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Nobody
likes a hospital stay. After all, a strange setting, a disruption in
routine and loss of control are enough to make anybody grumpy. But for the frail
elderly, such changes can lead to confusion and delirium, often with serious and
lasting consequences.
According to statistics, more than 2 million elderly patients develop delirium,
characterized by confusion, inattention, and changes in perception, mood and
activity level. And as the population gets older, the numbers are expected to
soar. Unlike dementia, delirium sets in rapidly. However, studies have shown
that keeping a hospital patient engaged and alert can prevent or mitigate the
condition, putting the brakes on functional decline, shortening the hospital stay
and delaying the need for long-term care.
The Hospital Elder Life Program (HELP) at Georgetown Memorial Hospital
and Waccamaw Community Hospital is designed to prevent or slow down the
onset of delirium in patients 70 and older.
Developed at Yale University and implemented in hospitals around the country,
HELP relies on the collective strength of a care team made up of physicians, an
elder nurse coordinator, nutritionists, pharmacists, chaplains, and physical and
occupational therapists, says Nancy Chesebro, RN, BSN, Elder Life Program
coordinator for Georgetown Hospital System (GHS). “Our goal is to help our
patients maintain physical and cognitive functioning throughout hospitalization
and to maximize their independence after they are discharged from the hospital.
HELP is a team-based and patient-centered program.” The program is funded by
the Georgetown Hospital System Foundation.
Volunteers are the key component in HELP and essential to its success,
Chesebro says. After being assigned a patient and an accompanying plan of care
the HELP volunteer is ready to work with the patient.
“Hospitalized patients require skilled clinical care, but patients with delirium
and confusion require attention beyond the realm of skilled care,” Chesebro says.
“While their needs are more complex, meeting some of them can be as simple
as reminiscing over old photos and talking about current events to feeding and
assisting with walking and range of motion exercises.”
Because they are key members of the care team, volunteers are required to
undergo 16 hours of intensive training on topics such as infection control, nutrition
and physical therapy. They also must work with a mentor at the bedside and take
GHS’ regular, four-hour volunteer training class before being assigned a patient.
Once they join HELP, volunteers are expected to commit to one four-hour
shift per week for six months. Chesebro admits that the role requires special
traits, but she is confident that more members of the community will volunteer
their time and join the inaugural group of volunteers.
What is the most important thing a HELP volunteer can do?
“Be a good listener,” Chesebro says. “Be empathetic; exercise judgment and
discretion, and be sensitive to the needs of patients and their families.”
And while Chesebro emphasizes what a volunteer must do, she’s also emphatic
about what a volunteer will gain.
“It’s no secret that volunteering and helping others have positive physical and
psychological effects,” Chesebro says.
“It keeps people engaged and makes
them feel better about themselves.
Volunteering with the sick and
elderly requires an extra dimension
of empathy and compassion, and
people who do it well have a
special gift. And that’s a gift that
keeps on growing.”
Kind Of Playbook
Extra Help For Older Patients WhoNeed It
Danita Vetter, coordinator at the Waccamaw Area Agency on Aging, agrees.
“When the health coach is there to reinforce disease education, help the person
to practice good self-care and make sure appointments are kept, that patient is
much more likely to feel better and remain at home,” she says.
When a patient’s hospital stay is ending, the health coach’s job is beginning.
The health coach meets with the clinical team to get care instructions and drives
the patient home, if needed, stopping at a store or pharmacy for essentials.
Once at the patient’s home, the health coach helps a patient get settled. “A
health coach might heat up a meal,” Vetter says. “The health coach always goes
over the medication and follow-up care orders and makes sure that the patient
schedules their follow-up appointments.”
Collins and Vetter say the ability of the program to provide transportation
not only makes the program unique but also is critical, because access to
transportation is the No. 1 factor that influences quality of life for the elderly.
Both say the program is an excellent example of a public and private
partnership. “This is a
wonderful collaboration of
medical and social services,
and we want to grow this
program,” Vetter says.
“The Health Coach
Program truly
exemplifies our
mission of providing
compassionate care to residents of the
community,” Collins says.
Volunteers have two days of intensive training and are expected to commit
to a minimum of three hours per week. Collins says a health coach must be
dependable, compassionate and have excellent communication skills. “They must
also want to make a difference in someone else’s life.”
www.georgetownhospitalsystem.org
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