The Caring@Home blog welcomes this guest post by Janet Parks, Client Services Director for the Mississauga Halton Community Care Access Centre.

According to the Mississauga Halton Community Care Access Centre (CCAC), Rapid Response Nurses are helping to bridge the gap between hospital and home. For some of our frail, elderly citizens, leaving hospital often means a return visit, usually within a week. This is not healthy for our seniors or for our healthcare system. We identified that some of our citizens with very complex care needs require more constant care coordination to ensure they progress and flourish out of hospital and are not readmitted – the Rapid Response program is a team approach to health management in the client’s home.

The Mississauga Halton CCAC partnered with local hospitals to identify patients who need this level of care and began this initiative.

These multi-layered seniors need an intensive level of care coordination to ensure medications are taken as prescribed; follow-up doctor’s visits are made and kept and ongoing medical assessments continue through constant monitoring by a consistent care coordinator during the crucial first 30 days after leaving hospital.

We’ve all seen the scenarios: An 80-year-old gentleman who lost his wife three months ago falls at home and ends up in hospital. Post-surgery and rehab, he heads home only to return for help, reassurance or clarification on next steps. Or the frail 86-year-old woman who ends up in emergency because she took the wrong medication. Close care coordination by a registered nurse can recognize many of these situations and intervene before misfortune happens.

Our Rapid Response Nurses will visit the most vulnerable patients within 24 hours of leaving the hospital. They will visit their clients at home, as needed, over a 30-day period to reduce the risk of clients being re-admitted to hospital. Clients will be discharged from the program once they are functioning well or can be followed less-intensely through CCAC programs and a community-based case manager.

The program has had some success in its short time, helping many seniors return home with the care and attention to their health management needs. Through the research and preparation of this program we have recognized that some of our patients with chronic obstructive pulmonary disease, or pneumonia and congestive heart failure, need more constant care coordination to ensure they thrive at home and are not readmitted to hospital.

A Rapid Response Nurse undergoes special training to support these unique citizens who need consistent clinical care and community supports. In partnership with the hospital clinical team, the LACE tool was developed to provide a process: it’s a predictor of hospital readmissions, patient diagnosis and demographics to determine and set up eligibility to receive care from a Rapid Response Nurse. The criteria is pretty straightforward: age 65 and over, with a complex medical case and returning home from the hospital.

This program will ensure equitable access to an intense level of care for the high-risk patients with complicated clinical care needs. Some areas of concentration are:
• Ensure medications are taken as instructed;
• Ensure follow-up doctor’s visits are made and kept;
• Provide ongoing medical assessments through constant monitoring during the crucial first 30 days after leaving hospital.

For many frail Mississauga Halton seniors, leaving the hospital means they won’t return thanks to the Rapid Response program.

The Mississauga Halton CCAC coordinates in-home and community support services, information and referral, and long-term care placement. It is funded by the Ministry of Health and Long-Term Care and serves a population of more than one million residents in the communities of South Etobicoke, Mississauga, Oakville, Halton Hills and Milton, Ontario. For more information about the Rapid Response program, please contact Janet Parks, Client Services Director at 905-855-9090. For more information on the Mississauga Halton CCAC, please visit: www.mh.ccac-ont.ca.

This poem is often shared on Mother’s Day. I still have my handmade Mother’s Day cards from my girls, and my mom still has the ones I made for her.

Every year, the second Sunday of May is our opportunity to say something to our mothers that will last the whole year through. Many of us show our appreciation to our mothers with a bouquet of flowers. But before you hit the mall or the flower shop on your way home today, think about other ways to show how much you care by giving the gift of caring – this is something different and something moms really need. Dignity, safety and independence are the keys to quality of life for our aging parents who, for the most part, want to remain in their homes for as long as possible. So, this Mother’s Day, give the gift of independence with a gift certificate of help at home.

Living a baby boomer’s life can be nerve racking on occasion, and being a family caregiver to your parents can be awkward but equally rewarding. This special Sunday in May allows us – sons and daughters – to give something back to the ones who were always there when we needed them. Now, with the tables turned, our mothers may rely on us more as the years go by. We can show our appreciation for everything she’s done, in a unique way.

Mother’s Day is a time to honour mothers and motherhood, and it’s celebrated in many parts of the world, usually in spring. The relationship you have with your mother is like no other – it’s a special bond that never leaves you and often can’t be put into words. Why not give the gift of assistance?

Spring brings much work to homeowners and if your mom lives alone she may need some help around the house. This Mother’s Day, think outside the traditional box by giving a gift certificate for a service that will help her to remain independent. It could be an afternoon of spring cleaning, a health management review and development of a personal health plan for fruitful aging, or providing a lift to her next medical appointment accompanied by a care provider. Talk to your mom and ask her what she needs. It could even be a new roof, carpet cleaning, air conditioner tune-up, or a week of meal preparation. I’m sure there are gift certificates available for almost anything.

