Hospital Elder Life Program (HELP)

 A Hospital stay can be overwhelming for anybody, but it can be particularly bewildering for the elderly. Hospitalized older adults suffer a significant disruption in their daily routines and can become easily confused and disoriented. The medical term for this is delirium and more than 2 million older Americans each year develop this sudden change in mental status during a hospitalization.  The Hospital Elder Life Program (HELP) is an innovative approach to improving hospital care for older patients, helping to make the most of their hospitalization and decrease the likelihood of delirium. HELP is designed to prevent delirium before symptoms develop and studies have shown that encouraging simple activities such as frequent orientation and reminiscing, patients are less likely to develop delirium and go on to suffer the consequences that it can bring.  If not prevented or detected early, delirium may last six months or more, leading to functional decline, a longer hospital stay, and the potential need for long term care. 

The primary goals of HELP are to:

• Maintain cognitive and physical functioning of high risk older adults throughout hospitalization
• Maximize independence at discharge
• Assist with the transition from hospital to home
• Prevent unplanned hospital re-admissions

HELP uses specially trained volunteers to maintain physical and cognitive functioning and decrease confusion for older patients who are at high risk. This program is available to seniors throughout the hospital and some of the services provided include:

• Daily Visits
• Feeding Assistance
• Therapeutic Activities
• Early exercise
• Sleep enhancement without medications
• Vision/Hearing devices
• Provider Education Programs
• Linkages to Community Services

What is delirium?

Delirium is defined as a sudden change in mental status, or onset of confusion that develops over hours or days. It can cause problems with thinking, difficulty paying attention, hallucinations and paranoia and it can also cause changes in personality.  Delirium is a serious problem for a hospitalized older adult as it can slow the recovery process and lengthen the hospital stay.

What can be done to help prevent delirium? 

DO bring:

• A friend or family member with you to the hospital.  Ideally someone to stay with you during initial evaluation and admission. This person can help keep track of what is happening and provide/verify information about usual level of functioning if needed.
• Glasses to help navigate a new environment
• Hearing aids to help with communication
• Dentures to promote eating/nutrition

Have a list that includes:

• Prescription medications (including eye drops and medications used on an as needed basis)
• Non-prescription medications (including herbals, vitamins and medication used only when needed)
• Physicians (include phone numbers)
• Family/Friends with contact numbers (include home, cell, and work numbers)

In the Hospital:

• Ask hospital staff to post the date, name of the hospital, and the room number in the room where it is easily visible. Family/friends can gently remind their loved one of the date/season and where they are when they visit.
• Make sure call bell, phone, TV remote and any other necessities are easily within reach. 
• Walk at least 3 times each day.  You may need assistance due to weakness or tubes, so discuss with your nurse the need to use a call bell for assistance.
• Stay awake in the daytime to promote sleep at night.  Bring in activities such as books, crosswords, or magazines to help pass the time.  Pictures are also fun to look at, talk about and help staff know you better.
• To promote sleep, go to bed at your usual time.  Turn off the TV.  If you have trouble falling asleep, try some herbal tea, back/hand massage, and/or quiet music to help relax.  If you are being awakened for medications or vital signs, ask your doctor if this is necessary or if times can be changed to promote sleep.

HELP combines the expertise of a Geriatrician, an Elder Life Nurse Specialist, and a Certified Recreational Specialist with the services of dedicated volunteers.

Additional Resources:
Yale Hospital Elder Life Program

Hospital Elder Life Program:
H.E.L.P. Team