Gaining the patient perspective through age related training

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By Taylor Grant

For most of us, getting dressed, paying for items at a store or following instructions can be done without much thought. As we age, various conditions can make these everyday tasks much more difficult.

Steven Hodge, Clinical Nurse Educator at the North Bay Regional Health Centre’s (NBRHC) Kirkwood Campus had the opportunity to experience for himself exactly how difficult it can be. Wearing special glasses to blur his vision, plastic gloves with tissue in the finger tips and headsets with static background noises, Hodge tried to follow simple instructions like buttoning a shirt, counting money and opening commonly found items on a patient meal tray. “It was a really eye opening experience,” he says. “I was trying to manipulate the activities the best I could, but all I could think about was how difficult it really was.”

That was exactly the point. The frailty simulation was part of the Health Centre’s Senior Friendly Care (SFC) Advocate Program—an educational opportunity for staff to increase their knowledge and expertise in providing quality care to older adults.

Melissa Hallett, Elder Life Coordinator at NBRHC explains the exercise Hodge and other staff participated in was designed to allow health care providers to walk a mile in the shoes of many of the seniors in their care: the glasses simulated various eye conditions such as glaucoma, the gloves limited dexterity and the headphones reduced hearing.

“Geriatric patients often have more complex medical conditions that are different from younger people, with other factors that need to be considered,” explains Hallett. “As health care providers, it’s important to understand these unique health care needs to enable seniors to maintain optimal health and function while they are hospitalized, so that they can transition successfully home or to the next appropriate level of care.”

The SFC Advocate Program encourages staff to identify quality improvements opportunities to positively impact the experience and well-being of older adults. The curriculum requirements draw from online resources such as the Nurses Improving Care for Healthsystem Elders (NICHE) program and Change Foundation, and are tailored to suit the specific duties of different service providers.

“Seniors are the most frequent users of hospital services and also stay longer once admitted to hospital. As the population ages, the number of people needing support is expected to grow,” Debbie Hewitt Colborne, Registered Nurse and chair of the Senior Friendly Hospital Committee at the NBRHC. “Older adults receive care throughout the entire hospital, so it’s important to ensure all staff are equipped with the knowledge and understanding needed to meet the current and future health care needs of our older patients.”

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The SFC Advocate Program was designed to build capacity in staff who were interested in adding to their skills and knowledge in providing quality care to older adults at the Health Centre. “This voluntary program allows participants to tailor their own learning around the core curriculum focused on delirium, functional decline and senior sensitivity,” Hewitt Colborne says. “It’s not only about gaining knowledge and skill, but also about participants applying their learning within their work setting and acting as a resource to peers.” In the first year over 90 staff members graduated from the program from across the organization and disciplines.

As a registered nurse (RN) in the Health Centre’s emergency department (ED), Kayla Budd knew it was important to take the program—seniors make up as much as 30 percent of the patients seen in ED, more than any other age group.

“Through the program I learned ways I could better approach the care I provide as a bedside nurse,” explains Budd. “For example, at one point I thought it was better to have lights dim so it wasn’t hard on their eyes, but in reality it was shown through the course that older adults need that extra light to properly see my face and read my facial expressions.”

The SFC Advocate Program is offered mainly online and runs twice a year with three months provided to complete the program requirements.  Budd credits this flexibility and the easy to follow modules for increasing her interest in the program.

“I work in the ED, I also have a part-time job with the university teaching on the medical floor and I am also currently working on my masters, so I’m pretty busy. The ability to learn from home or during down time was very helpful,” says Budd. “The program reinforced those little things we sometimes forget when we nurse, and I am now able to teach my students to increase the knowledge of the whole discipline.”

Hodge too found the SFC Advocate Program better prepared him to work with staff and identify quality improvement opportunities in his area.

“For me the reality of not being able to understand what was being said, and not being able to hear or see properly hit home during the frailty simulation. It showed me how important it is to have empathy and patience,” says Hodge. “It helped me recognize that while I want to make sure our senior patients remain as independent as possible, it might mean modifying my behaviour or their physical environment so they can reach their maximum potential.”

 

Taylor Grant is a Communications Assistant at North Bay Regional Health Centre.