home & longterm care

Finding the best home healthcare

Reliable information on healthy aging

Long term care planning

April 2016 www.homeandlongtermcare.ca

A world of difference

Telehomecare

See full story page 10

2 Home & LongTerm CARE | April 2016

Cover story: Telehomecare makes a world of difference

4 Editor’s note

5 Virtual tour videos of long term care homes

16 Long term care planning

21 Home care: is it covered by the government?

30 Caregiver SOS

31 End-of-life care in ontario gets better

April 2016

24 26

14

10

Finding home healthcare

Dementia caregiving

Music and memory

Getting care in a crisis6Reliable info on

healthy aging 8Seniors: Poison prevention

18


WITH THE FIRST ISSUE of Home & Long Term Care under our belt (March issue), we were excited for the feedback from readers and caregivers across Ontario. You didn’t disappoint! I would like to extend a personal thank-you to each and every one of you who sent an email providing feedback on the new magazine. It has been overwhelmingly positive and we have also received some great suggestions on articles for future issues.

Home & Long Term Care Magazine is dedicated to becoming your number one resource for information on caregiving. It is our goal – with every issue – to provide you with information that will assist you in your caregiving journey. Every month you will find tips and expert advice on a range of caregiving topics and challenges.

This month’s cover story focuses on telehomecare and how it is making a world of difference in the lives of so many Ontarians who are avoiding trips to doctor’s offices and long waits in waiting rooms thanks to technology that allows them to remain where they want to be – at home.

In this issue you will find a wealth of information on how to deal with caregiving challenges such as: getting care in a crisis; covering the costs of homecare; how to find the best homecare; and tips on preventing poisoning in seniors.

We always welcome your feedback and comments. To receive a digi-tal copy of Home & Long Term Care Magazine right to your inbox send your full name to [email protected]

Kristie JonesEditor, Home & Long Term [email protected]

Editor’s Note

Home and Long Term Care is published for consumers who are supporting and/or involved in home care or long term care. It is available free of charge from distribution racks in hospitals across Ontario.

The statements, opinions and view-points made or expressed by the writers do not necessarily represent the opin-ions and views of Home and Long Term Care, or the publishers.

Home and Long Term Care and Members of the Advisory Board assume no responsibility or liability for claims, statements, opinions or views, written or reported by its contributing writers, including product or service informa-tion that is advertised.

Changes of address, notices, subscrip-tion orders and undeliverable address notifications, and inquiries can be sent to: [email protected]

Subscription rates in Canada for single copies is $35.00 per year.

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April 2016 | Home & LongTerm CARE 5

PATIENTS AND FAMILIES can now access a new resource that will allow them to preview 68 Long-Term Care Homes in the Central East region, all from the comfort of their own home. The Central East Community Care Access Centre (CCAC) has developed the informational videos in collaboration with our Long-Term Care Home partners, to assist patients and families as they plan for the future.

The videos offer a glimpse of each of the Long-Term Care Homes in the Central East region, which includes homes in the Scarborough,

Durham Region, Northumberland, Peterborough, Trent Hills, Kawartha Lakes and Haliburton areas. Each video includes a preview of the exterior of the homes, the types of accommodations available and some of the special features that each home offers.

“The virtual tours of Central East’s 68 Long Term Care homes will increase the public’s ability to view the homes, especially for those who are not able to physically get out and tour,” says Lisa Mizzi, Program Director at the Central East CCAC. “It is anticipated that the virtual tours will assist the public in their decision making when long-term care is being considered.”

The videos are available on the Central East CCAC website, YouTube channel, and on CentralEastHealthline.ca. LC

New virtual tour

support patients and families planning for Long-Term Care

Longegion, rough,rough,areas. of thele andoffers.

Term o view

ableizzi, t is e

ral nd on

videos


IN A SEA OF HEALTH INFORMATION, it can be challenging to navigate the waters and find what’s credible and relevant. Furthermore, not all research findings apply to older adults – a population that may react differently to treat-ments and may have different needs.

Luckily, there are several good resources to turn to. Three Canadian organizations – The Canadian Agency for Drugs and Technologies in Health (CADTH), RxFiles, and McMaster University — are focusing on health evidence for older adults and have made the information publicly available.

CADTH has bundled its research reports and reviews on the topic of long-term care in a new section of its website for easy access: www.cadth.ca/long-termcare. Here you can browse the evidence by top-ics such as falls and bone fractures, mental health, pressure ulcers, nutrition, and more.

