Keeping the TLC in LTC in Hamilton

Opinion Aug 07, 2020 Hamilton Spectator

The devastating impact that COVID-19 has had on residents in long-term care, retirement home and congregate settings has sounded the long overdue alarm bell in this sector. The lives of hundreds of residents, their family members, and health-care workers have been affected.

However, while the pandemic has caused much suffering, it has also taught us that we must continue working together in order to protect one of our most vulnerable populations.

We applaud the province’s announcement about an independent commission into Ontario’s long-term-care system, and ongoing commitment to improving the lives of individuals living in these settings. However, we can and should be doing more, including an expanded look at how frail seniors are treated in the entire health system.

We are taking some steps locally to do better by those in congregate settings.

LTC-CARES Hamilton (Consults and Recommendations for Emergency and Support Services) is one such example. LTC-CARES was launched in early April and is making it possible for residents and their care teams to receive enhanced access to hospital-based care and resources from the comfort of their home.

An average of 2,000 long-term-care residents are transferred to one of Hamilton’s emergency departments (EDs) each year. Approximately half require a stay in hospital.

Through LTC-CARES, residents can receive care in the safety and comfort of their home. If an individual requires medical attention, their doctor or another member of their care team can speak with an ED physician 24 hours a day, seven days a week via telephone or secure video conferencing.

The ED physician can conduct an assessment and then work with the resident, family and care team at the home to determine next steps. This could include expedited tests such as mobile blood work or X-ray at the resident’s bedside, starting treatments in the resident’s home, a consult with other specialists (often done via a video visit), and/or a followup appointment in hospital.

The concept of keeping residents at the centre of all decision-making and wrapping health services around them is a key guiding principle in this sector. LTC-CARES is a partnership of numerous care providers to make this possible. For residents, they continue to be cared for by those that know them and their health situation best, while for staff, they have the reassurance of additional expertise and help navigating the continuum of care.

From the initiation of the LTC-CARES program, more than 50 LTC residents have been part of this initiative. Of these, 70 per cent were able to receive care in their home, and many received expedited subspecialty consultation without having to be transferred to hospital. The remainder were transferred to an ED.

It is important to emphasize that this program is not a hospital diversion strategy, but a way to provide enhanced appropriate and expedient care for the LTC resident — often within the comfort of their home.

Although the past few months have been particularly challenging, staff in congregate settings have adapted, honed their skills and worked incredibly hard to implement the public health directives and safety measures to protect residents and each other.

As our community (and world) moves ahead with a “new normal,” our focus will remain on ensuring residents have access to the highest quality long-term care delivered in the best way possible to foster their continued health and safety.

Dr. Kanwal Shankardass is Medical Director, St. Peter’s Residence at Chedoke and Associate Clinical Professor, McMaster University. Holly Odoardi is Senior Administrator, Macassa Lodge & Wentworth Lodge, Long Term Care Division, Healthy and Safe Communities Department, City of Hamilton. Jennifer Burgess is Nurse Practitioner, Hamilton Niagara Haldimand Brant Nurse Led Outreach Team. Dr. Greg Rutledge, Chief Emergency Medicine, St. Joseph’s Healthcare Hamilton, Assistant Professor, McMaster University. Dr. Michelle Welsford is an Emergency Physician, Hamilton Health Sciences, and a Professor at McMaster University. Dr. Mohamed Panju is a General Internal Medicine, Hamilton Health Sciences and an Associate Professor at McMaster University. Kelly Drake is a Nurse Practitioner in Community & Population Health Services Program, Hamilton Health Sciences.

Keeping the TLC in LTC in Hamilton

Keeping residents at the centre of all decision-making is key.

Opinion Aug 07, 2020 Hamilton Spectator

The devastating impact that COVID-19 has had on residents in long-term care, retirement home and congregate settings has sounded the long overdue alarm bell in this sector. The lives of hundreds of residents, their family members, and health-care workers have been affected.

However, while the pandemic has caused much suffering, it has also taught us that we must continue working together in order to protect one of our most vulnerable populations.

We applaud the province’s announcement about an independent commission into Ontario’s long-term-care system, and ongoing commitment to improving the lives of individuals living in these settings. However, we can and should be doing more, including an expanded look at how frail seniors are treated in the entire health system.

We are taking some steps locally to do better by those in congregate settings.

LTC-CARES Hamilton (Consults and Recommendations for Emergency and Support Services) is one such example. LTC-CARES was launched in early April and is making it possible for residents and their care teams to receive enhanced access to hospital-based care and resources from the comfort of their home.

An average of 2,000 long-term-care residents are transferred to one of Hamilton’s emergency departments (EDs) each year. Approximately half require a stay in hospital.

Through LTC-CARES, residents can receive care in the safety and comfort of their home. If an individual requires medical attention, their doctor or another member of their care team can speak with an ED physician 24 hours a day, seven days a week via telephone or secure video conferencing.

The ED physician can conduct an assessment and then work with the resident, family and care team at the home to determine next steps. This could include expedited tests such as mobile blood work or X-ray at the resident’s bedside, starting treatments in the resident’s home, a consult with other specialists (often done via a video visit), and/or a followup appointment in hospital.

The concept of keeping residents at the centre of all decision-making and wrapping health services around them is a key guiding principle in this sector. LTC-CARES is a partnership of numerous care providers to make this possible. For residents, they continue to be cared for by those that know them and their health situation best, while for staff, they have the reassurance of additional expertise and help navigating the continuum of care.

