Chances are you know an older adult who has a mental health and/or addiction issue. In Vancouver Coastal Health (VCH), of the older adults admitted to acute care with a DSM Axis I diagnosis, 67 per cent have dementia, delirium or depression. Most of these people are admitted to a medical unit, not to a psychiatry bed.
VCH and Providence Health Care (PHC) aim to improve the older adult acute care patient journey. A project steering group, chaired by Robena Sirett and Dr. Elisabeth Drance of the Regional Mental Health and Addiction Program, is leading this work.
Over the past year, the work included engaging teams and partners in our hospitals and community, as well as conducting a literature review, data analysis and Gemba, to follow the patient journey from emergency departments to acute medical and psychiatry units. It mapped the current and future state for older adults’ care.
Major regional issues identified
- Resource gaps in care provision
- People with dementia being treated in units that are not fully able to meet their needs
- Inconsistent communication across the continuum of care
- Inconsistent use of best practices
- Stigma or barriers to care experience
Recommendation highlights
- Implement best practices
- Address resource gaps
- Improve communication across sectors
- Address stigma
Thanks to everyone who has been involved in this process. There have been some remarkable examples of leading practice across our region. Many of these ideas are now being used elsewhere helping to improve the patient and family experience and also improve upon some of our broader “systems” challenges.
One example is the use of “My Daily Care Needs.” It is a bedside tool describing the care of a patient in the first person. It has been effective in transitioning care from hospital to residential care. This tool was adapted from the Czorny Alzheimer Care Centre in Surrey, and is now being used in a number of areas, including Parkview and Willow Older Adult Tertiary Mental Health.
Next steps
The steering group continues to engage with the leaders and clinical experts in emergency departments, acute medicine and psychiatry, tertiary mental health and community to implement the recommendations.
More information to get involved
If you would like to find out more or get involved in this work, contact:
Robena Sirett, Older Adult Leader, RMH&A
Dr. Elisabeth Drance, Older Adult Physician Lead, RMH&A
If you have access to VCH Connect, please check out the Regional Older Adult Mental Health & Addictions Continuum Project site. For others outside the VCH network, the project summary provides more detail.