital stays, and increased healthcare costs. Delirium, a state of confusion and disorientation, is particularly concerning as it not only affects the patient’s immediate recovery but can also have long-lasting impacts on cognitive function. The need for effective management strategies has prompted researchers to investigate how non-pharmacological interventions can be leveraged to mitigate these conditions, thereby enhancing the overall patient experience and clinical outcomes.
In this systematic review, the authors meticulously examined a plethora of studies that explored various non-pharmacological interventions, including physical therapy, occupational therapy, music therapy, and sensory stimulation. These therapies represent a crucial paradigm shift in how healthcare practitioners approach pain and delirium. Unlike their pharmacological counterparts, which often come with a range of side effects, these interventions focus on improving patients’ psychological and emotional states, ultimately fostering a more conducive healing environment.
One of the noteworthy findings from the review indicates that integrating physical activity into the care regimen can significantly alleviate pain levels in older patients. Simple exercises tailored to individual capability not only promote physical strength but also enhance psychological well-being. Engaging patients in movement is vital, as it helps diminish the sensations of pain and contributes positively to mood and cognitive functioning, reducing the likelihood of delirium onset.
Occupational therapy, another focal point of the review, emphasizes the importance of daily living activities in maintaining cognitive engagement and independence in older patients. By facilitating tasks that patients find enjoyable and meaningful, occupational therapists can mitigate feelings of helplessness, which are often exacerbated during hospitalization. This approach not only addresses pain management but also serves as cognitive therapy, keeping patients engaged and less prone to delirium.
Music therapy emerged as a promising intervention, with studies highlighting its potential in reducing anxiety and pain perceptions. The rhythmic and melodic properties of music have been shown to create a calming environment, allowing patients to experience emotional and sensory relief. By incorporating music therapy, healthcare providers can offer a non-invasive approach that resonates with patients on multiple levels, thereby reducing the reliance on analgesics.
Equally significant was the review’s focus on sensory stimulation interventions. Techniques that promote sensory engagement, such as aromatherapy or tactile stimulation, can decrease agitation and confusion in patients experiencing delirium. These interventions harness the power of smell, touch, and sound to ground patients, offering comfort in an often disorienting hospital environment. The physiological and psychological benefits of sensory stimulation are far-reaching, potentially leading to shorter hospital stays and improved recovery trajectories.
The authors also noted the importance of individualized care plans that integrate these various non-pharmacological interventions. Personalizing treatment to address the unique preferences and needs of each patient is crucial for the success of these approaches. Involving family members in the care process is an effective strategy to bolster support and ensure that interventions align with the patient’s history and preferences.
Transitioning from a traditional medical model to one that embraces non-pharmacological strategies involves rethinking hospital protocols. To implement these findings effectively, healthcare systems must train staff on the expanded scope of pain and delirium management. Equipping nurses and caregivers with the knowledge and skills to deliver these therapies is vital for both compliance and efficacy.
The review’s authors encourage further research to explore the long-term impacts of non-pharmacological interventions on pain and delirium in older adults. While the preliminary findings are promising, additional studies are necessary to build a robust evidence base that healthcare providers can rely upon when considering these methods within clinical practice.
It is essential to foster a culture of collaboration among various healthcare disciplines, including nursing, physical therapy, occupational therapy, and mental health services, to maximize the potential of these non-pharmacological interventions. Multidisciplinary approaches can facilitate comprehensive care strategies that not only address immediate symptoms but also consider the patient’s overall quality of life.
Moreover, the integration of technology into non-pharmacological interventions holds exciting potential. From virtual reality environments designed to distract patients from pain to mobile applications promoting mindfulness and relaxation techniques, the convergence of technology and healthcare offers innovative ways to enhance the efficacy of non-invasive therapeutic options.
Ultimately, the systematic review highlights a progressive shift in managing acute pain and delirium within hospital settings. By prioritizing non-pharmacological strategies, healthcare providers can redefine patient care for older adults, offering meaningful interventions that transcend traditional methods. This evolution signifies a commitment to improving the lives of vulnerable patient populations, focusing on their holistic well-being rather than solely on symptom management.
As the medical community continues to embrace these paradigms, it is imperative that health systems remain adaptable and invested in ongoing education regarding the implications of these findings. The success of non-pharmacological interventions lies not just in their adoption but in the recognition of the dynamic interplay between physiological and psychological wellness.
In conclusion, the systematic review conducted by Prandeh Afshar et al. underscores a pivotal moment in geriatric care, spotlighting the importance of reevaluating how acute pain and delirium are managed in older patients. By utilizing evidence-based non-pharmacological interventions, healthcare practitioners can improve outcomes, reduce reliance on medications, and fundamentally transform the patient experience in hospital settings.
Subject of Research: Non-pharmacological interventions for managing acute pain and delirium in hospitalized older patients.
Article Title: Non-pharmacological interventions for managing acute pain and delirium in hospitalized older patients: a systematic review.
Article References:
Prandeh Afshar, P., Ali, E.S.A., Dehghan, F. et al. Non-pharmacological interventions for managing acute pain and delirium in hospitalized older patients: a systematic review.
BMC Geriatr 25, 1036 (2025). https://doi.org/10.1186/s12877-025-06764-1
Image Credits: AI Generated
DOI: https://doi.org/10.1186/s12877-025-06764-1
Keywords: Non-pharmacological interventions, acute pain, delirium, older patients, systematic review, geriatrics, pain management, cognitive therapy, music therapy, sensory stimulation, occupational therapy.
