About

Trial Summary

The Hospital Elder Life Program (HELP) is an effective and evidence-based clinical program that has become standard care in hospitals worldwide because it works so well. HELP staff are highly trained and skilled to address many issues that can affect older adults (age 70 years and older) and lead to problems during hospitalization. In particular, HELP works to prevent delirium, a short-term condition that often develops suddenly, causes feelings of confusion, and is common among hospitalized older adults. The HELP program aims to help maintain thinking and memory for older persons throughout their hospital stay by providing many interventions (orientation, activities, exercise, nutrition, and special nursing care) designed to maintaining functioning and independence. HELP has also been shown to prevent falls, shorten hospital stays, and decrease the need for nursing home care after discharge.

The ENHANCE Trial will compare the effect of standard HELP to an adapted version of HELP, called Family-Augmented HELP (FAM-HELP), on patient health outcomes and experiences while in the hospital. FAM-HELP will train family members or care partners to add to the standard HELP components during a patient’s hospitalization. Families will be involved in providing orientation and communication, engaging in fun activities to enhance memory, providing assistance with walking or feeding as needed, and emotionally supporting their loved one in the hospital. We want to see if FAM-HELP can improve health and well-being for both patients and their family members, including an increased feeling of emotional and social support between patients and families.

The study will enroll 3,000 patients and their family members from 8 hospitals over 5 years.

Stakeholders

In PCORI-funded projects like our ENHANCE trial, researchers are required to have members on our team (called “stakeholders”) who have direct experience with the condition under study, with multiple different perspectives. Stakeholders contribute their own personal or professional lived experience and first-hand knowledge to our study of delirium. Their perspectives will help shape and guide our work.

The ENHANCE Trial includes 4 groups of stakeholders nominated by study leaders at participating research and clinical sites.

  • Patient Stakeholders all bring lived experience of having delirium or being at risk for delirium while in the hospital.
  • Family Stakeholders are caregivers or care partners for loved ones who have had delirium, or are advocates for caregivers and care partners.
  • Clinical Stakeholders care for patients with delirium or who are at risk for delirium and have experience delivering care using the HELP model.
  • Health System and Policy Leader Stakeholders work to improve care for patients with delirium, and patients who are at risk of delirium.

All stakeholder groups meet 5–6 times a year and provide feedback on key parts of the study.

Trial Timeline

March 1

2023

Trial begins

February 28

2028

Trial ends

When are Results Expected?

We hope to publish our preliminary results on the trial by the end of 2027 or early 2028.

Why This Research is Important

HELP has years of research and evidence to support its use in hospitals to prevent delirium. However, it is unknown if adding the additional layer of family and caregiver involvement (FAM-HELP) will work better than HELP, or if HELP will remain the best model of care. Our research trial hopes to answer this question, with the ultimate goal of improved care in hospital settings for older adults (age 70 years and older) and prevention of delirium. This trial may help us find new ways for family members to enhance the care of older adults during a hospital stay.