Optimizing Age-Friendly Hospital Care: American Geriatrics Society CoCare Hospital Elder Life Program (HELP)

Hospitalization has long been recognized as a time of high risk, often a pivotal event in the life of a vulnerable older person, with exposure to a myriad of hazards and potential “trauma” [1] from immobilization, lack of orienting influences, inadequate sleep, poor nutrition, dehydration, adverse effects of medications and procedures, and emotional stress. The leading complication of hospitalization is delirium, an acute confusional state, which is common, serious, and often fatal. Delirium occurs in up to 50% of hospitalized elders and costs more than $164 billion per year in the USA (2011 estimates) [2]. Delirium leads to high rates of functional decline, prolonged hospital stays, high rates of institutionalization and readmission, increased need for rehabilitation services, long-term cognitive decline, and increased mortality [2–4]. Importantly, delirium is preventable in 30–40% of cases, highlighting its significance as a target for intervention [2, 5].