The Hospital Elder Life Program (HELP) at the Jewish General Hospital, supported by McGill learners, improves outcomes with basic physical exercises, mealtime support and companionship. New data from the HELP team reveals a significant reduction in hospital days for those enrolled.
Imagine a healthcare intervention that contributes to reducing the length of stay of hospitalized, frail patients, helping them remain more alert, happy and independent. Some might think a costly treatment might achieve this result. However, a program at the Jewish General Hospital (JGH) has reached this impressive target another way.
An internal analysis by the Hospital Elder Life Program (HELP), which aims to prevent delirium and functional decline in frail, older hospitalized persons or those who are younger with a geriatric profile, showed that patients who availed of it stayed an average of 7.6 fewer days in hospital compared to those who declined to take part in 2023-2024. Seventy-six percent of the HELP patients were discharged either home or to a rehabilitation hospital.
Originally developed by Sharon K. Inouye, MD, MPH, at Yale School of Medicine, HELP was adapted to the JGH and is now offered across 10 of the hospital’s units.
Through visits to eligible patients, HELP offers activities like basic physical exercises, mealtime support, games and companionship to keep patients physically active and mentally stimulated.
For several years, placements with HELP have been included in mandatory training for first-year students from the School of Physical and Occupational Therapy (SPOT). In the 2023-2024 academic year, the School of Human Nutrition began a partnership with the program, with 17 master’s students in nutrition completing a placement with HELP, alongside 71 first-year physiotherapy and occupational therapy students.
Cheerful, awake and ready
Isabelle Lamontagne, HELP’s coordinator, and Emmanuel Nzayisenga, rehabilitation assistant, train and lead the program’s volunteers. Both have witnessed the positive impacts of learners on participating patients first-hand.
Patients who participate in the activities, “are more cheerful, more awake, more proactive and take more responsibility for their health,” Lamontagne says.
Each session with a learner or volunteer also prepares patients for their daily interactions with nurses, occupational therapists, physical therapists and other healthcare providers.
Helping a patient stay oriented and assisting with meals in this way has enormous benefits for both the patient and their care providers, says Mary Lattas, OT, Assistant Dean, Health Professions Education in the Faculty of Medicine and Health Sciences, Assistant Professor (Professional) at SPOT, and Director of Rehabilitation and Multidisciplinary Services at the CIUSSS West-Central Montreal.
“A lot of these patients are alone in hospital. They may have arthritis and struggle to open juice containers,” she explains. “If they don’t eat, they don’t have the strength to get up.”
“The fact that they have eaten, are up and are ready optimizes the time of a health professional,” she adds. “If the visit from a learner is communicated to a patient in advance, it’s also something they can look forward to.”
Other HELP activities, like physical exercise, listening to music, playing games, getting ready for bed or simply having a chat also play an important role in maintaining a patient’s cognitive abilities, sleep health and overall wellbeing.
Since HELP was launched at the JGH in 2017, many patients and their families have shared their appreciation for the program. One person who benefited from HELP in 2022 told the team: “Thank you and your team for your loving support and companionship, which was so important and vital for my recovery.”
Changing career aspirations for future healthcare providers
All HELP volunteers, including McGill learners, receive a significant number of hours of theoretical and practical training. They then commit to a specific number of volunteer hours to fulfil their program requirements. However, many keep volunteering with HELP long after their placements.
“When the learners work on the floor for the first time, they discover the pleasure one can have with the patients,” Lamontagne says. “Contrary to what one might think when going into the room of a patient who is a little depressed, most patients are happy to participate and at the end, they have a big smile.”
Embedding HELP into the curricula of future healthcare providers gives them a hands-on interprofessional experience in a clinical environment early in their studies. It also opens their eyes to a career path they might not have considered, says Gina Mills, SLP (C), Assistant to the Director of Rehabilitation and Multidisciplinary Services at the CIUSSS.
“Before, geriatrics was one of the areas people steered away from – learners wanted to go into pediatrics,” she adds. “But through HELP, they interact with the patients, have fun and can see that they make a difference.”
One testimonial from a learner in 2022, collected as part of the team’s ongoing research, concurred. “HELP completely changed the trajectory of my studies,” they told the team, adding it inspired them to complete a master’s degree in public health to gain a better understanding of healthy aging.
Lattas also points to the program’s success at introducing future health professionals to geriatrics at a time when recruitment at CHSLD sites or other geriatric care settings is proving difficult.
“We hope that learners will fall in love with working with the geriatric clientele,” she says. “HELP is changing the lives of patients, and this would not have been possible without our students, our future healthcare professionals.”
Recognition and impact
The new evidence of HELP’s effectiveness for patients has been presented at the recent Value-Based Healthcare (VBHC) Summit of the Americas at the CIUSSS West-Central Montreal, as well as at the Canadian Geriatrics Society Annual Scientific Meeting in Calgary and other conferences.
Fresh from receiving a special mention for the Prix Hippocrate, which recognizes excellence in patient care provided by a team of health professionals, the HELP team now hopes to continue to grow and increase its impact.
Mills says team members are “tremendously proud of the program’s sustained growth since its inception and appreciate the pivotal role our partnership with McGill University has played in this progression.”
“The opportunities, perspective and insight it affords learners will have an extremely positive impact on the professional development of the next generation of healthcare providers. We look forward to many more mutually beneficial collaborations of this nature with the McGill community.”
