Yale researchers find ways to ward off delirium in hospitalized patients and eliminate home hazards for the elderly

In separate studies, Yale geriatricians have found two ways to help the elderly maintain their physical and cognitive function. One study surveyed the homes of elderly people for physical hazards that can be easily eliminated. The other demonstrated the efficacy of a program to prevent delirium in elderly hospitalized patients.

Thomas M. Gill, M.D., associate professor of medicine, conducted the study on home hazards such as poor lighting, exposed electrical cords, throw rugs and insufficient bathroom grab rails or stairway banisters. Gill believes the potential for disabling accidents can be decreased by assessing potential hazards in the home and correcting them.

The delirium study examined the effects of the Elder Life Program, designed to ward off delirium among elderly hospitalized patients through a mix that includes conversation, exercise and memory aids. The program has been found to reduce symptoms by 40 percent, according to a study published in the March 4 issue of the New England Journal of Medicine.

The study, according to leader Sharon Inouye, M.D., M.P.H. ’89, associate professor of medicine, compared an intervention group with a control group, which had a higher rate of delirium. The Elder Life Program is the first major clinical program designed to prevent rather than treat delirium. It focuses on six risk factors for delirium —vision loss, hearing impairment, dehydration, sleep deprivation, cognitive im-pairment and immobility from prolonged bed rest.

Trained volunteers took patients for walks three times a day, talked about current events and offered warm milk rather than sedatives to induce sleep at night. A bedside bulletin board lists names of doctors and nurses, as well as a schedule of daily tests and activities.