Examining the Hospital Elder Life Program in a Rehabilitation Setting: A Mixed Methods Evaluation
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Delirium is a neuropsychiatric syndrome that is common among older adults in various care settings. It is consistently associated with increased rates of morbidity, mortality, long-term care placement and longer, costlier hospitalizations. Primary prevention may be the most effective strategy to reduce the incidence of delirium. The Hospital Elder Life Program (HELP) was developed to prevent delirium and functional decline in hospitalized older patients and has been shown to be effective in several acute care hospital units. To date, the effectiveness of the HELP had not been examined in a post-acute rehabilitation hospital setting. There is also limited research on patient, caregiver, volunteer and staff perceptions of, and satisfaction with, the HELP. This evaluation project is a pilot feasibility study to examine the implementation of the HELP in a rehabilitation setting using a mixed methods (quantitative and qualitative) approach. Data were collected through patient outcome measures, caregiver self-reported questionnaires, focus group interviews and individual interviews. Patients, caregivers, volunteers, and staff members involved with the program provided information to help determine the usefulness, feasibility, and satisfaction with the HELP in a rehabilitation hospital setting. Patients who received the HELP showed greater improvement on cognitive and functional outcomes and a shorter average length of stay than those who did not receive the program. Participant groups discussed perceived barriers, benefits, and recommendations for further implementation of the HELP. This study adds to the limited research on delirium in post-acute rehabilitation settings. This is the first study to examine the effectiveness of the HELP in a rehabilitation setting, and to explore patient, caregiver, volunteer, and staff perceptions of, and satisfaction with, the HELP.