Recruitment of volunteers to improve vitality in the elderly: the REVIVE* study

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Abstract
Background: Delirium is a common problem for frail, older patients in hospital and a marker of poor outcome and mortality. The aim of this study was to test a volunteer‐mediated delirium prevention programme for efficacy, cost‐effectiveness and sustainability on an Australian geriatric ward.Methods: Two controlled before‐and‐after studies were conducted. In study 1, 37 patients (>70 years, admitted to the geriatric wards) were enrolled during 5 months in 2003 for intensive individual study. Twenty‐one patients received usual care and 16 patients received the volunteer‐mediated intervention of daily orientation, therapeutic activities, feeding and hydration assistance, vision and hearing protocols. In study 2, we examined the effects of a general implementation for the whole department by measuring use of assistants in nursing, who were employed for individual nursing of delirious patients.Results: In study 1, we found a lower incidence (intervention vs control, 6.3% vs 38%; P = 0.032) and lower severity of delirium (1.2 vs 5.1; P = 0.045). There was a trend towards decreased duration of delirium (5.0 vs 12.5; P = 0.64). In study 2, use of assistants in nursing was reduced by 314 h per month suggesting a total annual saving of A$129 186 for the hospital.Conclusion: The programme prevents delirium and improves outcomes for elderly inpatients. Cost‐effectiveness supports the continuation of the programme and extension to other geriatric units.