RxFiles has developed a repository of information on long-term care and residential care, drawing from its own reports and brokering CADTH work: www.rxfiles.ca/ltc. To make it user-friendly, the information is sorted by category for health care providers, long-term care administrators, and resi-dents and their families.

McMaster University has launched the McMaster Optimal Aging Portal which fea-tures evidence-based information about

By Kasia Kaluzny

healthy agingReliable information on

and long-term care


healthy aging for seniors and their caregivers: www.mcmasteroptimalaging.org. Along with blog posts and evidence summaries, the Portal also rates the quality of online health information based on a 5-star rating system. You can also sign up for weekly email alerts when new content is available.

If you are someone who needs to make decisions about the health care of an older person, it’s impor-tant that you have credible, objective evidence to inform your decisions. These three websites provide a trusted gateway to health information, with a shared goal of improving health and health care for older adults. Hopefully you will find the information contained there useful. LC

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If you are someone who needs to make decisions about the health care of an older person, it’s important that you have credible, objective evidence to inform your decisions.


FROM CHOKING HAZARDS TO DANGEROUS CHEMICALS, many people know how to poison proof a home for a baby. But what about poison proofing for grandma and grandpa? Seniors and older adults are also at risk for poisoning, in par-ticular when it comes to medications.

National Poison Prevention Week is recognized each year during the third week of March by poison centres across North America. This year the Ontario

Poison Centre (OPC) focused on raising awareness of the issue of poisoning in seniors and older adults.

Canadians are living longer than ever before, and as developments in prescription medications continue, more Canadians are living with chronic conditions. This means more seniors are taking multiple regular medications for longer and longer periods of time. The number of calls OPC has received from this age group has increased over the past 10 years; the call

Carolyn Gooderham is a Communications Specialist at the Ontario Poison Centre.

Carolyn Gooderham

Seniors are also at risk

Prevention is not just for kids:

Poisoning


centre received over 8,000 calls from adults over the age of 60 in 2015.

“We worry particularly about seniors living in independent-living environments. They’re manag-ing their own medications and over time it’s very likely they will make a mistake at some point. We want these seniors and older adults to know they can call us if they think they may have mixed up their medications, or if they just have a question,” says Heather Hudson, Advanced Practice Nursing Educator at OPC.

Dr. Joanne Ho, Geriatrician and Clinical Pharmacologist at Grand River Hospital in Kitchener-Waterloo and former fellow of OPC, researches adverse drug events in the older patient and is inter-ested in the demand for expert toxicological service for this vulnerable population.

“As our population ages older adults with adverse drug events are more likely to require hospitalization and to experience cognitive and functional decline. Their burden of medical illness also increases the risk of death following a poisoning. Understanding the demand for the services OPC provides is neces-sary as we look to prudently allocate health care resources in the future,” says Ho.

Medications are by far the most common substance about which the Centre receives calls in this age group.

Unintentional poisonings in seniors and older adults can be prevented by taking some simple precau-tions. It’s important to keep in mind that while many of the recommended poison prevention strategies for children ring true for an older age group, many seniors have greater strength and capabilities. If an aging parent or grandparent starts to exhibit symp-toms of memory loss or confusion there are other risk factors to consider. A confused senior may still be able to open a child resistant bottle if they have done so in the past.

For more information and poison prevention tips, visit www.ontariopoisoncentre.ca and follow @ON_Poison on Twitter. LC

Poison prevention tips for seniors and caregivers• Post the Ontario Poison Centre phone

number (1-800-268-9017) in an accessible place or save it in the contact list of a mobile device.

• Turn on lights and wear glasses, if required, each and every time a medication is administered to check for the right pill and the right dose.

• Use a pill organizer to keep track of mul-tiple medications. But remember, these organizers are not child resistant. If you have children in your environment, be sure to keep any medicines locked up tight and out of sight.

• Ask questions about medications at med-ical appointments so there is a clear understanding of why the medication is prescribed, how it should be taken, and how often.

• Keep a medication card up to date with information about all prescription medicines, over-the-counter medicines and dietary or herbal supplements taken regularly. Carry this card at all times, and keep it with a driver’s license or health card. This information helps health-care providers make informed decisions about care in the event of an emergency.

• Keep cleaning products in their origi-nal containers. Seniors with memory loss or suffering from confusion or dementia could cause serious harm to themselves by ingesting these products.

• Be aware that depression can develop in older adults and seniors. Talk to friends and family members about mental health to help avoid intentional poisoning.


