The "D" Words: Depression, Delirium, and Dementia in the Home Health Patient

Advanced Competency in Home Health - Elective Course 

This .75 CEU elective course satisfies 2 HOURS of credit for PTs towards their ACHH Certification. It is also a stand-alone course & you are not required to participate in the ACHH program in order to complete this course for CE credit.  Click here to Learn more about the Advanced Competency.

Level: Intermediate 

Course Description 

Physical therapists and physical therapist assistants practicing in the home health setting commonly encounter  patients with cognitive impairment either as a primary or secondary diagnosis. This course provides a comprehensive overview of depression, delirium, and dementia, with an emphasis on differentiating among these cognitive impairments. Ms. Childers also provides evidence-based physical therapy interventions for these patients for improved outcomes. 

Course Objectives 

Upon completing this online module, the participant will be able to perform the following: 

  1. Describe typical age-related changes in cognition
  2. Differentiate, compare and contrast depression, dementia, delirium, and other cognitive impairments
  3. Compare and contrast Alzheimer's, Lewy body, and vascular dementia
  4. Describe medical interventions for cognitive diagnosis
  5. Justify physical therapy for individuals with cognitive diagnosis
  6. Develop appropriate plan of care, and interventions utilizing suitable outcome measures, for cognitive diagnosis in the home setting 

Meet Our Presenter 

Christine Childers, PT, MS, Board Certified Clinical Specialist in Geriatric Physical Therapy

Christine Childers received her bachelor’s degree in Physiotherapy from the University of East Anglia, England. In 1998 she moved, with her husband then serving in the USAF, to Utah where she became licensed to practice in the US. During their 8 years in SLC, Utah Chris practiced in the skilled nursing arena and in 2005 she gained her MS in Gerontology from the University of Utah the same year she became a board certified Geriatric Clinical Specialist. In 2006 she moved to California, again working in the skilled nursing arena until she transitioned into the academic setting in 2012, working as an assistant professor for the University of St. Augustine for Health Sciences. Teaching full-time she maintains her clinical skills through home health visits. Chris recently completed a four-year term serving on the Geriatric specialty council of the American Board of Physical Therapy Specialist and continues her relationship with them as a content expert for the specialty examination.  She is currently working on her PhD in Health Psychology from Walden University and has completed the certificate of Advanced Competency in Home Health.  

Course Fees

  • APTA Home Health Member - $54.00
  • APTA Member - $60.00*
  • Non-Member - $100.00

* APTA Members who are NOT Home Health members - please email us atadmin@homehealthsection.orgto receive a discount code to register with APTA Member pricing.

To purchase this course, click here. If you have already purchased the course, please make sure you are logged in to access the material. 


  1. Adamis, D., Slor, C. J., Leonard, M., Witlox, J., de Jonghe, J. F. M., Macdonald, A. J. D., . . . Meagher, D. (2013). Reliability of delirium rating scale (DRS) and delirium rating scale-revised-98 (DRS-R98) using variance-based multivariate modelling. Journal of Psychiatric Research, 47(7), 966-971. doi:
  2. Alexander, K., Adamson, J., Cunningham, C., Embleton, G., & Hartley, P. (2016). The effect of delirium and dementia on length of stay (LOS) and functional recovery of patients in elderly medical wards. Physiotherapy, 102, e180-e181. doi:
  3. Brooke, J. (2018). Differentiation of delirium, dementia and delirium superimposed on dementia in the older person. British Journal of Nursing, 27(7), 363-367. doi:10.12968/bjon.2018.27.7.363
  4. Busch, A. M., Ciccolo, J. T., Puspitasari, A. J., Nosrat, S., Whitworth, J. W., & Stults-Kolehmainen, M. A. (2016). Preferences for exercise as a treatment for depression. Mental Health and Physical Activity, 10, 68-72. doi:
  5. Glowacki, K., Duncan, M. J., Gainforth, H., & Faulkner, G. (2017). Barriers and facilitators to physical activity and exercise among adults with depression: A scoping review. Mental Health and Physical Activity, 13, 108-119. doi:
  6. Guccione, A. A., Wong, R. A., & Avers, D. (2012). Geriatric Physical Therapy (3rd ed.). St. Louis, Missouri: Elsevier Mosby.
  7. Hedman, A., Nygård, L., Almkvist, O., & Kottorp, A. (2013). Patterns of functioning in older adults with mild cognitive impairment: a two-year study focusing on everyday technology use. Aging & Mental Health, 17(6), 679-688. doi:10.1080/13607863.2013.777396
  8. Johnson, L., Deatrick, E. J., & Oriel, K. (2012). The Use of Music to Improve Exercise Participation in People with Dementia: A Pilot Study. Physical & Occupational Therapy in Geriatrics, 30(2), 102-108. doi:10.3109/02703181.2012.680008
  9. Kvam, S., Kleppe, C. L., Nordhus, I. H., & Hovland, A. (2016). Exercise as a treatment for depression: A meta-analysis. Journal of Affective Disorders, 202, 67-86. doi:
  10. Lewis, M., Peiris, C. L., & Shields, N. (2017). Long-term home and community-based exercise programs improve function in community-dwelling older people with cognitive impairment: a systematic review. Journal of Physiotherapy, 63(1), 23-29. doi:
  11. Pitkälä, K., Savikko, N., Poysti, M., Strandberg, T., & Laakkonen, M.-L. (2013). Efficacy of physical exercise intervention on mobility and physical functioning in older people with dementia: A systematic review. Experimental Gerontology, 48(1), 85-93. doi:
  12. Ridder, H. M. O., Stige, B., Qvale, L. G., & Gold, C. (2013). Individual music therapy for agitation in dementia: an exploratory randomized controlled trial. Aging & Mental Health, 17(6), 667-678. doi:10.1080/13607863.2013.790926
  13. Trzepacz, P. T. (1999). The Delirium Rating Scale: Its Use In Consultation-Liaison Research. Psychosomatics, 40(3), 193-204. doi:
  14. Whitney, S. L., Marchetti, G. F., Ellis, J., Otis, L., Asiri, F., & Alghadir, A. (2013). Relationship between cognition and gait performance in older adults receiving physical therapy interventions in the home. Journal of Rehabilitation Research & Development, 50(8), 1089-1097. doi:10.1682/JRRD.2012.06.0119
  15. Winchester, J., Dick, M. B., Gillen, D., Reed, B., Miller, B., Tinklenberg, J., . . . Cotman, C. W. (2013). Walking stabilizes cognitive functioning in Alzheimer's disease (AD) across one year. Archives of Gerontology and Geriatrics, 56(1), 96-103. doi: 

Course Details

Course Materials00:49:04
The "D" Words: Depression, Delirium, and Dementia in the Home Health Patient - Lesson 00:49:04
The "D" Words: Depression, Delirium, and Dementia in the Home Health Patient - Quiz
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