York Central Hospital is at the heart of a rapidly growing and changing community and one of the first hospitals in Canada to introduce an exciting new approach to care that is helping achieve better outcomes for hundreds of hospitalized seniors. Originally developed at Yale University in Connecticut, United States, York Central has modified the program to best meet the needs of patients and the dedicated volunteers who support it.
Located in York Region, just north of Toronto, the local population has dramatically increased in recent years and with the current building boom the population will continue to increase rapidly in the coming years. Although seniors over the age of 65 years currently represent only 9.5 per cent of the region’s population, at the hospital they represent 28 per cent of total hospital admissions and 63 per cent of bed days. In the next 10 years, it is predicted that the senior population in the region could increase by 55 per cent.
The hospitalized elderly are a particularly vulnerable group because of their complex chronic conditions and special needs. Research has shown that the hospitalized elderly experience functional, cognitive and physical decline more easily than the rest of the population. This decline can lead to increased mortality, higher rate of institutionalization and greater health expenditures.
To assist the elder population during their hospital admission, York Central Hospital implemented the Hospital Elder Life Program (HELP) in January of 2007. The program focuses on patients over the age of 70 who have shown signs of the onset of delirium. It is an innovative, friendly, visitor volunteer initiative designed to enhance the care of older adults while they are hospitalized. HELP is a quality enhancement program whose mission is to prevent older patients from experiencing a decline in both their physical and mental/cognitive abilities during their hospital stay.
Unlike dementia, delirium has a sudden on-set that, if caught and treated on time can be reversed. Delirium and functional decline are common and potentially preventable conditions caused by several factors such as immobilization, sleep deprivation and medication side effects.
“Our patients and staff say they are very happy with the volunteer HELP visits,” says Tatiana Diamond, Manager of the hospital’s Continuing Care Program. “It has made a real difference in the lives of many admitted seniors. It helps to keep the patients’ minds as sharp as possible and reduces the need for nursing staff to spend additional time visiting while their other patients are waiting for care.”
Volunteers use simple low technology interventions such as getting the patient to sit up, move around, placing things within easy reach and daily orientation. Volunteers also spend time with patients reading books, listening to music and playing board games.
The program is supported by a dedicated Elder Life Specialist (ELS) and 39 specially-trained volunteers. Volunteers are able to assist patients seven days a week including shifts Monday to Friday from 8:30 a.m. to 8:30 p.m. and 11:00 a.m. to 8:00 p.m. on Saturday and Sunday. Volunteers speak 16 different languages, which assists greatly when working with patients who may not speak English as their first language.
After assessment by the ELS, volunteers begin visiting those patients who had been identified as at risk for delirium or showing signs of the on-set of the condition. The goal of the program is to reverse the effects of delirium and where possible, to eliminate it completely. “Our volunteers have expressed great satisfaction with their placement as HELP volunteers,” shares Karen Andersen, Director, Volunteer Services. “The one-on-one connection with the patients really helps them feel connected to their community and their role within their local hospital.”
Before beginning any volunteer placement at the hospital, volunteers are thoroughly screened and participate in hospital orientation which includes training on confidentiality, infection control, basic wheelchair handling, safety codes, and a hospital tour. All HELP volunteers receive 12 hours of classroom training and 16 hours of on-unit training under the direction of the ELS with mentoring from experienced HELP volunteers. Retention of volunteers in this program has been phenomenal. Of the original 13 volunteers, only 3 have left the program and all were due to either employment or education (university) opportunities. The team is always growing and expanding, enriching the hospital experience for elderly patients at the hospital.
York Central Hospital is the second Canadian hospital and the first community-based hospital in Ontario to implement HELP. In its first full year of operation HELP was only available on two units within the organization. One is a medical unit and the other, an alternative level of care unit. In that time, HELP assisted 211 patients and the average age of patient was 81.1 years old.