FOR 86-YEAR-OLD ULLA JENSEN, it’s “great peace of mind”. For her 91-year-old husband of 67 years, Otto, it’s the hours not spent travelling to or in a doctor’s waiting room. “It’s the best thing that ever happened,” he says.

For nearly 9,000 Ontario patients with chronic conditions, Telehomecare health coaching and remote monitoring has reduced hospital stays and emergency room visits by more than 50 per cent as well as reduced unnecessary visits to their primary care provider by more than 45 per cent.

Developed and overseen by the Ontario Telemedicine Network (OTN), Telehomecare is funded by the Ministry of Health and Long-Term Care and Canada Health Infoway and is a program of Ontario Local Health Integration Networks (LHINs), delivered through hospitals or Community Care Access Centres. Information about where it’s available can be found at OntarioTelehomecare.ca.

Otto and Ulla aren’t alone in their enthusiasm for Telehomecare. A recently completed survey

of patients found that more than 94 per cent of patients felt Telehomecare improved their ability to self-manage their condition and 88 per cent said it improved their quality of life.

The program puts easy-to-use monitoring equip-ment into the homes of patients who check their vital signs daily. Results are monitored remotely by specially-trained clinicians who watch for signals that the patient’s condition is worsening. Patients also answer a few questions on a computer tablet about how they are feeling. More importantly, the clinician provides education and coaching which teaches patients how their lifestyle habits – food, sleep, exercise – affect their health.

The OTN Telehomecare patient experience survey found that 95 per cent found the technology easy to use and 99 per cent were satisfied with the quality of care and coaching they received.

“The right care in the right place at the right time is the mantra – and the mission – of a health care system transforming itself to meet the needs of an

Sharon Rose Airhart is the Telehomecare Communications Lead at The Ontario Telemedicine Network.

TelehomecareA world ofdifference:

By Sharon Rose Airhart


aging population,” says Dr. Ed Brown, CEO of OTN. “Telehomecare is a perfect example of that value in practice.

“More than 90 per cent of people want to stay in their own home – age in place – if they can,” Dr. Brown says, “but changes in health could necessi-tate a move. For example, more than 80 per cent of Ontarians over the age of 45 have at least one chron-ic condition. We know that chronic conditions, if not closely managed, may worsen, leading to emer-gency room visits and hospital stays. Telemedicine – remote monitoring like Telehomecare – is one of the easiest and most practical ways to ensure people have the best possible quality of life and are able to remain at home.”

According to the Change Foundation, 29 per cent of the provincial population – or 3.3 million people – provide some form of support, assistance, care or enrichment to a family member or friend.

Continued on page 12


That quality of life improvement extends to volun-teer caregivers like Ulla Jensen. According to the Change Foundation, 29 per cent of the provincial population – or 3.3 million people – provide some form of support, assistance, care or enrichment to a family member or friend. Telehomecare saves family caregivers nearly 10 hours a month of travel time according to the recent survey, roughly equivalent to the travel time patients saved. It also provides that “great peace of mind” that Ulla talks about.

“I feel more secure staying in my home alone now that I have this service. I am very grateful for it,” one patient wrote in the recent Telehomecare survey.

A caregiver responded that “the service gave my mother the opportunity to recover in the comfort of her home. This was a major contributor to her recovery. It was also a great relief and support for caregivers to help recognize and control potential crisis/anxiety in this serious condition. It gave us hope that my mother would survive her illness (and we) realized this result. Always received quality advice and speedy assistance! Thank you!”

As for Otto and Ulla, Telehomecare made such a difference in their lives that they were able to travel to Copenhagen last spring to visit family in the city where they met nearly seven decades ago. LC

Continued from page 11

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What you need to know about crisis placement into long-term careMany Ontarians want to remain living indepen-dently in their home as long as possible. But a sud-den change in health status, due to injury or illness, can mean that someone who was previously able to live at home, alone or with the help of family, is no longer able to safely do so.

When home and community care is not enough, long-term care may be the answer, and a crisis placement may be necessary to find a bed as quickly as possible.

in a crisiscareGetting


How do you know if you qualify for a crisis placement? You need to be assessed by a care coordinator at your local CCAC. Health care providers may indicate their expectation that you or your loved one require a crisis placement. But while they understand your health care needs, they may not understand the wide range of services now available for people who wish to remain at home. A CCAC care coordinator will meet with you, conduct a detailed assessment into your healthcare and needs, and decide if you qualify for long-term care, and a crisis placement. He or she can also tell you about other options and services available to you while you wait, or as an alternative to long-term care.

