The goal of a specialized geriatric unit in an acute care hospital setting is to minimize losses and have the patient maintain or achieve an optimal level of functioning and cognition. This study showed that more acute clients on a geriatric unit maintained or improved functioning capacity at a significant level in fewer days and at a lowered cost. Nursing implications include inservice training specific to caring for geriatric clients and providing early assessment and identification of strengths. Interventions such as reality orientation and early proactive measures can be used to maintain or achieve optimal cognitive functional capacity.