Table 1.

Targeted Risk Factors and Intervention Protocols of the HELP Program and Rationale for Inclusion in the Family-HELP Program

Targeted Risk Factor and Eligible Patients	HELP Standardized Intervention Protocols	Rationale for Inclusion in Family-HELP program
Cognitive impairment Patients with baseline Mini Mental State Examination score (MMSE) < 20	Orientation protocol	Providing memory cues such as a clock or family photos helps orient patients to their surroundings and are readily accessible for family caregivers from the home
	Therapeutic-activities protocol	Cognitively stimulating activities such as discussing current events and reminiscing are often part of the typical daily interaction between older adults and their family caregivers (Bogardus et al., 2003)
Sleep deprivation All patients	Nonpharmacologic sleep protocol
Immobility Patients with a Katz ADL score < 10	Early mobilization protocol
Visual impairment Patients with visual acuity worse than 20/70 on binocular near vision testing	Vision protocol	Family caregivers are often used to ensuring that the older adult has access to and wears glasses and uses other visual aids (Cole, 2004)
Hearing impairment Patients hearing </=6/12 whispers on Whisper Test	Hearing protocol	Hearing deficits are often a major focus of family caregivers as deficits impact their ability to communicate with the older adult (Mulrow et al., 1990)
Dehydration Patients with ratio of blood urea nitrogen to creatinine>/= 18	Dehydration protocol

Note. HELP protocols selected for the Family-HELP Program are shown in boldface. Adapted from “A Multicomponent Intervention To Prevent Delirium in Hospitalized Older Patients,” by S. K. Inouye, S. T. Bogardus Jr., C. S. Williams, L. Leo-Summers, D. Acampora, T. R. Holford, T. R., et al., 1999, New England Journal of Medicine, 340, p. 676. Adapted with permission of the author. Copyright 1999 by the Hospital Elder Life Program.