Long-TermCare in OntarioLong-term care homes are a residential option for people with high care needs, who meet the following criteria:

• Have health-care needs that can’t be met with any combination of caregiv-ing in the home or community

• Have health-care needs that can be met in a long-term care home

• Are 18 years of age or older

• Have a valid Ontario Health Card

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WE ALL TAKE DELIGHT in planning for vacations and holiday celebrations but when it comes to planning for old age, we literally run the other way. Aging and death only happen to other people, and therefore we don’t need to talk about it – at least not yet. Why is this?

• Canadians have an attitude of entitlement; I am a taxpayer and therefore the government is responsible for caring for me in my old age

• It won’t happen to me• My spouse will look after me• The kids will look after me

The reasons we should care about aging are obvious:• The first wave of Canada’s 10 million boomers

started turning 60 in January 2006• 1000+ people turn 65 every day• By 2038, over 1,125,200,000 Canadians will have

Alzheimer’s disease or a related dementia unless a cure is found before then.

These realities make it abundantly clear that we all need to plan for old age – and not just finan-cially. We need to understand the health care system

where we live, plan where we wish to age and live out our lives, and communicate our wishes to family members and health care providers.

The bottom line: Long term care planning needs to be a part of every financial and/or retirement plan written today.

Here’s how to begin:Step one: Understand and accept the need to plan.

Step two: Understand the health care system and care settings and services where you plan to live as you age.

Step three: Know whom you can count on for care and support, both from your family and from health care professionals.

Step four: Talk with your family about what you want – hold a family meeting. Understand your fam-ily history and what chronic conditions you have or may face.

Step five: Establish clear legal directions. Complete a will, Powers of Attorney and make copies available to those who need them.

By Karen Henderson

Long term care planning:

What is it and why

should I care?


Step six: Gather all critical personal, health, legal and financial information and store it in one place for easy access

Step seven: Make a care plan that covers the ‘what ifs’.

Step eight: Communicate the plan to your family and update it every year.

Creating a care plan will take time and effort, but once it is completed, you will have accomplished two very important goals:

1. You will have added the missing piece to your financial/retirement plan.

2. You will have removed a huge burden from your family; over time you will be thankful that you took the initiative to plan ahead.

As the saying goes: Just do it! LC

Karen Henderson, founder of the Long Term Care Planning Network is an independent aging and long term care

planning specialist, speaker, writer, researcher and consultant. Karen has worked with many families to help them make

care decisions, and has created unique Canadian educational tools, including The Ten-Step Long Term Care Planner.

You can reach Karen at 416.526.1090 or [email protected]

By 2038, over 1,125,200,000 Canadians will have Alzheimer’s disease or a related dementia unless a cure is found before then.


FOR MANY CANADIANS, caring for a loved one – although filled with compassion and love – can feel like a full-time job.

Our current pubic health care system is not able to provide families everything they need, requiring more families to shoulder the responsibilities of finding, managing and paying for home healthcare. Canadians are highly invested in caring for their loved ones. More than 25 per cent of us are involved in providing informal care for a family member or close friend, and over 500,000 Canadians pay for some form of private healthcare at home.

Over the past 20 years the Canadian health care and social service sector has experienced many challeng-es and changes that necessitate the need for better coordinated care teams, improved communication tools and the adoption of innovative technology to support better healthcare outcomes. The following tips are designed to help families and patients evalu-ate the best home healthcare options to meet their

needs. Consider the following “7 C’s” for Finding the Best Care. Start by asking if the home health care provider you are interested in offers the following:

1. Comprehensive care options. Patients often have a diverse set of health care and social service needs, so look for a care provider that offers a comprehensive range of caring profes-sionals, delivering the full spectrum of services and advocacy resources in a ‘one-stop-shop’.

2. Choice of caring professionals. Each person’s care is unique, requiring a personal-ized and custom approach to care. It is important that your care provider offers you direct opportu-nities to interview, select and hire the best caring professionals that meet your care needs.

3. Control over care. Look for a care provider who welcomes your voice and direct input into the development of care plans,

for finding the best home healthcare 7 C’sThe

More than 25 per cent of us are involved in providing informal care for a family member or close friend, and over 500,000 Canadians pay for some form of private healthcare at home.

By Janet Balfour


service delivery options and outcome evaluations. Involving family and patients in their own care is proven to deliver better health care outcomes.