From the initiation of the LTC-CARES program, more than 50 LTC residents have been part of this initiative. Of these, 70 per cent were able to receive care in their home, and many received expedited subspecialty consultation without having to be transferred to hospital. The remainder were transferred to an ED.

It is important to emphasize that this program is not a hospital diversion strategy, but a way to provide enhanced appropriate and expedient care for the LTC resident — often within the comfort of their home.

Although the past few months have been particularly challenging, staff in congregate settings have adapted, honed their skills and worked incredibly hard to implement the public health directives and safety measures to protect residents and each other.

As our community (and world) moves ahead with a “new normal,” our focus will remain on ensuring residents have access to the highest quality long-term care delivered in the best way possible to foster their continued health and safety.

Dr. Kanwal Shankardass is Medical Director, St. Peter’s Residence at Chedoke and Associate Clinical Professor, McMaster University. Holly Odoardi is Senior Administrator, Macassa Lodge & Wentworth Lodge, Long Term Care Division, Healthy and Safe Communities Department, City of Hamilton. Jennifer Burgess is Nurse Practitioner, Hamilton Niagara Haldimand Brant Nurse Led Outreach Team. Dr. Greg Rutledge, Chief Emergency Medicine, St. Joseph’s Healthcare Hamilton, Assistant Professor, McMaster University. Dr. Michelle Welsford is an Emergency Physician, Hamilton Health Sciences, and a Professor at McMaster University. Dr. Mohamed Panju is a General Internal Medicine, Hamilton Health Sciences and an Associate Professor at McMaster University. Kelly Drake is a Nurse Practitioner in Community & Population Health Services Program, Hamilton Health Sciences.

Keeping the TLC in LTC in Hamilton

Keeping residents at the centre of all decision-making is key.

Opinion Aug 07, 2020 Hamilton Spectator

The devastating impact that COVID-19 has had on residents in long-term care, retirement home and congregate settings has sounded the long overdue alarm bell in this sector. The lives of hundreds of residents, their family members, and health-care workers have been affected.

However, while the pandemic has caused much suffering, it has also taught us that we must continue working together in order to protect one of our most vulnerable populations.

We applaud the province’s announcement about an independent commission into Ontario’s long-term-care system, and ongoing commitment to improving the lives of individuals living in these settings. However, we can and should be doing more, including an expanded look at how frail seniors are treated in the entire health system.

We are taking some steps locally to do better by those in congregate settings.

LTC-CARES Hamilton (Consults and Recommendations for Emergency and Support Services) is one such example. LTC-CARES was launched in early April and is making it possible for residents and their care teams to receive enhanced access to hospital-based care and resources from the comfort of their home.

An average of 2,000 long-term-care residents are transferred to one of Hamilton’s emergency departments (EDs) each year. Approximately half require a stay in hospital.

Through LTC-CARES, residents can receive care in the safety and comfort of their home. If an individual requires medical attention, their doctor or another member of their care team can speak with an ED physician 24 hours a day, seven days a week via telephone or secure video conferencing.

The ED physician can conduct an assessment and then work with the resident, family and care team at the home to determine next steps. This could include expedited tests such as mobile blood work or X-ray at the resident’s bedside, starting treatments in the resident’s home, a consult with other specialists (often done via a video visit), and/or a followup appointment in hospital.

The concept of keeping residents at the centre of all decision-making and wrapping health services around them is a key guiding principle in this sector. LTC-CARES is a partnership of numerous care providers to make this possible. For residents, they continue to be cared for by those that know them and their health situation best, while for staff, they have the reassurance of additional expertise and help navigating the continuum of care.

From the initiation of the LTC-CARES program, more than 50 LTC residents have been part of this initiative. Of these, 70 per cent were able to receive care in their home, and many received expedited subspecialty consultation without having to be transferred to hospital. The remainder were transferred to an ED.

It is important to emphasize that this program is not a hospital diversion strategy, but a way to provide enhanced appropriate and expedient care for the LTC resident — often within the comfort of their home.

Although the past few months have been particularly challenging, staff in congregate settings have adapted, honed their skills and worked incredibly hard to implement the public health directives and safety measures to protect residents and each other.

As our community (and world) moves ahead with a “new normal,” our focus will remain on ensuring residents have access to the highest quality long-term care delivered in the best way possible to foster their continued health and safety.

Dr. Kanwal Shankardass is Medical Director, St. Peter’s Residence at Chedoke and Associate Clinical Professor, McMaster University. Holly Odoardi is Senior Administrator, Macassa Lodge & Wentworth Lodge, Long Term Care Division, Healthy and Safe Communities Department, City of Hamilton. Jennifer Burgess is Nurse Practitioner, Hamilton Niagara Haldimand Brant Nurse Led Outreach Team. Dr. Greg Rutledge, Chief Emergency Medicine, St. Joseph’s Healthcare Hamilton, Assistant Professor, McMaster University. Dr. Michelle Welsford is an Emergency Physician, Hamilton Health Sciences, and a Professor at McMaster University. Dr. Mohamed Panju is a General Internal Medicine, Hamilton Health Sciences and an Associate Professor at McMaster University. Kelly Drake is a Nurse Practitioner in Community & Population Health Services Program, Hamilton Health Sciences.