NEW YORK, NY: September 23, 2016 — The National Institute on Aging, part of the National Institutes of Health, has awarded The New Jewish Home $400,000 to study an innovative approach to reducing delirium, and the resulting hospitalizations and fatalities, among nursing home patients.
The grant will fund a two-year, 306-person pilot that starts this month. Dr. Kenneth Boockvar of The New Jewish Home’s research arm, The Research Institute on Aging, will lead the study.
While studies exist on ways to reduce delirium in hospital settings little research has been done on how to reduce the condition in long-term care settings. The numbers involved are staggering. Of adults over 75, 17.5%, or 1.4 million people, are patients at the nation’s 15,000 nursing homes. As many as 23% show signs of delirium when they are admitted and 33% experience delirium during their stay.
The protocol being tested in The New Jewish Home study has the potential to yield significant savings in Medicare and Medicaid costs. For example, a nursing home intervention that reduced patient hospitalizations by 17% would result in a national savings in hospital costs of $1.9 billion annually.
The centerpiece of The New Jewish Home’s study is an intervention model called the Hospital Elder Life Program for Long-term Care, or HELP-LTC. Developed by Dr. Boockvar and his team, HELP-LTC is based on the pioneering HELP program for hospital patients created by Dr. Sharon Inouye, Director of the Aging Brain Center at Boston’s Institute for Aging Research, who is assisting Dr. Boockvar on the Jewish Home study. HELP-LTC standardizes procedures and training for treating nursing home patients at risk of delirium, such as those with acute medical conditions and those with dementia or other cognitive impairments.
Caring for patients in the HELP-LTC model is a multidisciplinary team comprising a specially trained certified nursing assistant (CNA), a geriatrician, and the patient’s primary care physician and nurses. The team monitors the patients and delivers preventative care, such as orientation and memory activities (to maintain cognitive function), water and snacks (to maintain hydration and nutrition), and daily exercise (to maintain mobility).
The new study builds on an earlier one with promising results conducted by Dr. Boockvar at The New Jewish Home. Published in the May 2016 issue of the Journal of the American Geriatric Society, the study showed that of 143 patients who received a HELP-LTC intervention, 13% were hospitalized compared to 24% in the control group, and 11% died compared to 15% in the control group.
Traumatic for those who experience it and challenging for their health care providers, delirium is a widespread phenomenon affecting roughly 33% of older adults in both hospital and long-term care settings. It can be triggered by a variety of factors, including immobility, dehydration, poor nutrition, lack of sleep, and medication issues. The condition is characterized by hallucinations, disorientation, reduced alertness, and disrupted thinking, and many of those who develop delirium never regain their pre-delirium levels of cognition and are thus never able to return home.
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ABOUT THE NEW JEWISH HOME: Serving New Yorkers of all faiths and ethnicities for almost 170 years, The New Jewish Home (formerly, Jewish Home Lifecare) is transforming eldercare as we know it. One of the nation’s largest and most diversified not‐for‐profit geriatric health and rehabilitation systems, The New Jewish Home serves 12,000 older adults each year, in their homes and on campuses in Manhattan and Westchester, through short-term rehabilitation, long‐term skilled nursing, low-income housing, and a wide range of home health programs. The New Jewish Home believes that high-quality care and personal dignity are everyone’s right, regardless of background or economic circumstance. Technology, innovation, applied research and new models of care put The New Jewish Home in the vanguard of eldercare providers across the country. For more information, visit www.jewishhome.org.