The Hospital Elder Life Program: a model of care to prevent cognitive and functional decline in older hospitalized patients. Hospital Elder Life Program.
Level 4 - case-series / case-control
Historically controlled prospective program evaluation / observational cohort
PubMed 11129764 · doi:10.1111/j.1532-5415.2000.tb03885.x
What was done
Evaluated the Hospital Elder Life Program (HELP), an interdisciplinary multicomponent model designed to prevent cognitive and functional decline in hospitalized patients aged 70 or older. Patients admitted to specified units were screened on admission for six risk factors: cognitive impairment, sleep deprivation, immobility, dehydration, and vision or hearing impairment. Interventions were implemented by an interdisciplinary team (geriatric nurse specialists, Elder Life Specialists, trained volunteers, and geriatricians) with twice-weekly rounds. Adherence, quality assurance, cognitive decline (MMSE decline >= 2 points), and functional decline (ADL decline >= 2 points) were tracked across 1,507 patients during 1,716 admissions (37,131 patient-days).
What was found
Overall adherence (at least partial) across all interventions was 89%. Cognitive decline (>=2 points on MMSE) occurred in 8% of admissions, and functional decline (>=2 points on ADL) occurred in 14% of admissions. These were reported alongside comparator rates from a prior trial control group (26% cognitive, 33% functional decline) and historical literature benchmarks (14% to 56% cognitive, 34% to 50% functional decline).
Why it matters
This evaluation details the operational implementation and feasibility of the HELP model, showing that structured, volunteer-supported nonpharmacologic interventions can achieve high adherence and low rates of in-hospital functional and cognitive decline in older adults.
Limits
The study is an uncontrolled program evaluation relying on comparisons with historical literature and prior trial controls rather than a concurrent control group. Outcomes are limited to in-hospital changes; long-term post-discharge outcomes and cost-effectiveness are not reported in the abstract.
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