Hospital stays can be unsettling for some older adults. Add to that the shortage of healthcare specialists to manage their specific needs.
U-T Southwestern Medical Center and UT Dallas are trying to address both problems in geriatric care through a national project called the Hospital Elder Life Program.
The director, Dr. Jessica Voit, an assistant professor of internal medicine in UTSW's geriatric medicine division talked with KERA’s Sam Baker about the HELP program.
What is the Hospital Elder Life Program (HELP)?
What it is is really a skilled interdisciplinary team - nurses care coordinators, physicians. And then very importantly, it has trained volunteers who implement delirium prevention interventions and really promote a normal sleep-wake cycle.
What can make a hospital stay unsettling for seniors?
So many things. One, even just being in an unfamiliar environment. That alone can be distressing. And it can contribute to cognitive disorientation.
Also, the hospital. While it's meant to be a place of healing, there are lots of things that go on in the hospital that are disruptive. It can be noisy; sleep can be disturbed. You might be woken up in the middle of the night by beeping machines or by someone needing to give you medicine or take your vital signs. And all of that is really disorienting.
And so, part of the program is intended to try to bring a little bit of normality as well, trying to give conversation, to play games, but also to add some of the reminders to eat, to order lunch, to have a glass of water while you're here in the hospital.
There are older people who act as volunteers in that capacity. But with this program, it's important to have student volunteers?
Our specific organization here, UT Southwestern, really utilizes undergraduate and then pre-clerkship medical students. So, people who are interested in a career in the healthcare professions and they're the ones helping our patients on the wards. And they're also then getting exposed to the hospital and being exposed to the intricacies and the challenges of geriatric care.
Why is it necessary to make that happen?
As a geriatrician, I see the rates of older adults rising more, living longer with diseases like cancer, with strokes, with heart attacks.
But it also means we have more and more older adults who are needing medical care, and the rates of people who are interested in geriatrics are not meeting that demand.
So, my hope is that by exposing students early in their careers to geriatric medicine, when they go into medicine, whatever they go into, they'll be better equipped to take care of older adults. And I also hope that some of them do choose to go into geriatrics.
With so little interest in it now, though.
I think, one, some people aren't exposed early, which is one thing I'm hoping to change. Some people have been exposed to cardiology or oncology and they already enter medical school with a career in mind. I think it's also a challenging field that sometimes people just don't consider. It often isn't reimbursed quite as highly as other specialties. So, it often is really a calling for people to come to geriatrics.
Do the patients really take to the younger volunteers that well?
So, I think that's something that's often surprising to both volunteers and patients. There is this intergenerationality that I love about the program. I think our patients have a lot to offer our students so they can share words of wisdom. They can bridge this gap just because there are many decades between the two people. We're able to see some beautiful relationships foster even in just a short period of time.
What was it that interested you about geriatric care?
So, my mentor, who was assigned to me on my first day at med school is a geriatrician, and she just opened my eyes up to the world of geriatric medicine and it really spoke to me.
And so, I hope to give this opportunity to future people, to maybe have them have a eureka moment, the way my mentor helped me find my eureka moment.
RESOURCES:
Hospital Elder Life Program (NIH)
A UT Southwestern Hospital Elder Life Program: HELP to Reduce Delirium in the Hospital
Changing Hospital Care For Older Adults: The Case for Geriatric Hospitals in the United States
