This paper examines the effectiveness of a nursing intervention for elderly hospitalized patients (N = 235) as measured by functional outcomes. A nursing intervention targeted at factors which influence acute confusion or delirium employed strategies to educate nursing staff, mobilize patients, monitor medication and make environmental and sensory modifications. Subjects who received the intervention were more likely to improve in functional status from admission to discharge than subjects who did not receive the intervention.

Continued restraint use in nursing home residents in this study most often occurred with severe cognitive impairment and/or when fall risk was considered by staff as a rationale for restraint. Efforts to reduce or eliminate physical restraint use with these groups will require greater efforts to educate staff in the assessment and analysis of fall risk, along with targeted interventions, particularly when cognition is also impaired.

The SEMs were similar to previously reported values and can be used when working with African American and white older adults. Estimates of MDC were calculated to assist in clinical interpretation.

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Older adults admitted to SICUs were at high risk for developing delirium during hospitalization. Further research is needed to elucidate the risk factors for, and outcomes of, delirium in this uniquely vulnerable population.