Eighty-three year-old Adelle Howe is carefully applying her lipstick and make-up. After spending three months in Humber River Regional Hospital (HRRH), she is finally able to leave, albeit only on a day pass.
Today, she is preparing to visit a local nursing home, where her family believes she will continue to get the long term care she needs. But for Adelle, who walks with a spring in her step despite being hospitalized for a stroke, leaving HRRH is bitter sweet. “Everyone here has been really good to me,” says the Cuban-Canadian, her voice soft and shaky. “I’ve had no problems at all.”
Indeed, staff members on the geriatric floor have been equally taken with Adelle, greeting her by name and commenting on how well she looks as she walks down the hall.
Even Dr. Adam Krajewski, Head of Geriatrics at HRRH, who has been with the hospital over 10 years, has a special fondness for Adelle. “She is a wonderful lady” he says, “All of our patients are special and we provide them all with the best care, but sometimes you meet someone that touches you. Adelle has a dignified grace and peacefulness about her that connected with all of us.”
Adelle’s story is typical of many of the older patients for whom HRRH provides care. She was independent and living on her own, but plans and social activities she had organized, including a cruise trip with a friend, fell by the way-side after a sudden stroke.
Geriatric patients require a unique blend of medical expertise and emotional support. Like Adelle, many are formerly active and independent adults. According to Dr. Krajewski, taking a multi-disciplinary approach to their care is a key aspect to the continuation of excellent treatment provided to elderly patients. “We are a community hospital, and I think the care that we provide and the involvement and effort that is made to ensure that patients are well looked after is very good”
Dr. Krajewski believes that one of the key components of continued excellence in care for HRRH’s Geriatric patients is the Geriatric Rounds that take place monthly. The rounds are a lively affair full of debate and discussion. The speaker’s are often from HRRH or other hospitals in Toronto. All staff including Social Workers, Chaplains, Clinicians, Dieticians and even the hospital’s Ethicist attend to share their experiences and gain and give advice.
“We all really work together,” says Annette McLean, Resource Nurse for the Six West Geriatric floor. We had a team of different experts looking after Adelle for example. It was all part of a holistic approach to her care.”
That holistic approach means that even the Chaplains play an essential role in delivering care to elderly patients. “We facilitate bereavement and grief for loss of home, mobility and life as they knew it,” says Laura Sutton, one of HRRH’s two Chaplains, “We also provide social support. I have often arranged or gone myself to pick up their walker or even feed their pets.”
For patients, social support can also take place in unexpected ways. “As Adelle got better, she would come by the nursing station and ask what she could do to help,” explains McLean. “She would fold towels and would even help the other patients make their bed. This helped her rehabilitation and also helped to keep her active and alert. And it helps provide a more normal social experience.”
In HRRH’s emergency department, dedicated Geriatric Emergency Management (GEM) nurses deal exclusively with elderly patients in the ER, providing vital care and helping to facilitate the hospital’s older patients’ care needs.
Once on the floor, a Geriatric Assessment Unit means that patients suffering from severely limited mobility, agitation, confusion or who are in need of consistent pain control do receive specialized care in one area. A Geriatric Psychiatrist and two full time Palliative Care Physicians are also part of the team that contributes to the continued excellence of HRRH’s Geriatric program.
“We’ve also done exceptionally well with wound-care and fall prevention,” says Dr. Krajewski. “It is an area that we have all worked very hard to raise awareness in and with a Wound Care Specialist on board, it has really helped to reduce the prevalence.”
A Geriatric Out-Patient Clinic that runs four days a week ensures that even after they are discharged, HRRH’s elderly patients can return to get the care they need from familiar faces in a familiar setting.
But, for Dr. Krajewski and the rest of the Geriatric team, what is important is the team effort that is made to get elderly patients better. Nurse McLean sums it all up by saying: “The men and women on our floor have lived their lives, they have contributed to society and worked hard. They deserve to be well taken care of and that’s what we try to do everyday at HRRH.”