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Invited Commentary
October 21, 2019

Including the Family in Perioperative Care of Older Adults—A Call for HELP

Author Affiliations
  • 1Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco
  • 2Department of Surgery, University of California, San Francisco, San Francisco
JAMA Intern Med. 2020;180(1):25-26. doi:10.1001/jamainternmed.2019.4202

Delirium occurs frequently in hospitalized older adults, especially after a major surgical procedure. Delirium prevention in hospitalized older adults involves multicomponent nonpharmacologic interventions, such as the Hospital Elder Life Program (HELP), that target delirium risk factors. Through HELP, hospitalized older adults are assessed for their risk for developing delirium, and protocols addressing the delirium risk factors are followed. These HELP intervention protocols are often carried out by trained hospital volunteers and address patients’ orientation, nutrition, hydration, sleep, and mobility. Although shown to reduce delirium rates (ie, 15% delirium in the usual care group vs 9.9% in the HELP intervention),1 implementation of HELP faces barriers of cost, staffing, and culture in some health care systems.

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