Dr. Kristine Josef is a Neurologic Clinical Specialist with experience working in various areas including adult inpatient rehabilitation and acute care. While working in acute care, she was involved in the Early Mobility project in the intensive care unit that resulted in patient decreased length of stay, decreased hospital costs, and increased incidence of patient discharge home vs post-acute facilities. She has given multiple presentations on the topic of delirium. Recently, she co-authored a poster that was presented at the 2017 Combined Sections Meeting in San Antonio, TX that was titled “Delirium in patients with cerebrovascular accident: increasing treatment team awareness.” Her doctorate in physical therapy is from the University of Medicine & Dentistry of New Jersey, which now is Rutgers University. She is a board certified neurologic clinical specialist through the American Board of Physical Therapy Specialties.
In this interview, she discusses: distinguishing delirium from encephalopathy; tools for accurate delirium screening and diagnosis in critically ill patients; the role physical therapy plays in dealing with the problem of patients with delirium from the standpoint of diagnosis and treatment; if anything can be done pre-surgically to prevent the occurrence of delirium; aging and co-morbidities in relation to delirium; the role of family members in changing the course of delirium in a patient; and the advantages and disadvantages of using physical restraints to manage behavioral symptoms of hospitalized patients.
Kaitlin Hanley works as a speech-language pathologist in acute care and Rehabilitation at NYU Langone Medical Center and Christina Marino is an occupational therapist who works on that same unit. Kaitlin has cross-covered acute care and acute rehabilitation for her entire career with a focus on functional therapy for enabling patients to return to the community as it pertains to cognitive, speech, and language therapy. She completed her graduate work in Speech Language Pathology at MGH Institute of Health Professions in Boston. Christina has worked in a variety of settings, including Rusk and the Tisch Hospital acute care service at NYU Langone. Along with treating cardiopulmonary patients with cognitive deficits, another specialty includes working with limb loss patients. Her undergraduate and graduate degrees are from the University of Scranton.
In this interview, Kaitlin and Christina discuss the kinds of patients they treat and problems regarding how cognitive impairments affect cardiopulmonary patients; occupational therapy and speech-language pathology tools available to arrive at an accurate diagnosis; factors involved in making a determination of which types of interventions would be most appropriate for patients who may differ by age, frailty, and extent of their problems; activities that are aimed at preventing a recurrence of problems; and areas where further research might provide guidance for making additional improvements in patient care.