Every Tuesday morning Patricia Jose and Rosamund Claire Moore of the Volunteers Involving Seniors in Activities (VISA) program flip through a binder at the Geriatrics Unit nursing station at St. Michael’s Hospital. The binder lists the names of patients in the unit who want a visit from a volunteer, with comments about their interests and how best to approach them.
“Sometimes when we come in the nurses warn us that a patient isn’t very happy, but we always check in anyways,” says Jose. “Most of the time they recognize my face and are genuinely happy to see me.”
The VISA program was launched at St. Michael’s in 2012 by volunteers and two staff members in the Geriatrics Unit. The program focuses on social visits and activities with older patients as part of the patient’s therapy and to prevent delirium, a form of acute confusion that can be brought on by isolation and detachment during a hospital stay.
Delirium is a common issue in elderly patients who are hospitalized. Disruption in routine, unfamiliar surroundings and lack of regular social contact can result in acute confusion and disorientation, or delirium.
“When I was first in the hospital I was confused and disoriented, going off on tangents when I spoke,” says Helen Hutchinson, one of the first Canadian women in television and a patient in the Geriatrics Unit. “Nothing is familiar and you start to blame yourself for being confused.”
Hutchinson became a patient after a fall and subsequent head injury. Usually a very sharp and active senior, she found she was confused and had trouble focusing for the first few days in the hospital. The VISA volunteers began to drop by for a visit after rounds, at first to make sure Hutchinson had everything she needed, then to chat and listen to her incredible life stories. She now greets Jose and Moore like old friends, slipping easily into conversation about her travel plans in the next few months that include Chile, Florida and Los Angeles.
“The volunteers visiting and chatting has been wonderful – there’s someone to talk to when you’re here for a long time,” says Hutchinson. “It has helped me focus and become myself again, especially after a fall where I had a head injury.”
The VISA initiative was adapted from the Hospital Elder Life Program, an American program developed for older patients who have been hospitalized. Similar programs have been proven to shorten hospital stays, increase cognition and generally improve patient mood and happiness.
The volunteers make social visits and do activities with patients, ranging from 30 minutes to two hours. They try to engage seniors in purposeful conversation, reminisce or play games. One volunteer even helped a patient write her memoirs over the summer. The patient had started the story of her life but the contents were lost in a fire. The volunteer visited her three times a week to listen to her stories and help with the dictation. Together, they filled multiple binders with her memoirs, despite the patient’s hospitalization and limited mobility.
“Many patients have routines and things they like to do when they’re at home, like keep a diary or a journal,” says Jose. “We had one patient who loved poetry so we brought in some poems and she recited them from memory to me for hours at a time. It was fantastic.”
Volunteers converse and interact with patients about their lives and memories to keep their minds grounded in the present and stave off delirium. The program purchased an iPad for patients to communicate and interact beyond the hospital walls, which has been hugely popular with tech savvy seniors.
“Even with all the available activities, I find that most patients just want to talk or have someone to listen,” says Moore, a VISA volunteer. “I have patients asking when I’ll be back next or planning for the next time. I think they very much look forward to it because it’s a bit of normalcy.”
The program has received positive feedback from staff, relatives and patients. The program includes family education, where volunteers coach relatives on how to prevent delirium using VISA activities and conversation.
“I feel that I’m doing something good for these patients, even though I’m often just listening” says Moore. “I help to pass a few hours in the day or I’m a human connection for someone. We help a patient to also be a person.”