For my mom, it’s the gift of voice. A few months back, my mom called to say a friend had suffered a stroke and lay in her home for three days before anyone noticed she wasn’t out and about. Now, my peace of mind is knowing that my mom starts every day with a phone call to me. And for her it’s the gift of voice and another day.

So before you go out and buy something just for the sake of buying, think about what your mom truly needs.

Happy Mother’s Day to all mothers: Sit down, put your feet up and have a wonderful day!

For more information about purchasing a Bayshore gift certificate, speak with one of our care agents at 1-877-289-3997.

Mom… 40 years later, here’s a new poem for your fridge:
Momentous in worth
Outstandingly smart
Tough as nails
Healthy at will
Eager to do
Resourceful in age

Love your daughter

Dear Bayshore Nurses,

Because you have been such compassionate caregivers to Dad these past few weeks, I wanted to send you an update to explain the next stage in his journey.

This morning, Mom and I reached the decision that we lacked the competency to give Dad the sort of care he needed 24/7, here at home. So this afternoon we three headed to Freeport Hospice and settled Dad into a bright and airy room. I was careful to “instruct” the nurses and doctor on all the fine points of keeping Dad safe and happy, which you taught me. We wanted to make sure they knew about his love of milk, back rubs and his talking wristwatch!

Eventually the rest of our family arrived and he was surrounded by us all, even the dog Biscuit.

Nurse J, your spiritual understanding and support will never be forgotten, nor your tender encouragement to not to give up! And what a lot we learned from your years of nursing experience!

Nurse G, you were patient with Dad in his stubborn moments and stalwart when things began to get complicated, always calm. You even gave up trick-or-treating with the boys for us!

Nurse K, your sense of empathy and tenderness – which I recall when you crouched down to encounter Dad eye-to-eye at bed level so he could see you directly when you first met – was priceless! It taught me that there is always an extra “inch” one can go when things get tough. And that the world’s most beautiful smile can prompt immediate reciprocity in even a drowsy patient.

Finally Nurse S, who stayed extra time to bid Dad adieu when the trip began to the Hospice Centre this morning – thank you for your sunshine and cheerfulness. I am certain it will brighten many others in your career ahead.

As a team you have allowed Mom, Dad, my brother and I to enjoy a wonderful month together at home. You have not only taken care of human necessities in an extremely professional way, but of equal or even greater importance you have, by your joy, sharing of your personal stories and affectionate care of Dad, shown the sterling “stuff” of which you all are made.

I know that in different ways life has presented some of you with serious challenges. Rather than be defeated by them, you have shown determination to not only surmount obstacles, but without bitterness reach out to others in need through your nursing work.

Persuaded, as I am of the existence of a God who rewards selflessness, I have no doubt whatsoever that you will be amply blessed for the love you daily show to others, including Dad.

I truly am in awe that each of you crossed our family path at the time you did and can only say how enriched we have been by it. Thank you from the bottom of our hearts.

Big hug!
The R. Family

Every year, I like to honour National Nursing Week with a dedication on the Caring@Home blog. I think this letter did it. The overwhelming responses I’ve received from Area Directors exemplified the work our caregivers provide. Caring is a simple word with an infinite depth and that’s what nurses deliver every day.

Happy Nursing Week to all my fellow nurses. Keep making a difference in the lives of your patients and families – your work is never forgotten.

Tell us how you will celebrate?

We’re at it again. For the eighth consecutive year, Bayshore offices coast-to-coast will be lacing up and walking on Sunday May 5 to raise money for local palliative care hospices in the Association’s annual Hike for Hospice. This is the third year that I will be donning my walking shoes. The fundraiser is organized by CHPCA (www.chpca.net), the national voice for hospice palliative care in Canada, and raises money to allow individuals to have quality end-of-life care.

The annual Hike is Bayshore’s company-wide event. It brings us together for a little friendly competition, and all for a great cause. Bayshore nurses and caregivers are on the front lines of palliative care every day, so they know how important access to hospice care is for patients and their families. The Hike is the perfect way for each of us to give back knowing that individuals and their families will be able to remain in their community surrounded by their loved ones in their greatest time of need (hospitals serve a huge purpose, but not at their end-of-life journey).

People who’ve been touched by hospice palliative care know what I’m talking about when I say hospices or home palliative care is the best place for this final journey. This year I will be supporting the Dorothy Ley Hospice, a centre where, on a recent visit, I felt emotions of sadness and joy at the same time. The atmosphere of caring, love and dignity flows throughout the centre because it enables individuals to bring their homes into the hospice for their final stage of life. From the living wall (which reflects everlasting memories) and the welcoming environment of joyous conversations, to the smell of the barbecue and the comforts of home, I understood why I needed to Hike for Dorothy Ley Hospice.

