Geriatric Therapists focus on the aging process and related psychological and biological issues. A geriatric therapist may look for the psychological effects of a chronic or acute physical illness.​ A geriatric therapist’s evaluation will take into consideration a geriatric patient's needs and perhaps modify their treatment plan to accommodate the aging person. A geriatric therapist may want to focus on prevention, environment, and social supports as a way to improve psychiatric symptoms and improve functioning. They may even look to reduce or change medications depending upon the patient's needs. Dr. Sharon Inouye, along with a multidisciplinary team of physicians, nurses, pastoral care, and researchers, developed the Hospital Elder Life Program, more commonly called HELP. Recently  HELP has been integrated into the American Geriatrics Society (AGS) CoCare portfolio and is described below:

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The AGS CoCare: HELP™ Program is a comprehensive program of care for hospitalized older patients, designed to prevent delirium and functional decline. The program is intended to integrate the principles of geriatrics into standard nursing and medical care on any hospital unit, and to bring geriatric expertise to bear on patient care decisions being made on not only patients enrolled in the program, but ultimately to patients throughout the institution. 

 

The program provides targeted interventions implemented by a skilled interdisciplinary team (including a geriatric nurse specialist, specially trained Elder Life Specialists, and trained volunteers) that address a broad scope of geriatric issues known to contribute to cognitive and functional decline during hospitalization. These include cognitive orientation and stimulation activities, therapeutic activities, sleep enhancement strategies, exercise and mobilization, hearing and vision aids, feeding assistance and preventing dehydration, pastoral care, family support and education, and individualized discharge planning. 

 

Successful implementation of these interventions can counteract the detrimental effects of hospitalization. The effectiveness of the program for delirium prevention has been well established through a controlled clinical trial in 852 patients (Inouye, et al., 1999).

 

Additional benefits of the program include:

 

• Prevention of functional decline

• Improvement in overall quality of hospital care for older patients, including improvement in hospital outcomes and satisfaction with care

• Provision of cost-effective care, with reduced overall hospital costs on average

• Recognition of the hospital as a Center of Excellence in provision of geriatric care

• Increased hospital volunteer base

• Enhanced public relations and community outreach

• Educational site for acute geriatric care

 

Program Goals

 

While the core interventions focus on prevention of delirium, the program was conceptualized as a comprehensive program of care for hospitalized older patients. It was designed to address a broad scope of geriatric issues and iatrogenic complications contributing to cognitive and functional decline during hospitalization. The specific program goals are:

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• To maintain physical and cognitive functioning throughout hospitalization

• To maximize independence at discharge

• To assist with the transition from hospital to home

• To prevent unplanned readmission (Inouye, et al., 1993)