4. Communication tools. Caring is often a team effort. Effective communica-tion between patients, friends and family, as well as professional care teams is critical for delivering qual-ity care outcomes. Look for care providers that offer easy online communication tools, with Facebook-like functions, but offer security and confidentiality features that are specifically designed to support the sharing of sensitive health care information.

5. Coordinated care. Being an effective patient advocate requires coor-dinating care plans, care teams and care outcomes. Look for care providers who offer effective tools and resources to support you with the planning, sched-uling, budgeting, payment and delivery of care on your laptop, tablet and phone.

6. Cost of care. Look for care providers who are dedicated to offer-ing the lowest possible rates for home healthcare options, while ensuring the highest possible wages for quality caring professionals. You want to ensure that as much of your family’s budget goes directly to the cost of care.

7. Caring approach. Seek care providers who are dedicated to empowering patients and families to be the best advocates they can be for themselves and their loved ones.

Many individuals and families want more afford-able, transparent care options, as well as innovative digital tools that offer cost savings and online sup-port for care. These easy to remember tips can help you better assess the fit between your care needs and the approach of various home healthcare ser-vice providers. LC

Janet Balfour, PhD, RSW & President of eAdvocate.com



How long will it take?Typical waitlists for long-term care are 150-300 days, depending on the facility. But a crisis place-ment means that there is an immediate need for admission, so wait times are reduced, sometimes to as little as one week.

Once a bed becomes available, you have 24 hours to accept, and must move in within five days.

Making choicesUnder normal circumstances, you can request five long-term care homes, anywhere in the province. When you are assessed as needing crisis placement, you are able to list as many as you wish.

You may not get your first choice, but remember, with a crisis placement, your safety is everyone’s first concern. You can accept and still keep your name on the list of your preferred home. You will no longer be considered a crisis placement, but you will be waiting in a facility that provides the care and support you require.

However, if you decline a bed offer, your placement file will be closed and, under Ontario legislation, you will have to wait three months to reapply.

Financial considerationsThere are fees for all long-term care, and it’s impor-tant to be realistic when making your selections.

Not surprisingly, a private room costs more than a room shared with one to three other people. Subsidies are available, but only on basic (shared) rooms.

CaregiversProviding care to a loved one can be exhausting, physically and emotionally, and many caregivers, especially spouses or siblings, may have their own health challenges. But caregiver burnout is not usu-ally a cause for crisis placement.

Instead, there is support to help caregivers avoid getting to this point in the first place. Respite care provides care in long-term care homes for up to 60 days, or 90 days throughout the year. This can allow a caregiver to take a trip, visit family or friends, or just rest.

There are some circumstances, such as the hos-pitalization or death of a caregiver, when a crisis placement of a dependent family member may be appropriate. LC

Getting care


CANADA IS HOME to more than 1.8 million seniors. As Canada’s fastest growing demograph-ic, seniors face unique health and financial chal-lenges. Some seniors may find themselves recov-ering from a fall, while others may be returning home from a hospital stay. Both scenarios may suddenly require home care, and with that comes concerns about how to pay for it.

“Many Canadians believe that full-time care will be fully paid by government health care programs,” says Bruce Mahony, of Home Instead Senior Care Toronto. “However, the truth is that government health care programs may cover only a small part of the cost or not at all in some cases.”

In a study released in June 2015 by the Ontario Securities Commission on the top financial concerns of older Canadians (entitled Financial Life Stages of Older Canadians), unexpected financial crises that disrupt savings and planned retirement spending are far more common than the OSC anticipated.

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By By Mary Ann Freedman

Home careIs it covered by the government?



One of the most common events that disrupts retire-ment plans is paying significant health care expenses for oneself or a family member.

“Clients and their families generally don’t know the funding options available to them,” says Scott Johnson, of Home Instead Senior Care in Halton. “Families often look to us for information about the existing financial options.”

Here are some ways to help cover the costs of home care, with less financial burden to the senior and the family.

1. Community Care Access Centre. Funded by Ontario’s Ministry of Health and Long-Term Care at no direct cost to patients, CCAC assesses patients’ clinical and support needs and delivers specialized health care services to help patients maintain inde-pendence in their own homes safely.

2. Veterans Affairs (Federal). If your aging mother or father is a veteran, the Department of Veterans Affairs will provide funding for home care and per-sonal care, but only for those vets who served over-seas; however, many people don’t know this. The surviving spouse of a deceased veteran is not eligible for assistance unless the veteran was receiving some form of care before death.

3. Downsizing. If your aging mother or father lives alone in their home, it may make sense for them to sell and move to a more practical apartment or condominium. Then they can invest some of the proceeds from the sale of their home into home care.

