A seminal program for preventing delirium and loss of function for older adults stands poised for a major expansion thanks to the American Geriatrics Society (AGS). As the soon-to-be newest addition to the AGS “CoCare” portfolio, a suite of programs helping embed geriatrics expertise in broader care for older adults, AGS CoCare: HELP™ represents a new step forward for a program that has already made significant strides.
“Empowering health systems to recognize, manage, and prevent delirium is one of the hallmarks of geriatrics, one that put the specialty on the map,” noted Sharon K Inouye, MD, MPH, who developed the original Hospital Elder Life Program (HELP), now known as AGS CoCare: HELP. “With this critical expansion of a key program that made delirium prevention possible, we now have bandwidth through the AGS to demonstrate to more health systems than ever before how collaborating with geriatrics leads to improved health, safety, and independence for us all,” Dr Inouye concluded.
Through AGS CoCare: HELP (which will launch later this year at help.agscocare.org), health systems will have access to tools and hands-on guidance for making delirium prevention actionable locally and for individual patients. Institutional subscriptions offer access to a comprehensive implementation toolkit, an online educational curriculum for HELP staff and volunteers, a certification program, scheduling for routine coaching calls, and an online community available 24-7.
Perhaps more importantly, this expansion also helps standardize best practices while supporting work to keep these practices at the cutting-edge of delirium-prevention science. The program ultimately promotes a growing trend toward “age-friendly health systems”—so named because they help promote unique expertise on geriatrics focal points, such as care for mentation, medications, mobility, and what “matters most” to patients as people.
Behind it all is an evidence-based program with decades of experience and proven results in improving the health and care of hospitalized older adults. For millions of older adults, HELP has made health systems safer—and health care more effective. Delirium affects more than 2.6 million older adults per year in the United States, accounting for more than $164 billion annually in excess Medicare expenditures.1,2 HELP set out to change that—and did so with resounding success. On average, delirium cases dropped by more than 30% among the more than 200 hospitals employing HELP, which also reduced costs by more than $7 million annually at participating hospitals (a savings of more than $1000 per patient).1,3-5
HELP provides an organized system to manage markers of delirium and delirium prevention—from maintaining physical and cognitive function to maximizing independence in transitions between care settings. This system includes training to understand the value and practical implementation of daily patient visits, therapeutic activities, early mobilization programs, protocols to optimize sleep and hearing/vision, and opportunities for smoothing transitions between care settings. Using comprehensive HELP resources and training, whole health systems can implement delirium prevention protocols, provider education, and audio-visual tools, while individual HELP staff and a network of specially trained volunteers can work with patients one-on-one to reduce personal risks and prevent lengthier stays.
For more information, visit AmericanGeriatrics.org/
1. Inouye SK, Bogardus ST Jr, Charpentier PA, et al. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med. 1999;340(9):669-676. doi:10.1056/NEJM199903043400901
2. Oh ES, Fong TG, Hshieh TT, Inouye SK. Delirium in older persons: advances in diagnosis and treatment. JAMA. 2017;318(12):1161-1174. doi:10.1001/jama.2017.12067
3. Rubin FH, Neal K, Fenlon K, Hassan S, Inouye SK. Sustainability and scalability of the hospital elder life program at a community hospital. J Am Geriatr Soc. 2011;59(2):359-365.
4. Hshieh TT, Yang T, Gartaganis SL, Yue J, Inouye SK. Hospital Elder Life Program: systematic review of effectiveness and cost-effectiveness. Am J Geriatr Psychiatry. 2018;26(10):1015-1033.
5. Hshieh TT, Yue J, Oh E, et al. Effectiveness of multi-component non-pharmacologic delirium interventions: a meta-analysis. JAMA Intern Med. 2015;175(4):512-520.