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One impediment is plastic wrapping the food, often a challenge for an older person’s arthritic hands. Flood has enlisted college students to help remove the wrappers. Volunteers sometimes help feed patients, spending time with them during meals, making conversation that often helps lonely older people feel more like eating, Flood said.

The program is modeled after one at the University of Texas Medical Branch in Galveston, and Flood is evaluating whether the Alabama program has improved patients’ function or shortened hospital stays.

She called it “one tiny piece” of maintaining baseline functioning.

The elder-care units where such efforts occur are one of the best-known models of geriatric hospital care, typically featuring specialists, nurses, physical therapists and other staffers who collaborate to keep older patients from becoming frail.

Often there is carpeting, special lighting or curtains to make older patients feel more at home. But the concept also involves challenging standard practices, from bed rest and feeding methods to routine use of things like urinary catheters that can increase risk of infection and which studies have shown are often needlessly used in older patients.

Developed more than a decade ago, the units have been slow to catch on. Fewer than 300 hospitals have them, or less than 10 percent of the nation’s more than 4,000 hospitals.

Startup costs, typically at least $200,000, may be a key reason, but these units can save money in the long run, said Dr. Kyle Allen, an elder-care expert who worked for Summa Health System in Akron, Ohio.

A comparison showed that hospital stays for patients in these settings there were almost half a day shorter than for those in standard hospital units, Allen said. “That doesn’t sound like a lot,” but it translates to hundreds of thousands of dollars in annual savings, he said.

Now he is helping Riverside Health System develop an elder-care unit at its regional medical center in Newport News, Va.


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