GivinG families a choice for seniors care
For 20 years, Edmonton’s Comprehensive Home Option of Integrated Care for the Elderly (CHOICE) Programs have been quietly keeping frail seniors out of hospitals, emergency rooms and long-term care – and in their homes where they prefer to age. Expansion of the program could do even more to ease the pressure on the health system as well as lighten the load for caregivers in need of support.
Comprehensive care of Edmonton’s frail seniors in a day program setting cuts their hospital admissions in half and reduces their visits to emergency department by 32 per cent, studies show.
The CHOICE Program, operating since 1996 by Alberta Health Services in partnership with CapitalCare and the Good Samaritan Society, helps 382 seniors get the care they need to continue living in their own homes as they age.
“The changes we saw in our mom after she began the program were incredible,” said the family of Lillian Marko, 88.*
“Most importantly, Mom was able to continue to live at home with Dad.”
CHOICE Programs combine personalized supports at home – such as medication administration, bathing and meal assistance – with medical, psychological and social support at day centres staffed by a doctors, nurses, pharmacists, social workers and occupational, physical and recreation/activity therapists.
Clients visit CHOICE centres twice a week on average. There are five CHOICE centres in Edmonton, including one that focuses on mental health and another with a specialized dementia program.
“Our mom would return home from CHOICE and her face would light up as she told us about her time having coffee with the ladies or the singers she listened to,” said Marko’s family.
“Dad was able to enjoy some time for himself to get his own things done. The support he felt reduced his stress immensely.”
A study by the University of Alberta in 2015 revealed the average age of CHOICE clients is 80 and 56 per cent are women. All clients have multiple chronic conditions and take an average of 12 medications daily (the range is from two to 24).
Upon admission to the CHOICE program, clients were found to be high users of the health system. But the study found visits to the emergency room, hospital admissions and falls decreased significantly in the year following enrolment in the program.
“CHOICE is effective at preserving the health of frail seniors, keeping them out of hospital, and avoiding or delaying their admission to long-term care,” said Trish McGrath, manager for CapitalCare’s CHOICE Programs.
Ernie G. has been a client at CHOICE Dickinsfield – Canada’s first CHOICE Program – for more than a decade. The CHOICE team maintains stability of his heart disease, lung disease and kidney failure so he doesn’t have to rely on frequent hospital visits.
Renuika Singh has been with the CHOICE program at Dickinsfield since it opened. The continuity of care between staff and clients helps clients stay well and out of hospital. So does the socialization they receive from coming to the centre and participating in the many recreational activities.
Ernie plays piano while his friend, Clem Loy, plays the guitar. Together they are known as the ‘dynamic duo.’
“I can always gauge how well my dad is doing by how he’s playing,” said Ernie’s daughter Ellen.
Ernie was 78 when he entered the CHOICE program. He had experienced a heart attack, several surgeries and was exhasuted from frequent trips to the hospital. His family was equally exhausted from trying to juggle all his medical appointments with their own hectic lives.
“CHOICE has been a godsend,” said Ellen. “We seriously doubt if Dad would be doing as well as he is today without it.”
Dr. Bryn Whittaker retired from CHOICE Dickinsfield a few years ago and now supports expansion of the program. A west-end location could accommodate another 100 people, and the ripple effects could ease pressure on acute and continuing care systems.
“Expansion of this model would be, in my opinion, the single most important thing health care could do to improve the lives of frail seniors,” said Whittaker. * Lillian Marko passed away Aug. 19, 2016.
CHOICE is effective at preserving the health of frail seniors, keeping them out of hospital, and avoiding or delaying their admission to longterm care. trish mcgrath, manager, capitalcare’s chOicE Programs