Table 1.

HELP-LTC intervention components^* (N= 231 cases of acute illness and 3671 CNA visits).

Component	Delirium Risk Factor	Staffing	Description and Timing	Imple- mented	Reasons not Implemented
Orientation	Cognitive Impairment	HELP CNA	Day, month, year, season, and place reviewed using props; hearing aids and glasses provided; daily	97%	2.3% off floor or unavailable; 0.5% not enough time
Therapeutic activity	Cognitive Impairment	HELP CNA	Discussion of past using resident’s own or other pictures; reading, music, games w/props; daily	97%	2.3% off floor or unavailable; 0.5% not enough time; 0.4% refused
Mobilizatio n	Immobility	HELP CNA in collaboration w/physical therapist & unit CNA	“Head-to-toe” physical activity at resident’s max ability, including active range of motion,walking, chair stands; daily	84%	12.9% refused; 2.4% off floor or unavail; 0.6% not enough time; 0.4% medical reason
Hydration	Dehydration	HELP CNA in collaboration w/unit CNA & RN	Two 6-ounce cups of fluid orally unless not indicated (e.g., congestive heart or renal failure or at risk for fluid overload); daily	90%	6.4% refused; 0.8% medical reason; 2.4% off floor or unavailable; 0.6% not enough time
Snack	Under- nutrition	HELP CNA in collaboration w/unit CNA and RN	Yogurt or nutritional shake unless within 15 min before or after a meal; daily	76%	19% refused; 0.9% medical reason; 3.3% off floor or unavailable; 0.8% not enough time
Sleep or relaxation	Sleep problems; Medications	HELP CNA	Massage, warm drink, quiet music for those who report sleep difficul- ties; daily in PM	85%	10.1% off floor or unavailable; 3.7% not enough time; 1.5% refused
Medication alerts	Medications	Automated w/MD oversight	Computerized alerts to medical staff of prescribed meds associated with delirium	Not imple- mented	--

^*Adapted with permission from the Hospital Elder Life Program <www.hospitalelderlifeprogram.org>