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RECRUITINGINTERVENTIONAL

Evaluating Novel Healthcare Approaches to Nurturing and Caring for Hospitalized Elders

Evaluating Novel Healthcare Approaches to Nurturing and Caring for Hospitalized Elders (ENHANCE)

Important: This information is not medical advice. Talk to your doctor about whether a clinical trial is right for you.

About This Trial

The goal of this clinical trial is to compare the Hospital Elder Life Program (HELP) with a family-augmented version of HELP (FAM-HELP), that includes family members and care partners, for the prevention of delirium in older patients during hospital admission. The main objectives of the trial are the following: 1. To compare the effectiveness of FAM-HELP and HELP in reducing both the incidence of delirium and its severity. 2. To compare the effectiveness of FAM-HELP and HELP in improving patient- and family-reported outcomes. 3. To explore the implementation context, process, and outcomes of the FAM-HELP program in diverse hospital settings.

Who May Be Eligible (Plain English)

Who May Qualify: - Provision of willing to sign a consent form - At least 70 years of age - Anticipated length of hospital stay at least 72 hours - Family member or care partner available to be on-site in the hospital - At least one delirium risk factor (e.g., cognitive or functional impairment, dehydration, vision or hearing impairment) - Evaluable cognitive function at baseline (i.e., ability to complete baseline cognitive function assessment) Who Should NOT Join This Trial: - Delirium on admission - Unable to communicate verbally (e.g., coma, mechanical ventilation) - Unable to participate fully in interventions (e.g., terminal condition, advanced dementia) - Staff safety concerns (e.g., violent behavior) - Cardiac or intracranial surgery (due to competing causes of delirium) Always talk to your doctor about whether this trial is right for you.

Original Eligibility Criteria

View original clinical language
Inclusion Criteria: * Provision of informed consent * At least 70 years of age * Anticipated length of hospital stay at least 72 hours * Family member or care partner available to be on-site in the hospital * At least one delirium risk factor (e.g., cognitive or functional impairment, dehydration, vision or hearing impairment) * Evaluable cognitive function at baseline (i.e., ability to complete baseline cognitive function assessment) Exclusion Criteria: * Delirium on admission * Unable to communicate verbally (e.g., coma, mechanical ventilation) * Unable to participate fully in interventions (e.g., terminal condition, advanced dementia) * Staff safety concerns (e.g., violent behavior) * Cardiac or intracranial surgery (due to competing causes of delirium)

Treatments Being Tested

BEHAVIORAL

HELP

This is usual (standard) care across hospitals in this trial. A multidisciplinary team of nurse specialists, social workers, and volunteers implement daily protocols focused on orientation, cognitive stimulation, early mobilization, sleep enhancement, support with visual and hearing aids, mealtime assistance, hydration, reduction in polypharmacy, and nursing-based delirium prevention protocols.

BEHAVIORAL

FAM-HELP

Family members and care partners will provide daily emotional and social support during hospitalization. Additionally, family members and care partners will engage in HELP-based protocols throughout the day. The rationale for this protocol augmentation is two-fold: (1) HELP may not consistently have available volunteers (e.g., short-staffing) during a hospital stay, and (2) patients may be more likely to engage in therapeutic activities with a family member given the connection and comfort level.

Locations (7)

Saddleback Medical Center
Orange, California, United States
MaineHealth
Portland, Maine, United States
Michigan Medicine
Ann Arbor, Michigan, United States
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
Allegheny General Hospital
Pittsburgh, Pennsylvania, United States
University of Utah
Salt Lake City, Utah, United States
Meriter Hospital
Madison, Wisconsin, United States