title: Examining the Hospital Elder Life Program in a rehabilitation setting: a pilot feasibility study.
abstract: The Hospital Elder Life Program (HELP) has been shown to effectively prevent delirium and functional decline in older patients in acute care, but has not been examined in a rehabilitation setting. This pilot study examined potential successes and implementation factors of the HELP in a post-acute rehabilitation hospital setting.
  
  
  
  A mixed methods (quantitative and qualitative) evaluation, incorporating a repeated measures design, was used. A total of 100 patients were enrolled; 58 on the pilot intervention unit and 42 on a usual care unit. Group comparisons were made using change scores (pre-post intervention) on outcome measures between pilot unit patients and usual care patients (separate analyses compared usual care patients with pilot unit patients who did or did not receive the HELP). Qualitative data were collected using focus group and individual interviews, and analyzed using emergent coding procedures.
  
  
  
  Delirium prevalence reduced from 10.9 % (n = 6) to 2.5 % (n = 1) in the intervention group, while remaining the same in the usual care group (2.5 % at both measurement points). Those who received the HELP showed greater improvement on cognitive and functional outcomes, particularly short-term memory and recall, and a shorter average length of stay than patients who did not. Participant groups discussed perceived barriers, benefits, and recommendations for further implementation of the HELP in a rehabilitation setting.
  
  
  
  This study adds to the limited research on delirium and the effectiveness of the HELP in post-acute rehabilitation settings. The HELP was found to be feasible and have potential benefits for reduced delirium and improved outcomes among rehabilitation patients.
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.|School of Health and Life Sciences and Community Services, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, N2G 4M4, Canada.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Huson
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, N2L 3G1, Canada. stolee@uwaterloo.ca.
authors.forename: Paul
authors.identifier: 0000-0002-5685-0843
authors.initials: P
authors.lastname: Stolee
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.
authors.forename: Nancy
authors.initials: N
authors.lastname: Pearce
authors.affiliation: Grand River Hospital, Kitchener, ON, N2G 1G3, Canada.
authors.forename: Corrie
authors.initials: C
authors.lastname: Bradfield
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.|Schlegel-UW Research Institute for Aging, Waterloo, ON, N2J 0E2, Canada.
authors.forename: George A
authors.initials: GA
authors.lastname: Heckman
mesh_terms: D000208:Acute Disease / Q000534:rehabilitation*; D000368:Aged; D002170:Canada; D003071:Cognition; D003422:Critical Care; D003693:Delirium / Q000209:etiology / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D005853:Geriatrics; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010346:Patient Care Management / Q000379:methods*; D010865:Pilot Projects; D015397:Program Evaluation; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: Delirium; Evaluation; Hospital Elder Life Program; Rehabilitation