In anticipation of Vancouver’s All-Staff Forum about Home is Best, we received questions from staff about their personal experiences on — and off — the job. Today, we answer two of these questions.

Today’s answered questions

Q. I’ve spent the past 10 years looking after elderly loved ones and have managed to keep most of them at home.  However, I’ve found dementia is a game changer. When my stepfather developed dementia, my mother kept him home as long as she could — but then her health started to suffer. She couldn’t leave him alone, and became a bit of a “prisoner” in her own home.  It was helpful to have people come into the house to assist him, but it wasn’t enough.  She needed time alone in her own home so she could relax/take a nap/whatever.

Will there be more day programs for people with dementia to alleviate the stress on elderly caregivers?

A. Thank you for sharing your personal story with us. It must have been a very difficult experience. While the ideal is to keep loved ones at home for as long as possible, we recognize that it can be hard for the caregiver.

That is why we’re happy to share with you that a review has just been completed on the current state of the Vancouver Adult Day Program (ADP) and Respite Continuum. The review defined the client groups served by the ADP and Respite services continuum, opportunities to improve access and align client care needs with our model of care, as well as define the continuum of services required moving forward. The summary report also outlines the next steps in this process and will be shared with VCH staff mid-June. If you don’t receive a copy and would like one, we would be happy to forward the document to you.

While change won’t happen overnight — and we can’t “spill the beans” before the report is released — we can say that we’re confident that implementation of the review’s findings will lead to our better serving our clients and their caregivers, offering more support, and, in the process, improving outcomes for the individuals and families we serve.

Q. As an occupational therapist working in community mental health (West End/downtown core), I am seeing many of my clients aging with chronic physical health conditions as well as a significant mental health issues (50-75 age group). Accessing services is difficult as we have to work within our mental health system and access additional services via AOA [Adult Older Adult].

How can we ensure this is more collaborative, and possibly a “one stop shop” approach for those with chronic health conditions (psychological, physical and cognitive)?

These clients need a “wrap around” service under one roof. This would be effective re: time and money and how services are allocated.  They should receive integrated services (mental health and physical health) to meet their needs and this should also include medication management, and possibly housing options ie: long-term care. Many of my clients have no family and are on basic disability pensions and have no funds for private services; other services like Better at Home have huge waitlists.

A. You bring up some interesting and valid points.

As more of our population continues to age (population growth indicators tell us that between now and 2040, there will be a 94.5 per cent increase in those 65 and older and a 156.3 per cent increase in the 85 and older age group), this will result in increased demand and utilization of health care services. Also, as life expectancy has and is increasing, we’re finding people are living longer and new health concerns are emerging, such as people living with multiple chronic diseases and acute mental illness. We are also aware that there are multiple contributing factors that influence health outcomes and especially when there are also mental health considerations. Given this, we’re striving for an integrated and balanced approach to address these concerns.

You’ll be happy to know that, through the Downtown Eastside Second Generation Strategy, implementation planning is underway, including how we can best integrate care around client need with the ultimate goal of offering a range of low-barrier health care services in an integrated continuum for the Downtown Eastside (DTES), including interdisciplinary teams at individual sites.

The DTES Design Paper identified a number of opportunities for improvements to services, including the need for greater integration of health services and supports. The focus of the current working group is to build on these recommendations to improve treatment outcomes with a focus on chronic conditions (i.e., persistent mental illness, COPD, hepatitis C). The group is looking at improving care coordination across interdisciplinary and multi-scope teams; improving access to care along the continuum of services; improving systems processes to avoid and prevent unnecessary duplication and gaps in service; reducing ED visits, acute admissions/readmissions, and length of stay; and increasing system efficiency and expanding access to care.

There are similar initiatives taking place in the downtown core, too. In fact, Vancouver Community directors are currently meeting with staff to discuss similar opportunities for the West End and to work towards more integration of services for our clients.

Another initiative, the Mental Health & Addictions Access and Assessment Centre, to be located on the VGH campus, will provide a centralized point of access for adults with mental health conditions. The 24/7 services provided by a multidisciplinary team onsite will also lead to greater access for clients to primary care services.

Got a question?

If you have a question, comment or suggestion, we encourage you to email us what’s on your mind at onevancouver@vch.ca.

Refer to VCH News next week for more answers to your questions and full coverage of the June 10 Vancouver All-Staff Forum and Home is Best Fair.