Table 1: HELP program interventions and staff.

Interventions	Staff	Description
Core interventions
Orientation	ELS, volunteers	Daily orientation, orientation board with names of care team members and daily schedule
Therapeutic activities	ELS, volunteers	Cognitive stimulation activities three times daily
Sleep enhancement	ELNS, ELS, volunteers	At bedtime, warm milk or herbal tea, relaxation tapes or music, and back massage. Ward-wide noise reduction and schedule adjustments to allow uninterrupted sleep
Early mobilization	ELNS, ELS, volunteers	Ambulation or active range-of-motion exercises three times daily. Minimizing use of immobilizing equipment
Vision protocol & Vision protocol - Blindness	ELS, volunteers	Visual aids (e.g., glasses, magnifying lenses) and adaptive equipment (e.g., large illuminated telephone keypads, large print books, fluorescent tape on call bell), with daily reinforcement
Hearing protocol	ELNS, ELS, volunteers	Portable amplifying devices and special communication techniques, with daily reinforcement. Ear wax clearing by ELNS as needed
Fluid repletion/constipation	ELNS, ELS, volunteers	Encourage fluids. Encourage mobility and regular toileting. Added fiber to diet. Laxatives if needed
Feeding assistance	ELS, volunteers	Feeding assistance and encouragement during meals
Additional interventions based on the NICE
Hand Hygiene	ELNS, ELS, Volunteers	Hand washing protocol. Generalized infection control measures
Aspiration Prevention	ELNS	Regular oral care. Head of bed at 60 degrees during meals. Monitor for signs of pneumonia
CAUTI Prevention	ELNS	Sterile insertion technique. Early catheter removal
Constipation management	ELNS, ELS. Volunteers	Encourage fluids. Encourage mobility and regular toileting. Added fiber to diet. Laxatives if needed
Pain management	ELNS	Pain management plan and modify as needed. Non-pharmacological and pharmacological management
Hypoxia management	ELNS	Seek advice regarding oxygen administration. Check oxygen flow. Elevate head of bed to 45 degrees
Other interventions
Geriatric nursing assessment and interventions
Delirium protocol	ELNS	Create calm, orienting environment. Regular communication with patient; family involvement. Geriatric consult if needed
Dementia protocol	ELNS	Collaborate with medical staff and patient family. Avoid psychoactive medications
Psychoactive medications	ELNS, interdisciplinary group	Screen medication list daily. Interdisciplinary group discussions about potential adverse medication outcomes
Discharge planning	ELNS	Assessing home environment and social supports for possible discharge needs
Optimizing length of stay	ELNS	Identify risk factors for need of intensive discharge planning and anticipate discharge needs
Additional areas	ELNS	Nursing assessment and interventions for emotional health, nutrition, function, skin care, incontinence and elimination problems, social issues
Interdisciplinary rounds
Geriatric consultation	Geriatrician	Targeted consultation on Elder Life issues, as referred by program staff. Formal geriatric consultation as needed
Interdisciplinary rounds	ELNS, ELS, geriatrician, primary nurses, physical therapist, dietitian, pharmacist, chaplain, and consultants.	Twice-weekly rounds to discuss each Elder Life patient, set goals and review all Elder Life issues with interdisciplinary input. Interventions are recommended and tracked
Ongoing educational programs	ELNS, geriatrician, and nurse practitioner	Formal didactic sessions, one-on-one interactions, resource materials to educate about Elder Life issues
Community linkages & Telephone follow-up	ELNS, ELS	Referrals and communication with community agencies to optimize transition home. Telephone follow-up phone call within 7 days after discharge.

ELS: Elder life specialist, ELNS: Elder life nurse specialist, CAUTI: catheter association urinary tract infection