New hospital

For Ms. Groves, she says she is grateful for the compassionate staff, extra support and care she had while she recovered.

In most cases, upon discharge from PTCC patients receive community support and home-care once they return home, ensuring a successful transition. However now, the hospital has recently received additional Ministry of Health funding for a pilot program called the Providence Care Transitions Home Program, which will extend the PTCC allied health care team into the community, supporting the patient and caregiver from hospital to home.

“This new program means enhanced continuity of care,” says Woods-Fournier.

and emotional factors that influence their ability to withstand life stressors. These individuals have an increased risk of hospitalization, longer hospital stays, hospital readmission, emergency department visits and in-hospital death. A staggering 340,000 seniors at risk of frailty are admitted to hospital each year.

Break down silos between sectors to help ensure that older adults with frailty receive the care they need –close to home – when they need it. This includes streamlining navigation through cross-sectoral partnerships, community-driven coordinated intake and access points and better mechanisms for information sharing.

Bring together providers from different health care organizations and sectors to wrap care around patients as a collective. This requires clarifying roles to understand which organization best serves which type of patient and creating formal communication opportunities, such as shared rounds.

Improve information access and knowledge sharing for older adults, caregivers and health care providers. Stakeholders need to be able to find reliable information to navigate the system and make sense of work happening both provincially and regionally.

“The patients’ skills and confidence they’ve built up at PTCC will continue once they are home with a team they are already familiar and comfortable with; a team who knows and supports their unique journey,” she adds.

“We are bridging the gap in healthcare, alleviating the strain on regional hospitals, while helping older adults age well at home.”

The PTCC inter-professional care team taking part in the new pilot-program includes occupational therapists and assistants, physiotherapists and assistants, recreational therapists and behavioural therapists.

More patients, just like Ms. Groves, will now be able to benefit from familiar, extended support in the comfort of their own homes with a team they know and trust. ■ H

Jonna Semple-Kloke is a Communications Officer at Providence Care.

St. Joseph’s Health Care London (St. Joseph’s) has been the regional lead in Southwestern Ontario for geriatric programs and services for more than 30 years. In 2017, with the support of Ontario Health West, St. Joseph’s set out under the Southwest Frail Senior Strategy to improve outcomes and experiences for older adults with frailty and their caregivers through creation of an integrated health care system in Southwestern Ontario. Through this work, and in consultation with patients, caregivers, providers and community partners, we learned key lessons in enhancing the quality of care for older adults, providing equitable access to services and improving the patient and caregiver experience. As a system, key steps are required now if we are to meet the looming challenges ahead. We must...

Advocate for government investment beyond long-term care. Investment is also needed in suitable housing options for older adults such as assisted living and improved home care and community services so individuals can continue to safely live at home.

Address the ageism that exists in our system and society.

In a recent St. Joseph’s DocTalks Podcast episode, Dr. Sheri-Lynn Kane, Chief of Geriatric Medicine at St. Joseph’s identifies a common misperception that, “…anyone with white hair and a blue gown is going to be a drain on the health care system.” The opposite is actually true, she says. Older adults are extremely resilient and resourceful and have a lifetime of experience, perspective, time and talent we should tap into and harness.

So, perhaps the question is not, “Are we ready?” It is, “Are we doing the work necessary to get there?” I’m optimistic that, together, we can face the wave and continue to provide older adults with the respect, care and compassion they deserve. ■ H

Roy Butler, PhD is the President and CEO at St. Joseph’s Health Care London.