Each year the Hike marks the start of National Hospice Palliative Care Week, and once again Bayshore, as the national sponsor, will be donating $2,000 on behalf of the lucky winner of our Hospice Donation Draw. Beginning May 6, visit our website www.bayshore.ca. Click on the Hospice Donation Draw button and type the password: HOSPICE DRAW. The entry form must be completed by June 6. The winner – who receives $2,000 to donate, in their own name, to a local hospice of his or her choice – will be announced on Bayshore’s website during the week of June 17.

Hospice palliative care programs allow patients to gain more control over their lives, manage pain and symptoms more realistically and provide support to family, friends and caregivers. Despite the many benefits, more than 70 per cent of people dying in Canada do not have access to hospice palliative care, which is funded disproportionately by private donors. The CHPCA is working toward ensuring that more Canadians receive the end-of-life care they deserve in a setting that understands, accommodates and respects their wishes.

Palliative care is something most of us will require at some time or another, either for a friend, loved one or neighbour. I encourage you to go online and sponsor me in my Hike to support Dorothy Ley Hospice. Help us raise much-needed funds to enable them to continue to offer their wonderful services to the community – at no cost to the patient or family

Every little bit helps. It’s a simple click of your mouse: http://my.e2rm.com/personalPage.aspx?registrationID=1788364#.UVsaRUjXfK8.facebook
I’ve only managed to hit 10 per cent of my goal this year. Please help me raise funds for hospice palliative care. Your support will be appreciated by many families whose loved ones are on their end of life journey.

No amount is too small. Thank you kindly for your support!

About Dorothy Ley Hospice Centre
The Dorothy Ley Hospice is a volunteer-based community service organization offering compassionate care to people living with the challenges of a life-limiting illness or loss. Its goal is to provide comfort and help individuals and their families manage so they can live every day to the fullest with dignity, meaning and hope. All of their services are offered at no cost to the individual thanks to the generosity of donors, government funding and the support of community partners. For more information visit their website at www.dlhospice.org.

When planning a vacation we tend to spend the greatest amount of time on finding the right location and for most women, finding the right clothing to pack. More important is the fact that we should be looking into the proper travel vaccinations. There’s no point investing all that time and energy into the plan if you don’t omit the potential danger that could affect your health and ultimately ruin your holiday.

Travel-related vaccinations safeguard against infection and diseases that are uncommon in Canada but may be prevalent at your travel destination, such as yellow fever, typhoid, cholera and malaria.

There are many websites that provide information on travel immunization as well as clinics that offer the vaccine treatment. Some travel agencies even recommend the vaccines travellers should consider based on the vacation end point.

Learning about travel vaccines should be on everyone’s travel list. Protecting your health and guaranteeing you have a successful vacation starts with a travel clinic consultation.

According to the Public Health Agency of Canada, there’s no single schedule for the administration of travel immunization. Each schedule must be personalized according to the individual traveller’s:

• Immunization history
• Countries to be visited
• Type and duration of travel
• Amount of time available before departure, as some vaccines require an incubation period before travel.

Many travellers around the world don’t have any vaccinations prior to going on vacation, which only increases their chances of disease, disability and even death.

It’s our personal responsibility to ensure we’re up to date with our boosters. Immunization doesn’t end in childhood, especially for diphtheria, pertussis and tetanus. Although rare in Canada, these are still very prominent in other countries. Secondly, one of the most high-profile hazards of travelling is contracting hepatitis, a disease characterized by varying degrees of inflammation of the liver.

If you’re unsure of your present immunization status, please speak with your health-care practitioner. A vacation is a special opportunity for you and your family to enjoy and gain fond memories. Suffering from a travel-related illness shouldn’t be part of it.

DID YOU KNOW

• Hepatitis A is the most common preventable viral illness acquired by travellers. Unsuspecting travellers obtain Hepatitis A from consuming contaminated foods and water. Be sure to take precautions when enjoying a poolside drink with lots of ice – many times it’s the ice that’s contaminated.

• The incidence of traveller’s diarrhea is high. Unprotected travellers increase their risk greatly. Evading bacteria-contaminated food and water isn’t easy. Traveller’s diarrhea can certainly put a damper on your plans, so talk to your pharmacist about the oral vaccine that treats traveller’s diarrhea.

• Malaria exists in many popular vacation spots. It’s a mosquito-borne disease that causes grave illness, especially to children and the elderly, and should be taken seriously.

• You need to seek out pre-travel health advice at least three or four weeks before your departure. Our immune system produces antibodies that help the body recognize and kill a virus or bacteria. Sometimes it takes time for a vaccine to be most effective.

What should you do before you even begin planning a vacation?

1. Learn which travel vaccinations you must have based on your destination.
2. Talk with your doctor or pharmacist about the vaccines.
3. Plan far ahead so that the vaccines have enough time to kick in.
4. Book your flight and hotel, pack your favourite outfits and enjoy!

Travel smart – don’t skip travel-related vaccinations that will keep you healthy during, and after, your perfect vacation.

For more information on travel and safety and diseases visit the Public Health Agency of Canada’s website at http://www.phac-aspc.gc.ca/tmp-pmv/info/index-eng.php#diseases.