Therapeutic model enhances standards of care in geriatric psychiatry

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When Robert was advised that his wife Marlene, 72, who is living with Alzheimer’s disease, should be transferred from a long-term care facility to a mental health hospital, he was devastated. “I expected that she would be placed in a cell with a bed and four walls,” he says.

However, when he first arrived at Ontario Shores Centre for Mental Health Sciences (Ontario Shores) to tour the facility and speak with clinical staff in the Seniors Memory Disorders Unit, he was pleasantly surprised to see plenty of light and open space within the unit, throughout the hospital and its surrounding property.

Marlene came to Ontario Shores to receive the kind of patient-focused care that other long-term health care facilities were unable to provide. “Because of her illness, she had verbal and physical behavioural challenges, lashing out when anyone tried to assist her with simple day-to-day tasks,” Robert says. “You know it is the illness that is causing her to behave this way because by nature she is the kind of person who would not swat at a fly if it landed on this table – that’s just the kind of person she is.”

Over the last 60 days, Robert has come to Ontario Shores almost daily for several hours at a time to spend time with his wife, holding her hand and showing his love and support. “She may not be aware of why she is here or what her health issues are, but she knows something is different,” he says. “She often tells me ‘I just want to be normal again’.”

Today he is happy his wife is being cared for by a good team of health care professionals and pleased with the way Ontario Shores staff have been able to care for his wife and manage her behavioural challenges.

Robert is one more person whose perception about mental healthcare has changed.

“There is a misperception about senior mental health care,” explains Steve Mathew, Clinical Manager, Outpatient Services, Geriatric Psychiatry and Neuropsychiatry Program. “Many people believe seniors are here because they are getting old and no longer have the ability to function at home; but at Ontario Shores, we provide specialized care that is goal-directed, individualized and focused on helping each patient reach or maintain his or her potential and optimal wellbeing.”

As the aging population across Canada increases over the next twenty years and the number of people with dementia is on the rise, Ontario Shores is enhancing the standards of senior psychogeriatric care and introducing the province’s first Psychogeriatric Services Therapeutic Model for Inpatient Care.

“This therapeutic model was developed to strengthen customized psychogeriatric inpatient services at Ontario Shores,” says Sheryl Bernard, Administrative Director, Geriatric Psychiatry and Neuropsychiatry Program. “The ultimate goal is to achieve excellence in patient care and the highest quality of living for the older adult living with both medical and psychiatric disorders.”

The majority of senior patients at Ontario Shores are over 65 years of age who live with dementia or some form of memory loss that is persistent and interferes with daily functioning.

“The therapeutic model allows us to give hope to people like Robert, who, like many loved ones, struggle with the impact of this disease,” Mathew explains. “Our staff often provide more than clinical care to our patients – they provide education, information and counsel to family members and loved ones as they try to cope with and understand the illness and associated symptoms.”

The therapeutic model involves educational and best practices initiatives which provide staff with the necessary tools and training to help guide patients and families through Ontario Shores’ collaborative recovery model, bringing a sense of hope for patients and families.

In addition to mental healthcare, Ontario Shores interporfessional teams provide assessment and care for physical and medical issues that are common among seniors.

The therapeutic model for pshychogeriatric care was developed by a best practices working group at Ontario Shores and is based on several guidelines including the Canadian Coalition for Seniors Mental Health, the Canadian Consensus on Dementia, the Registered Nurses Association of Ontario Best Practices Guidelines and the American Psychiatric Association.