Elder Care Programs

Fletcher Allen Elder Care Services sponsors the following program in support of providing optimal care for seniors.

Nurses Improving Care for Health System Elders (NICHE)

This nursing education program evaluates level of understanding around geriatric care and provides educational programs where indicated. A Geriatric Resource Nurse certification is included in the program.

Started in 1992, NICHE (Nurses Improving the Care of Health system Elders) is a national geriatric nursing program comprising 300 active sites in North America. A program of The John A. Hartford Foundation Institute for Geriatric Nursing at New York University, the goal of NICHE is to achieve systematic nursing change that will benefit hospitalized older patients. The vision of NICHE is for all patients 65 and over to be given sensitive and exemplary care. The mission of NICHE is to import principles and tools to stimulate a change in the culture of healthcare facilities to achieve patient-centered care for older adults.

The NICHE program at Fletcher Allen began in 2004 with funding provided by the Frymoyer Scholars Program and awarded to Sue Goetschius, APRN, BC, MSN, Director of Nurse Education and Research.  Education was initially targeted to nursing staff within the hospital but now includes nurses from other community agencies such as home health and long term care as well as social workers, administrators and case managers. 

Since its inception, over 400 nurses have completed training around how to care for elders in institutional settings including nurses from Medicine, Surgery, Cardiology, Oncology, Emergency, Nurse Educators, CNSs, Critical Care, Dialysis, Rehab, Mental Health Services, Outpatients, Perioperative Services, Patient and Family Advocacy, Case Management and Social Work.  Projects completed by NICHE nurses include patient and family education materials, Geriatric Nursing columns in unit newsletters and unit based care improvement plans. 

NICHE Resources for Patients and Family

NICHE recognizes that patients and families are key members of the health care team. A number of valuable tools and resources for family caregivers have been developed under the NICHE program.

Please follow the link below to the NICHE site which offers a variety of valuable tools to help family caregivers cope with and understand the needs of their hospitalized loved ones.


HELP (Hospital Elder Life Program)

In 2007, Elder Care Services at Fletcher Allen launched a new program to improve care and safety for hospitalized older adults.  The program is entitled the Hospital Elder Life Program (HELP) and its goal is to prevent delirium, a common complication of hospitalization among elders.  The Fletcher Allen program was modeled after one started at Yale-New Haven by Dr. Sharon Inouye in the 1990s.  Inouye’s work has demonstrated that preventing delirium can shorten length of hospitalization, improve patient safety and enhance function in older adults. 

The HELP program is an innovative approach joining a skilled interdisciplinary team with geriatric expertise to a highly trained and well supervised volunteer staff.  The interventions used are simple but require time and resources that are unavailable in today’s acute care environment.  This combination of tested methods and a team approach provides the resources to consistently address the special needs of older patients and prevent decline in function during hospitalization.

HELP Services Include:

  • Daily Visitor Program: cognitive orientation, communication, and social support.
  • Therapeutic Activities Program: cognitive stimulation and socialization.
  • Encouraging a Non-Pharmacologic Sleep Protocol: promotes relaxation and sufficient sleep without medications.
  • Promoting fluid and nutritional intake
  • Encouraging physical activity
  • Hearing and Vision Protocol: hearing and vision adaptations and equipment.

If you are interested in becoming a HELP volunteer, call the Fletcher Allen Volunteer office at 802-847-3536.