4. Home equity line of credit. Your parent’s home can be their largest asset. It can also be one of their most powerful financial tools because home equity gives them access to a wider variety of borrowing options. The more they have paid off, the more

home equity is available. That value can then be used as security for a loan or line of credit. Loans and other forms of unsecured credit may always be an option, but using their home equity has unique advantages available to homeowners.

5. Reverse mortgages. If your aging parent is a home owner, they can sometimes take equity from their home to finance home care.

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Home care “Canadians need to look at their finances differently as they age. Less government spending, longer life expectancy, and family dynamics are just some of the issues that impact finances as we grow older,” says Nathan Kupusa, President of Solutions for Aging. “Canadians should look for advisors who specialize in the senior marketplace.”


6. Extended Health Insurance. wwThere are many options for extended health coverage. While cover-age varies from plan to plan, this option can help fill in the gaps in your senior’s home care.

“Canadians need to look at their finances differently as they age. Less government spending, longer life expectancy, and family dynamics are just some of the issues that impact finances as we grow older,”

says Nathan Kupusa, President of Solutions for Aging. “Canadians should look for advisors who specialize in the senior marketplace.”

It is time to start thinking about retirement plans and how important it is to save for health care need-ed later in life, including residential long-term care. Government resources are likely to not be enough. Families need to know what the options are. LC


ONE IN FIVE CANADIANS aged 45 and older are caregivers to seniors living with long-term health problems. This means that while you are a caregiver, you likely know others who are too. Caring for a family member can be a rewarding experience but it’s also common to feel physically and emotionally exhausted. It may seem difficult to ask for help, but it’s important to remember that you aren’t alone.

The Alzheimer Society offers support groups, coun-selling, workshops and other resources in commu-nities across Canada. They can also connect you with day programs or respite care when you need a break. Access to support in your community and from friends and family can help you feel good about the care you provide.

Read Rina’s story, and to find your local Alzheimer Society and more information about

Alzheimer’s disease and other dementias, visit: www.alzheimer.ca

Rina Clark was a self-described people person before becoming a caregiver for her husband David, who has Alzheimer’s disease. Twelve years later, Clark is still very social, with a close group of friends who have “stood by me and propped me up,” she says.

The fact she’s the same person she was before David’s diagnosis may seem self-evident. But it’s a message society often forgets, says Clark, 68. Caring for someone with dementia can be all-consuming, but it isn’t all-defining.

That’s not to say Alzheimer’s disease hasn’t taught her important and often difficult lessons. For the first six months after David’s diagnosis, she couldn’t even say the word Alzheimer’s.

“David was a high school physics, chemistry and calculus teacher,” says Clark. “I called him my walk-ing encyclopaedia. I used to joke I married him for his brains.”

Watching his facility with numbers and words deteriorate was especially hard. So she decided she would “build memories” for him. They travelled to Egypt to see the pyramids, to China to see the Great Wall, and went on safari in east Africa.

Caring for someone doesn’t mean having to go it alone

Dementia

Caregiver Tips

LEFT: David and Rina Cark.


One in five Canadians aged 45 and older are caregivers to seniors living with long-term health problems.

Submitted by the Alzheimer Society of Canada.

In between, she learned all she could about drug tri-als and enrolled him in some of the more promising ones. She identified the best Alzheimer’s doctors and got him on their patient lists, even if it meant regular trips from their home in Sault Ste. Marie to Toronto.

“I was always trying to control it, but I couldn’t do it,” she says. “I learned life is a series of adjustments with Alzheimer’s disease.”

Instead of trying to control things, she now feels the way forward is to let her friends help her, and help

David. One friend picks up David every Wednesday for an outing. Someone else stops by after her yoga class to feed him. Others regularly take her out for coffee, a walk, or a movie.

Even a simple card in the mail, letting her know she isn’t alone can make a big difference.

But because Clark is a people person, she knows that when friends ask what they can do, the onus is on her to tell them what she needs. Often, she says, the answer is quite simple: ask how she is and listen. LC


Bruyère’s Music and Memory program is literally music to patients and residents’ ears; enhancing their lives and transforming care.

It all started in the spring of 2014, when Therapeutic Support Services staff at Bruyère participated in webinars so that Bruyère could become a certified Music and Memory site. This initiative caught the attention of Angela Paric, a PhD candidate and a volunteer at Bruyère.

