ELIZABETH — The new Hospital Elder Life Program (HELP) at Trinitas Regional Medical Center now reduces cases of hospital-acquired delirium among the senior population, hospital officials said. A multi-disciplinary team of healthcare professionals has successfully reached more than 550 patients since March 2013. The Hospital Acquired Delirium Project at Trinitas was made possible by a $100,000 grant from the Healthcare Foundation of NJ.
“As many seniors are faced with debilitating cognitive and memory issues, they and their families frequently become frustrated with the onset of these impairments,” explains Johanna Thomas, intervention clinician, in the Behavioral Health & Psychiatry Department, who adds, “Often, hospital stays can contribute to such declines.”
The Trinitas team developed its program based on evidence of successful programs across the country and around the world. Tim Clyne, nurse manager, notes, “HELP has a proven track record as a cost-effective approach to preventing an under-recognized condition during hospitalization.” He further notes that since older patients have a higher risk of rapidly developing a sudden change in mental status, the onset can have severe consequences in the recovery of older patients.
The program addresses daily, repetitive actions that are familiar to seniors. They receive help from Johanna Thomas as well as Intervention Assistant Diana Noboa. In addition, 16 well-trained volunteers bring a world of cultural sensitivity to the program since they speak Spanish, French-Creole, Portuguese, and Vietnamese that reflects the cultural diversity of the hospital?s patient population.
Each morning, volunteers greet patients to inquire if they have slept well and to help with their breakfast trays. “Beyond these practical concerns, the volunteers offer companionship, engage patients in reminiscent conversation, assist with meal selections and participate with the patients in cognitive and motor skill activities,” explains Thomas.
As volunteers get to know the patients on a personal level, they help to identify more quickly any changes in a patient’s mental status, even if a patient is not able to communicate on his or her own. Through this close monitoring, any change in a patient’s mental status is immediately communicated to Tim Clyne and Clinical Nurse Specialist Diane Reehil.
“The nursing component of HELP can’t be emphasized enough. When any confusion is seen in
a patient,” Diane Reehil explains, “the patient’s nurse is notified so the cause of the confusion can be targeted before it escalates. In these instances, family input and involvement help tremendously.”
“Communication with the patient’s family further optimizes the benefits of HELP. By bringing the family into the conversation in person or by phone, we can find out more about a patient’s preferences in food, music, television shows and their room environment,” says Diana Noboa.
To keep senior patients in HELP remain engaged and involved, Elisabeth Marrapodi, Director of Library Services, recommends appropriate CDs and DVDs. She explains: “Music therapy has benefited patients in hospitals and other healthcare facilities for many years. At Trinitas, we’ve seen comparable results with HELP patients. Our world music collection lets patients enjoy music in English to Spanish, Polish to Greek, and many other languages. Inspirational DVDs provides positive and uplifting viewing for our patients, too.”
Patient and family response to HELP is reflected in increased patient satisfaction rates. “We’ve seen a complete culture shift in the approach to the care we give to our most fragile and vulnerable population, the elderly,” adds Mary McTigue, vice president of Patient Care Services and chief nursing officer. “Our increased satisfaction rates are also the result of our culture of safety that promotes less restraint of elderly patients and a focus on reducing falls in this population.”
Tim Clyne reports that patients and families appreciate the extra attention they receive. “Once patients are admitted to the unit devoted to senior patients, HELP offers reading glasses, reading materials, hearing devices, and other activities if needed. Patients and their families are extremely surprised when they learn that the services are free of charge and designed to help in a speedy recovery.”
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