Hospital Elder Life Program (HELP) lowers 30-day readmission rates

November 09, 2017

The Hospital Elder Life Program, or HELP, is an evidence-based treatment plan developed in the 1990s to prevent hospitalized older adults from developing delirium (the medical term for sudden confusion). Delirium can cause people to be either aggressive and agitated or sleepy and inactive--sometimes even a combination of the two. Delirium is also the most common complication older adults experience after surgery.

Delirium has many causes, including infection, excess time in bed, and an imbalance in electrolytes (important minerals dissolved in bodily fluids). Older adults with delirium have longer hospital stays, higher care costs, and increased rates of death and institutionalization.

In a new study published in the Journal of the American Geriatrics Society, researchers examined the HELP program. They wanted to learn how effective it was at preventing older people from being readmitted to the hospital within 30 days, which is often harmful for patients and costly for hospitals.

HELP consists of one or more in-hospital teams, which include an Elder Life Specialist, an Elder Life Nurse Specialist, a geriatrician, and trained volunteers. The team works together to reduce an older person's risk of developing delirium through simple strategies that target specific risk factors. For example, team members help keep patients moving and orient them as to where they are and what the time and day is The team members engage the older adults socially, and provide eyeglasses and hearing assistance as needed. HELP units also use alternatives to medication to ease insomnia and anxiety, and to make sure that older adults who might be at risk for developing delirium eat well and stay hydrated. Since it was developed, HELP has now been implemented in more than 200 hospitals across the United States and around the world.

The research team studied eight medical and surgical units with HELP programs at the University of Pittsburgh Medical Center Shadyside. During the study period (2013 to 2014), the HELP units had 4,794 patients over the age of 70. Researchers compared these older people to 2,834 similar individuals who were cared for in non-HELP units during the same period.

The researchers learned that the differences in hospital readmission rates between the HELP units and non-HELP units translated into 100 fewer readmissions during the year-long study.

The researchers said that on a national scale, HELP could potentially reduce hospital readmissions for older adults by 40,000 cases each year, potentially saving nearly $500 million dollars annually.
-end-
This summary is from "Effect of the Hospital Elder Life Program on the Risk of 30-day Readmissions". It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Fred H. Rubin, MD, AGSF; Johanna Bellon, PhD; Andrew Bilderback, MS; Kevin Urda, MPH; and Sharon K. Inouye, MD, MPH, AGSF.

About the Health in Aging Foundation

This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit http://www.HealthinAgingFoundation.org.

About the Journal of the American Geriatrics Society

Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging insights on principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most impactful publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.

About the American Geriatrics Society

Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has--for 75 years--worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.

American Geriatrics Society

Related Delirium Articles from Brightsurf:

Delirium could be an early marker of COVID-19
Delirium accompanied by fever could be an early symptom of COVID-19.

Delirium a key sign of COVID-19 in frail, older people
A new analysis of data from researchers at King's College London using information from the COVID Symptom Study app and patients admitted to St Thomas' Hospital in London, has shown that delirium - a state of acute confusion associated with a higher risk of serious illness and death - is a key symptom of COVID-19 in frail, older people.

Does having Alzheimer's disease and dementia affect severity of delirium?
Recently, researchers published findings from the Better Assessment of Illness (BASIL) study, in the Journal of the American Geriatrics Society.

Scientists find new link between delirium and brain energy disruption
Scientists have discovered a new link between impaired brain energy metabolism and delirium -- a disorienting and distressing disorder particularly common in the elderly and one that is currently occurring in a large proportion of patients hospitalized with COVID-19.

Delirium may cause long term cognitive decline
A new meta-analysis of 24 observational studies from researchers at Columbia University Vagelos College of Physicians and Surgeons found that delirium may cause significant long-term cognitive decline.

Is delirium associated with long-term cognitive decline?
The results of 23 studies were combined to examine whether an episode of delirium is a risk factor for long-term cognitive decline.

Researchers work to better measure delirium severity in older patients
In a study published in Dementia and Geriatric Cognitive Disorder, researchers reported on their effort to improve and validate tools used to assess the severity of a condition called delirium, an acute confusional state often experienced by older hospitalized patients.

Coronavirus infections may lead to delirium and potentially PTSD
People taken ill by coronavirus infections may experience psychiatric problems while hospitalized and potentially after they recover, suggests an analysis of past research led by the UCL Institute of Mental Health with King's College London collaborators, published in The Lancet Psychiatry.

Music shows promise in decreasing delirium in critically ill patients
Mechanically ventilated ICU patients -- more than a million adults annually in the US -- are at increased risk for delirium, which is associated with prolonged ICU stays, higher healthcare costs and increased mortality.

Scientists isolate biomarkers that can identify delirium risk and severity
Regenstrief Institute and Indiana University School of Medicine researchers have identified blood-based biomarkers associated with both delirium duration and severity in critically ill patients.

Read More: Delirium News and Delirium Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.