Keeping dreams alive

519

David Kissoon discovered a passion for dance early in life. Though he chose to be a lawyer, David also pursued professional training in ballroom dancing. Today, he is proud of his two bronze, two silver and one gold medal, earned in competitions over the years.

David’s dancing was temporarily put on hold in 2001 when he was diagnosed with kidney failure. “All that was new to me, as I never was really sick before,” he says. In addition, he underwent a heart operation, after which he was in a coma for six and a half weeks. To help him regain his strength and mobility, his physicians suggested the hemodialysis rehabilitation program at University Health Network (UHN) and the Toronto Rehabilitation Institute (Toronto Rehab). Working diligently for another six and a half weeks, he was able to start dancing again.

Since 2002, UHN and Toronto Rehab have offered the only rehabilitation program in Ontario that provides a combination of hemodialysis and inpatient rehabilitation to older adults.

“Recent data shows that 55 per cent of patients on dialysis have difficulty doing one of these four basic tasks: bathing, dressing, getting up from bed and walking from room to room in their own home,” says UHN nephrologist Dr. Vanita Jassal. “Until this unit, patients needing dialysis were kept in acute care for rehabilitation, or not offered rehabilitation on a regular basis. As a result many went to nursing homes rather than back to their own homes.”

The program is designed for patients whose average age is 76 and who have complex and multiple health-care problems. For instance, a patient with kidney failure who has an ulcer and undergoes leg amputation requires complex care. About 98 per cent of patients admitted into the program come from acute care hospitals.

“This service integrates hemodialysis care for older adults with chronic kidney disease with a specialized program of rehabilitation to increase the person’s independence and quality of life,” says Carol Holmes, manager of Toronto Rehab’s Geriatric Rehabilitation Program.

One of the advantages of the program is that it offers daily dialysis, instead of the typical three times a week in-hospital service. According to Dr. Jassal, patients feel less tired and have more time for rehabilitation.

A patient’s rehabilitation begins with a comprehensive health assessment by a multidisciplinary team of specialists. The patients set the goals they want to accomplish and the team works together to help them. For example, a patient who has a hip problem and cannot bend down to put on their socks may be helped by a physiotherapist to increase movement of the hip, while an occupational therapist will teach the patient to use a tool to bend effectively.

“Another example,” says Dr. Jassal, “is a patient who is unable to get out of bed in the morning. We discovered that it was probably related to their medications. With the help of the doctor and the pharmacist we altered the medications, and the patient was able to get out of bed and walk around.”

When they are discharged from the program, patients themselves assess how much they have improved and how well they have achieved their goals. Staff also observe and measure patients’ achievements. Over the last three years, 76 per cent of patients successfully achieved their rehabilitation goals.

“When a patient tells us that their goal is to return home after the program and live independently again, the rehab team works with the person to be as successful as possible in achieving this goal,” says Holmes. “Our ultimate aim is for patients to manage their everyday activities as independently and safely as possible.”

Thanks to the UHN/TRI dialysis rehabilitation program, David Kissoon, like many others, can live a full and active life, and even dance. He comes to Toronto General Hospital three times a week, always sittling in the same chair in the dialysis unit. For three hours he is connected to a dialysis machine that removes the toxins and extra fluid from his blood, doing the work his kidneys would normally do. He spends this time exercising his legs on a bicycle and talking about ballroom dancing.

“Now that I’m riding a bicycle, and exercising my legs, I want to go back to dancing just for the fun of it. Little by little.”

David celebrated his recovery by giving his physician, Dr. Jassal, a lesson in ballroom dancing right in the dialysis unit.

“I’m trying to have a positive attitude towards life, trying to be as honest as possible, to be accepted by people as I am. And I’d love to share my passion for ballroom dancing with people.”