Geriatric Therapists specialize in the diagnosis and treatment of mental health issues that occur more commonly in older patients, such as delirium, dementia, depression, anxiety, late life addiction disorders.
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:
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
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:
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)
Dr. Sharon Inouye Interview
Dr. Sharon Inouye, Professor of Medicine, the Milton and Shirley F. Levy Family Chair at Harvard Medical School, and Director of the Aging Brain Center in the Institute for Aging Research at Hebrew Senior Life. Dr. Inouye is one of the world's leading researchers in the field of geriatric care and has developed a widely used validated assessment tool to identify delirium called the Confusion Assessment Method. Dr. Inouye is also known for creating the Hospital Elder Life Program which is commonly referred to as HELP. The mission of HELP is to prevent delirium in hospitalized patients.
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