Embracing elder friendly care at North York General Hospital

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Care of the elderly, one of the four strategic priorities at North York General Hospital (NYGH) is being embraced in an ambitious four-year plan to train 80 per cent of staff in elder friendly principles. Becoming elder friendly means the hospital is changing wherever seniors interact and receive services and care, including in its approach to care, philosophy, services and physical facilities.

Elder friendly care is a priority because seniors are often the ones who have the most frequent experiences with health care. They may have multiple co-morbidities, longer hospital stays, more procedures, are at greater risk for acquired complications, and have fewer resources for recovery. At NYGH two-thirds of medical patients and one-third of surgical patients are over the age of 70.

“Elder friendly training is one important element to becoming an elder friendly organization because it focuses on the non-clinical needs of seniors by covering topics like age discrimination, elder abuse awareness, creating barrier free environments, the challenges of aging and resources for better communication,” says Susan Kwolek, Vice President and Chief Nursing Executive. “It also supports our vision of becoming a leader in providing integrated geriatric care and services which has other exciting projects in the future.”

Currently 19 staff and volunteers have been trained by ‘Friendly to Seniors’ as master trainers. The master trainers will train over 3000 staff during the next four years in providing elder friendly care. ‘Friendly to Seniors’, part of the Toronto Seniors Council, is a volunteer group dedicated to helping organizations better respond to the needs of seniors and the challenges of aging.

The curriculum for master trainers includes learning about environmental assessments of facilities, as well as role playing and simulations to experience first hand the challenges of aging. At NYGH, each training session is led by a team of two, one of whom must be a senior. The personal experiences of seniors’ interactions with the health-care system and the challenges of aging enhance the credibility and applicability of training.

“The curriculum makes participants think about the challenges of aging and how they impact our elderly patients and the care we provide,” says Beatrise Edelstein, Care of the Elderly Coordinator. “It could be as simple as not calling a senior honey or deary but Mr. or Mrs. Smith, (these names are often perceived as disrespectful by older generations) or as important as being aware that a senior patient with decreased vision, hearing, sensation, and mobility is at higher risk for falls.

The curriculum for elder friendly training includes items that actively engage participants to think about and experience some of the challenges of aging, including: decreased mobility, safety issues, slower reflexes, diminished vision, hearing, taste, touch, smell and appetite, decreased strength and flexibility, memory loss, dementia, depression, feelings of loss, grief and loneliness.Elder friendly training is only one component of becoming elder friendly. Over the next few years NYGH will also be creating a welcoming physical environment that responds to the challenges of aging, including:

  • Upgrading signage throughout to ensure it is easy to read and understand.
  • Renovating 75 patient rooms and washrooms to incorporate higher toilet seats, easy to use faucet handles and brighter lighting.
  • Reducing the shine on floor wax to help prevent falls. Patient rooms will have a matte finish, while hallways will have a low shine finish.
  • Making magnifiers available to seniors who need them to read and fill out forms.
  • Providing patient care areas with large, low vision wall clocks and calendars, elder friendly telephones with big, easy to see push buttons, and amplifiers to help patients with severe hearing impairments.