Angela developed a research project to measure the benefits of music and all that jazz. Eight patients in complex continuing care at Saint-Vincent Hospital participated in the study. Among them is Janet, born in London, England, a big fan of Michael Bublé.

“On days when I have really been in agony, I put a tune on and hear that nice music. I listen to it and sing along, it helps. It stops me from getting to that dark place,” explains Janet.

Anne-Laure Grenier is a Communications Officer at Bruyère.

Music and

By Anne-Laure Grenier

memory program


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Overall, results showed reduced negative emotions and increased life satisfaction. This, along with qual-itative evidence, suggests that personalized music listening positively affects complex care patients’ well-being.

This study was the prelude to implementing the Music and Memory Program on other units and in other programs at Bruyère. Soon, over 100 iPods fine-tuned to each patient’s taste will be in circulation.

A personalized playlist does wonders for the soul. It awakens, captivates, distracts and most of all, brings back memories. In some cases, people resume their identity through the power of music.

“It’s amazing how music reminds you of cer-tain things in your life. Some songs make you sad, some make you happy but you can always put yourself in a certain place with music. The sound that you get from the little iPod, it’s just unbelievable,” reveals Janet. LC

On days when I have really been in agony, I put a tune on and hear that nice music. I listen to it and sing along, it helps. It stops me from getting to that dark place


Look around you. Have you or your loved one been touched by the care and compassion of an outstanding nurse? Do you know a nurse who has gone above and beyond the call of duty? Now is your chance to acknowledge and recognize the nursing heroes in your facility or community.

Hospital News will once again salute nursing heroes through our annual National Nursing Week (May 9th to 15th) contest. We hope you will share your stories with us so that we can highlight the exceptional work that our nurses are doing and how they touch our lives.

Nominations can be submitted by patients or patients’ family members, colleagues or managers. Please submit by April 15th and make sure that your entry contains the following information:

Hospital News’ 11th Annual Nursing Hero AwardsNURSINGHEROAWARDS!

11 th Annual

Please email submissions to

[email protected]

• Full name of the nurse • Facility where he/she

worked at the time • Your contact information• Your nursing hero story

NOMINATE A NURSING HERO!

or mail to: HOSPITAL NEWS 610 Applewood Crescent Suite 401 Vaughan, ON, L4K 0E3

www.hospitalnews.com

TUESDAY APRIL 5 is National Family Caregiver Day – an important milestone to recognize the estimated 8.1 million Canadian family members, friends, and neighbours who take on a caring role. Family caregivers support people with diminishing physical ability, debilitating cognitive conditions and/or chronic life-limiting illnesses. This special day encourages all Canadians to pay tribute and recognize the valuable contribution of family caregivers to our lives and society.

Locally, the Ontario Caregiver Coalition (OCC) advocates for Ontario’s family caregivers. Upon the

OCC’s request, MPP France Gelinas introduced a Private Members Bill to create a Family Caregiving Day in Ontario. This would fall annually on the first Tuesday in April and would coincide with National Family Caregiver Day. The OCC is looking for resi-dents across Ontario to bring forward petitions to their local MPP in support of an Ontario Family Caregiving Day. For more information please con-tact Lisa Levin, Chair, Ontario Caregiver Coalition [email protected]

For more information on National Family Caregiver Day go to www.carerscanada.ca LC

Attention caregivers!

The OCC is looking for residents across Ontario to bring forward petitions to their local MPP in support of an Ontario Family Caregiving Day.

MARTHADIDN’T HAVE TO GO TO THE HOSPITAL TODAY.

geriatrics.otn.ca ontariotelehomecare.ca

With Telehomecare and other virtual healthcare programs, like

the Ontario Geriatrics Learning Centre, the Ontario Telemedicine

Network supports home and community care. OTN is a non-

profi t organization supported by the Ontario Ministry of Health

and Long-Term Care and Canada Health Infoway.



Caregiver SOS

My elderly mother plays head games. “You never call, you never come over,” she’ll say. She is always trying to guilt me into visiting more often. How do I tell her to stop doing that without a fight?

Am I the bad guy?

As a parent ages, relationships can be a challenge emotionally. Hearing a parent express such disap-pointment can be hurtful. Don’t take the bait and get into an argument. Instead, help identify the issue for her. “Mom, are you feeling lonely?”, or “I wish I could see you more often”. These care-ful responses help take away the stage for a fight. Mom can’t argue with your expression of support or concern.

