When 89-year-old Eugenie Thomas fell and hurt her leg last October, the West End resident made her way to St. Paul Hospital’s Emergency Department. Like many frail seniors, she was unaware of the alternative health services available to her.

And then she met Jo Birdsall.

St. Paul’s staff connected Eugenie with Jo, a nurse practitioner (NP) at our Three Bridges Community Health Centre. Since then, Eugenie’s greatest wish has come true. She’s still living and thriving at home.

Helping seniors live independently

“The West End has the largest group of seniors living alone with supports,” says Jo. And, if she has her way, that group will only continue to grow.

“My primary goal is to reduce unnecessary emergency visits as they can cause complications for frail seniors,” she says. “By identifying frequent users of emergency services, we can determine what health needs are not being met for them.”

Working with the Three Bridges Home Care Team, Jo is achieving her goal. Since the fall of 2016, her patients have reduced their visits to emergency departments by an impressive 54 per cent.

The work requires intensive case management. Jo’s in regular contact with her patients, their families, home care staff, other support networks, pharmacies and general practitioners. She also works to connect unattached patients to a family doctor. For every hour with a patient, she invests another five hours behind the scenes.

Still, this former emergency nurse is fulfilling her desire to play a more active role in addressing patients’ day-to-day health care needs.

Home is best: For Eugenie, living at home and spending more time at her local seniors’ centre with friends, instead of the hospital, means “everything”.

“I remember seeing a lot of frail seniors at the ED for primary care concerns that weren’t being addressed in the community,” Jo explains. “I observed a real need for additional support for seniors, many who have very complex requirements. With a nurse practitioner, patients feel reassured knowing someone is listening and working with them to achieve their health goals.”

Home is best

Jo’s ultimate objective is to provide her patients with the supports they need to live independently as long as possible.

And, our new City Centre Community Health Access Centre will help her do just that. Three Bridges and the West End Mental Health Team will move into the new centre in 2018, and Jo is among the staff helping to design the new space.

“I’m really looking forward to the integration, particularly with the older adult mental health team,” says Jo. “It’s great to have input on the design and to make sure the layout works for frontline staff and patients. This is very important for frail seniors and patients like Eugenie.”

Thanks to Jo and other members of the Home Care Team, Eugenie’s life is returning to normal. In March, she made her first trip in five months to a seniors’ centre where she has many friends.

“Living in my own home means everything to me,” says Eugenie. “It’s magical that all these people are trying to keep us in our homes and out of the hospital. Jo is like a daughter to me, keeping in touch and spurring me on.”

Don’t forget to register!

Learn more about the evolving role of nurse practitioners and what this profession means for staff, physicians and our shared patients/clients at the Vancouver All-Staff Forum on May 3 (2 to 3 pm). To reserve your seat or webcast connection, early registration is recommended: click here.

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