Delirium frequently occurs in older inpatients and constitutes a major and serious complication in acute care. It is associated with increased mortality [
1‐
6] and worse outcomes, such as loss of personal independence [
1,
2,
7,
8], significantly accelerated cognitive decline, a progressive pattern of dementia, increased hospital readmission and prolonged periods of hospitalization [
5‐
12]. Old age [
7,
8,
13‐
15] and predisposing (intrinsic) factors, such as chronic, especially cerebral diseases and geriatric syndromes, such as multimorbidity, frailty [
16] and cognitive impairment represent high risks of developing delirium [
2,
7,
11,
14,
16,
17]. Moreover, extrinsic factors, such as the clinical environment and conditions (e.g. surgery, infections, psychological stress, polymedication and disturbed day-night rhythm) may act as additional triggers [
18,
19]. Consequently, a pronounced pre-existing vulnerability of individual patients who were predisposed by trigger factors in quantitative and qualitative terms, strongly correlates with delirium development as shown by the threshold model of Inouye et al. [
19,
20]. Although the exact pathophysiological process remains unclear, the model indicates a multifactorial development of delirium, which requires multifactorial approaches for prevention and treatment. In the acute care setting, several delirium intervention programs provided by nonprofessionals, e.g. trained volunteers [
20‐
27] or family members [
28‐
30] are well-established and positively evaluated. Most of these programs focused on few selected intervention components to prevent delirium. In contrast, interventions to treat an already existing delirium are often disregarded. Consequently, these programs disclosed a limited range of interventions; however, professional expertise is required to ensure a more comprehensive delirium prevention and to also address delirium management and treatment. For this reason, this scoping focused on interventional programs provided by ward team professionals. In addition, these programs refer to the target group of older and endangered patients, but current evidence does not conclusively clarify whether this similarly applies to persons with cognitive decline, especially in the acute care setting [
20,
21].
Previous reviews have also analyzed the effectiveness of nonpharmacological interventions. In the systematic overview by Abraha et al. [
31] systematic reviews and meta-analyses and selected primary studies were included. Preventive effects were demonstrated in older inpatients ≥60 years, but not to treat delirium of older inpatients. The systematic review and meta-analyses by Martinez et al. [
32], which exclusively included RTSs, also demonstrated significant results for older inpatients (e.g. reduced delirium incidence: relative risk, RR: 0.39, 95%, confidence interval, CI: 0.63–0.85,
p = 0.001). The authors reported that the effects did not differ according to the prevalence of dementia. The extent to which the two populations with and without dementia differed within the included studies was not reported. Further two reviews, also focussing on acute care but not especially on older inpatients, demonstrated the effectiveness of nonpharmacological interventions. In the meta-analysis by Hshieh et al. [
33] in which randomized and nonrandomized matched trials were included, significant effects were reported (e.g. delirium incidence: odds ratio, OR: 0.47, 95% CI: 0.38–0.58). The second review [
34] (including quantitative studies) investigated critically ill inpatients and reported also an effectiveness of nonpharmacological interventions (e.g. a reduced delirium incidence: 24.7%, range 9.7–31.8%). Furthermore, from the empirical data of general delirium research it is known that the delirium syndrome can be reduced by 30–40% with multicomponent, nonpharmacological interventions [
4,
20,
35‐
38]. This, of course, does not preclude the possibility of supplementary pharmacological interventions. In this context, nonpharmacological and pharmacological interventions often overlap and should be considered complementary. Noteworthy, an ongoing discussion addresses efficacy and safety of pharmacological approaches and some experts strongly discourage a pharmacological prevention on a routine base [
19,
39‐
41]. Following the current findings from Siddiqi et al. [
38], with the exception of atypical antipsychotic drugs (e.g. olanzapine), there is no clear evidence of the benefit of cholinesterase inhibitors, melatonin or antipsychotic drugs, e.g. haloperidol. The latter may be applied if there is psychometric overactivation or symptoms, such as hallucination. In this case, pharmacological treatment may supplement nonpharmacological treatment. In addition, drugs can also trigger a delirium syndrome, e.g. those with an anticholinergic potential [
18], and sedatives and hypnotics have also shown potentially deliriogenic effects [
42]. Remarkably, the multicomponent, nonpharmacological interventions have proven to be most effective [
38,
43]. This is why the aim of this scoping review was to identify these nonpharmacological interventions for older inpatients with and without cognitive decline, as the previous reviews mentioned above did not all include these populations. Furthermore, this scoping focused, in contrast to previous reviews, on interventions performed by ward team professionals. The selection of the methodology of a scoping review is explained to the broad scientific question that is to be answered. In addition to previous reviews, which contained only specific study designs, this review was not limited to any study design.