According to the latest report by the United States Department of Labor’s Bureau of Labor Statistics, eight percent of teens ages 16 to 19 who volunteered in September 2012 did so at a hospital or health care organization. In a new pilot program, the Tender Loving Care-Advanced (TLC-A) Program, Holy Cross Hospital in Fort Lauderdale is utilizing high school student volunteers to assist in managing delirium of elderly patients in acute care.Based on the Hospital Elder Life Program (HELP) curriculum developed by Dr. Sharon K. Inouye and colleagues at the Yale University School of Medicine, the program uses an innovative volunteer model to provide personal, supportive attention to vulnerable older patients.
As stated by HELP, the primary goals are maintaining cognitive and physical functioning of high risk older adults throughout hospitalization, maximizing independence at discharge, assisting with the transition from hospital to home and preventing unplanned hospital readmissions.At Holy Cross, the TLC-A program focuses on elder care in the hospital. Delirium is a common occurrence among hospitalized older adults and is associated with significant morbidity and mortality. Delirium can escalate to the point of agitation and acting out, which then poses a safety risk to both nurses and patients.
In an effort to protect their patients, nurses sometimes resort to the use of restraints and sedatives, which can cause further agitation and possibly cause additional complications.
The TLC-A program offers the opportunity to utilize alternative measures which incorporate caring behaviors to help prevent injury, such as falls, and foster dignity and independence to patients experiencing acute symptoms related to delirium.
At Holy Cross, our volunteer training begins with sessions with a human patient simulator in scenarios which include practice interactions with patients, helping them with simple tasks and requests. These sim lab experiences allow modeling of caring behaviors such as authentic listening, use of touch to communicate caring, and assuring hearing aids and glasses are being used to optimize communication.
The volunteers are next taught to utilize reminiscence books, special low vision playing cards, music, videos, and arts and crafts activities to enhance the time they spend with patients, and to help patients express what matters most to them.
We are piloting the program on a neuro-telemetry step-down unit. Referrals are made to two nurses in the Clinical Practice Department of patients who would benefit from the program. A volunteer is then matched to each patient.
As the volunteers spend time with patients, the authentic presence of commitment occurs and the volunteers come to know a patient as a person. The result is a decrease in patient confusion and agitation, as the time spent with a caring volunteer gives patients an opportunity to express what matters most to them.
The pilot program began with four volunteers from Northeast High School. Early feedback is positive from patients, nurses, and administrators. The goal is to expand the program throughout the non-profit hospital in keeping with our commitment to provide compassionate care and uphold reverence for each person. Metrics regarding restraint use and patient fall rates will be evaluated to determine if the program is successful in enhancing patient safety.
