As a part of New York Presbyterian Hospital's quality of care initiatives, a new program addressing the special needs of hospitalized older adults is being introduced at NYP Weill Cornell Medical Center's Acute Care for the Elderly unit. The Hospital Elder Life Program (HELP), developed by Dr. Sharon Inouye and colleagues at Yale-New Haven Hospital, provides extra care to vulnerable older patients, in addition to good nursing and medical care. Initiation of the program at our hospital has been made possible through a grant from The Fan Fox and Leslie R. Samuels Foundation, whose health care mission is to improve the health care and quality of life for New York City's elderly.

Older patients are at high risk for developing hospital-induced delirium and initiated interventions to mitigate the risk factors contributing to impairment. Key risk factors include cognitive impairment, immobility, sensory impairment, polypharmacy (especially use of sedatives), and dehydration. HELP helps prevent delirium and functional decline while improving quality of hospital care and reducing overall patient costs.

The combination of an interdisciplinary team and hospital volunteers makes HELP unique. HELP staff consists of an Elder Life Specialist, Elder Life Nurse Specialist, and Geriatrician who assess older patients for delirium risk factors and determine appropriate interventions, based on individual patient needs. Then specially trained volunteers carry out most interventions, including:

• Daily visits to provide orientation, communication, and social support
• Therapeutic activities for mental stimulation and socialization
• Early mobilization through daily exercise and walking assistance
• Feeding assistance and companionship during meals, including hydration maintenance
• Vision and hearing adaptations and equipment
• Nonpharmacological sleep enhancement to promote relaxation and sufficient sleep.

These interventions help patients maintain cognitive and physical functioning throughout hospitalization and remain as independent as possible. It also attempts to make the transition from hospital to the community easier and prevent unplanned readmission. Further information about the Samuels Foundation and Dr. Inouye's work can be found at: www.samuels.org and http://www.hospitalelderlifeprogram.org/public/public-main.php.