HELP – Hospital Elder Life Program – ein multimodales Interventionsprogramm zur Delirprävention bei älteren Patienten
详细信息 查看全文
- 作者：PD Dr. K. Singler MME ; C. Thomas
- 关键词：SchlüsselwörterKognitives Screening ; Primärprävention ; Risikofaktoren ; Kognitive Beeinträchtigung ; Demenz
- 刊名：Der Internist
- 出版年：2017
- 出版时间：February 2017
- 年：2017
- 卷：58
- 期：2
- 页码：125-131
- 全文大小：
- 刊物类别：Medicine
- 刊物主题：Internal Medicine; General Practice / Family Medicine; Cardiology; Gastroenterology; Hepatology; Nephrology;
- 出版者：Springer Medizin
- ISSN：1432-1289
- 卷排序：58
文摘
Delirium in older adults is associated with an increased risk for cognitive and functional decline. Multiple risk factors, such as underlying dementia, multiple comorbidities, anticholinergic medication or visual and hearing impairment foster the incidence of delirium. By identification of patients at risk and the initiation of a multiple component delirium prevention program delirium is preventable in 30–40% of all cases. There is broad evidence for comprehensive multicomponent delirium prevention strategies in patient care, but their implementation is still lacking in many hospitals. The Hospital Elder Life Program (HELP), designed in 1999 by S.K. Inouye, is a comprehensive protocol for hospitalized elderly patients and has been implemented successfully in more than 200 hospitals worldwide. In German hospitals, positive experiences with HELP, with minor modifications, have been made. The core of the HELP concept is the identification of a patient’s delirium risk profile and an individually assigned intervention protocol consisting of (re-)orientation, cognitive activation, simple mobilization or meal companionship and nonpharmacological sleep promotion. Many strategies for the prevention of delirium in elders integrate substantial elements of HELP; however, a measurable preventive effect requires the modification of multiple predisposing and precipitating factors. The article reviews the original Hospital Elder Life Program and its implementation in German hospitals.