Now you need to ask yourself how often you actual-ly visit and how often you think is reasonable given your specific life situation. Ponder this when you are not feeling angry, harassed and hearing mom’s unhappy words ringing in your ears. You know that juggling a job, partner relationships, kids and all the normal stresses and activities of your life can make it difficult to see your mom more often. She is prob-ably in your thoughts, you have good intentions to visit, but without making a firm plan ahead of time, the visits get pushed to “another week”.

If there’s been a history of a difficult relationship between the two of you, and you both don’t get along for whatever reason, then admit to yourself that the visit is really a “job” and approach it as

such, aiming to do the best you can to help her.

Once you have decided what is reasonable and plausible in terms of visiting frequency, start to plan the purpose of your next visit. Is it to help with a chore, organize mom’s finances, or just sit and gab together? Parents

often have expectations of what the visit will be about before you get there and that makes it dif-ficult if you and mom are not on the same page. Start with a call to your mom. Tell her that you have thought about her concerns and have intentions to be there and fulfill her needs as best you can. This is a good opportunity to ask what her priorities are. Giving her a choice of what is more important in a visit puts her in the driver’s seat and allows her to feel like you care. Sometimes a concrete time plan helps. Telling mom that you will spend half the visit on a chore that she needs done and the other half relaxing and chatting with her is one approach.

Consider engaging in an activity that you both will enjoy, such as spending time in a café, local park or shopping mall. Aging often leaves many seniors with less friends (they die or move), and mobility issues can limit opportunities to socialize and lead to feel-ings of isolation, loneliness and depression. This could be what’s behind the protest that you don’t visit enough. If you suspect this, talk to your parent about joining a local day centre for seniors and look at what’s available in the neighbourhood. LC

Nira Rittenberg is an occupational therapist who specializes in geriatrics and dementia care at Baycrest Health Sciences

and in private practice. She is the co-author of Dementia: A Caregiver’s Guide, available at Baycrest.org/dacg. Email

questions to [email protected]. Reprinted from The Toronto Star, with permission from Nira Rittenberg.

Elderly momputs pressure on me

Nira Rittenberg


HOSPICE PALLIATIVE CARE IS NOT ABOUT DYING. It’s about living well to the natural end of our lives. In fact, when done well, hospice pal-liative care can be introduced when an individual is diagnosed with a life-limiting illness. It has nothing to do with dying and everything to do with living well until we die.

Do the words ‘hospice’ or ‘palliative’ care make you shudder because someone has a life-limiting illness or do you heave a sigh of relief, know-ing that someone with a life-limiting illness is benefitting from a holistic approach to care that manages pain and supports quality of life to the natural end of their life?

Hospice palliative care is a philosophy of care that takes into account an individual’s spiritual, psy-chosocial, emotional, practical and medical needs as well as those of their family and caregivers. As opposed to the conversation restricted to white blood cell count and scan results, the conversa-tion with a hospice palliative care provider would likely delve into an individual’s emotional wellbeing and their values, while also seeking to determine whether caregivers at home are coping well with the burden of care provision.

Most Canadians indicate they would prefer to die at home, surrounded by their loved ones and yet, more than 70 per cent of Canadians are dying in hospitals – perhaps partly because a lack of support in the community means individuals cannot confidently remain at home, resorting to the urgency of an emergency department even though the care they require and desire is less an emergency than it is

attentive, expert pain management – something that can be easily supported at home when the appropri-ate preparation and support is in place.

If you live in Ontario, you can be assured that the right people are working on your behalf to put into place the kind of support you and your family need, when you need it, where you need it.

The good news is the recent provincial budget announced $75 million new dollars which improves access to hospice palliative care in the community and increases support of caregivers, helping them support individuals at home and in the community.

It will provide additional funding for existing hos-pices, support 20 additional hospices and promote advance care planning. With the growing care needs of an aging population, the demand for quality end-of-life care could easily overwhelm the provincial heath care system unless access to community-based hospice palliative care is expanded now.

For individuals and families, the ability to receive and support care at home is more desir-able and more likely to satisfy the emotional needs of individuals and their families. For the provincial health care system, quality commu-nity-based hospice palliative care is more desir-able and less costly.

Based on the current momentum in Ontario, better access to coordinated community-based end of life care means more individuals will remain at home longer, supported by caregivers in the community, avoiding costly and often unnecessary hospital visits and stays. LC

Helen Reilly is the Communication Officer at Hospice Palliative Care Ontario.

tTo learn about hospice palliative care services in your community, call toll free: 1-800-349-3111 ext. 28

Care in Ontario is about to get a whole lot betterBy Helen Reilly

End-of-life care

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