Purposeful Visits for Hospitalized Elderly Patients: Program Impact on Orientation, Agitation, and Mood

1University of Colorado Denver, Denver, CO
2University of Colorado Hospital, Denver, CO

Meeting: Hospital Medicine 2011, May 10-13, Dallas, Texas.

Abstract number: 163

Background:

Hospitalization can be an isolating and disorienting experience for elderly patients who find themselves cut off from normal routines and social support. Providing structure to social and cognitive stimulation provided by specially trained hospital volunteers allows visits to be designed to achieve specific objectives.

Purpose:

Purposeful visits were intended to improve the patient's subjective hospital experience and diminish depression, agitation, and disorientation.

Description:

Visits were provided on the University of Colorado Hospital ACE Service. Five volunteers were trained by a recreational therapist to develop an understanding of the fundamental principles of the Peterson and Gunn Therapeutic Recreation Service Model and to improve communication and active listening skills. Selected goals of the structured patient visit were: (1) enhance patient's memory, concentration, and social interaction abilities; (2) help patients identify activities that will decrease boredom, loneliness, depression, and agitation; and (3) assist patients in exploring and experiencing feelings of enjoyment and satisfaction. After each visit, a survey was completed by patient, volunteer, and nurse. A 5‐point scale rated change in mood, agitation, and orientation with 1 and 2 = worsening, 3 = no change, and 4 and 5 = improvement. During the first year 98 patients completed a structured purposeful visit by a trained volunteer, and 63% of surveys were completed by all 3 evaluators. Volunteers rated visit achievement of goals an average of 8.2 on a 10‐point scale. For change in patient mood, the average volunteer score was 3.94, and the average nursing score was 3.65. For agitation, the average volunteer score was 3.46, and the average nursing score was 3.42; for orientation, the average volunteer score was 3.38, and the average nursing score was 3.24. The improvements in mood were significantly greater than in the other 2 domains (P < 0.05). Ninety‐nine percent of patients reported enjoying their volunteer visit, and 96% thought other patients would also benefit from such a visit.

Conclusions:

The Purposeful Visitation Program is a viable option to provide structured meaningful activity for elderly patients in a hospital setting and has the potential to provide modest measurable benefit to patients. Both volunteers and nursing reported improvement in assessment of patient mood, agitation, and orientation after a purposeful visit. Volunteers consistently rated a higher percentage of patients as showing improvement compared with nursing. However, both volunteers and nursing reported the same effect trend, with a greater magnitude of improvement observed for mood than for agitation and the least impact on orientation. This program utilizes specially trained volunteers to leverage the skills of recreational therapists. Programs such as this have potential to reduce social isolation and its cognitive‐emotional consequences in vulnerable hospitalized elderly patients in a cost‐effective manner.

Disclosures:

B. Mramor ‐ none; J. Hagman ‐ none; D. Ford ‐ none; E. Cumbler ‐ none

To cite this abstract:

Cumbler E, Mramor W, Hagman J, Ford D. Purposeful Visits for Hospitalized Elderly Patients: Program Impact on Orientation, Agitation, and Mood. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 163. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/purposeful-visits-for-hospitalized-elderly-patients-program-impact-on-orientation-agitation-and-mood/. Accessed April 1, 2020.

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