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Successes at Baycrest


The following provides an overview of the measures and practices that are in place at Baycrest. The list is not meant to be comprehensive but rather to give the reader an impression of Baycrest's ongoing commitment and approach towards accessibility. It is a track record of our successes.

As a health care provider, Baycrest's approach to accessibility is embedded within key activities related to advocacy, education, research, and health promotion, as well as within the provision of care and treatment as guided by our Mission to "Enrich the Life of the Elderly".

Advocacy, Education and Research

As an academic centre affiliated with the University of Toronto, Baycrest is strategically committed to the integration of care, research, and education as pillars of excellence of the organization. As such, this commitment has supported an informed, best evidence approach to accessibility.

Baycrest has undertaken a number of initiatives to advocate for increased accessibility, to educate about accessibility, to conduct research and deliver care that incorporates accessibility. The overall intent is to enhance the lives of persons with disabilities. Some examples include:

Advocacy
  • Advocating for hard of hearing clients on accessibility issues:
    • The Hard of Hearing Club was consulted as a focus group regarding accessibility issues at Baycrest. They identified several concerns, including accessibility of public pay phones, taxi phones and information phones, all of which were made accessible as a result
    • The Hard of Hearing Club also advocates for access to public places and services, e.g. informing the TTC regarding risk in emergencies on the subway, where they have been unable to hear announcements over the public address system, and informing the Minister of Health that his public forum for seniors was inaccessible due to lack of provision of amplification.
  • Advocating against the use of background music in public areas due to its effect on persons with hearing loss.
    • Our outpatient self-management groups were consulted regarding physical accessibility e.g. getting to and from the parking lot, accessing bathrooms. They identified a number of concerns that were followed up with regards to available close distance parking spaces, shuttle schedules, adaptations to the centre’s public washrooms.
    • Our resident and family councils are a strong and consistent voice, monitoring accessibility challenges and highlighting them for follow up e, g, enabling accessible prayer services during the religious holidays, enhanced call bell responsively in the nursing home and hospital, etc.
    • Occupational Therapy, Physiotherapy, Psychology, Speech & Language Pathology/Audiology are all departments that advocate for accessibility and enablement of clients by addressing a range of physical, sensory, perceptual and cognitive challenges with clients and families.
Education
  • Educating staff on the use and care of amplification devices through in service training and promoting awareness through the Intranet, newsletters, and information sheets.
  • Educating staff to reduce the amount of noise and reverberation by use of quiet areas for therapeutic and social groups.
  • Educating Baycrest staff through Grand Round presentations – "Wired for Sound – Making Baycrest accessible for hard of hearing clients".
  • Educating new staff and paid companions on the safe and proper use of positioning and mobility devices such as wheelchairs and walkers.
  • Educating the public through publications: Baycrest and the CNIB collaborated on the development of a "Low Vision Resource Guide" – providing information on low vision programs and services in Ontario. Caring for Your Loved One – Baycrest.
  • The Anne & Louis Pritzker Wellness Library was officially opened. This library contains a range of written and audiovisual health-related materials as well as large screen/font computer, CCTV, and modified telephone to enable user-friendly access to health information.
  • The second edition of caring for Your Loved One, a guide for caregivers of persons with dementia and a training manual for those working with Holocaust survivors: Caring for Aging Holocaust Survivors were both launched this year. Both contain educational materials about safety, accessibility, enablement for these key client groups that Baycrest provides services to.
  • To support the advancement of technologies to address the diverse needs of an aging population and to further client enablement, Baycrest provided expert advice to private sector company (TZORA Active Systems) on the design and develop of new/improved mobility equipment.

Care and Treatment

Baycrest has provided care and services to the elderly for more than 85 years. Many of the existing programs and services provide care and treatment to persons with disabilities: examples include; Communication Disorders (Audiology and Speech – Language Pathology), Rehabilitation (Occupational Therapy and Physiotherapy), Mental Health (Psychiatry and Behavioural Neurology), Psychology, The centre runs various ambulatory clinics including audiology,ophthalmology, low vision, hand and foot orthotics, mobility and seating clinic, swallowing clinic, Mem-link (treatment clinic for individuals with short term memory problems).

Specialized support groups are also offered including the Hard of Hearing Club, and self-management groups for individuals with Parkinson’s, Stroke, Arthritis, and Osteoporosis. Accessibility is addressed as part of the support that is provided.

Hearing assessments are conducted for all new patient and resident admissions to identify presence of hearing loss for the purpose of assisting the client and enabling appropriate care planning for staff.

Occupational Therapy provides a Power Mobility Program to encourage safe and proper driving of power wheelchairs.

Volunteer Placement

Baycrest has a history of providing volunteer opportunities to persons who have a variety of special needs including; blindness, hard of hearing, mental disorders, physical disabilities, and degrees of learning disabilities. The outcome has been very positive resulting in many long-term volunteer placements.

  • Implement a Volunteer Greeting Program to help direct persons to where they are going and/or to watch over clients who are being dropped off while their family member/friend is parking the car. This program is currently utilized in our Apotex Building.
  • Volunteers have been used in the cafeteria to assist persons with serving and carrying their trays to their seating area.

Architectural

  • All of Baycrest's building and facilities were built to exceed building code standards for their time. The architectural structure and features within each of the buildings were designed with care and consideration to the population being served. This same approach is used throughout the centre during the planning and construction of renovations.
  • The Apotex Centre Jewish Home for the Aged opened in May 2000 and was designed and built with special attention to accessibility issues, examples include: floor surfaces were chosen to ensure safe and easy mobility, enhanced lighting through both natural and engineered lighting techniques, acoustical treatment to support hard of hearing, easy to use door handles and other opening devices, wheelchair accessible washrooms throughout the home, automated power doorways, wayfinding design features built into the building structure, room signage, etc.

Physical

  • Art and design are an integral part of the environment throughout Baycrest. Particular emphasis is placed on external environment support to help compensate for the cognitive changes experienced by many of our clients. Visual cues can help people who are no longer able to evoke images in their own minds. Not all brain functions deteriorate with diseases of the brain. We now know that that regions responsible for emotions are better preserved in many forms of dementia. Colour, patterns and shapes may trigger memories and feelings by acting as shortcuts to the emotional centers of the brain. We bear these principles in mind whenever we are installing art or interior design so that no two areas will look alike, or feel alike. This acts as nonverbal cueing throughout the Centre to assist clients in orientation and wayfinding.

    An inventory was undertaken by Physical Plant to identify many of the features that exist throughout Baycrest which support accessibility. The following are examples: (also see architectural description above).
  • Wheelchair accessible washrooms are located throughout the Centre.
  • "User friendly" elevators in the Home with audio floor indication and easy to use controls. Hospital elevator that automatically stops on all floors and permits front and rear entry/exit.
  • A wheelchair accessible ramp is used to connect the main car park. Handicap parking that exceeds code requirements. Special parking arrangements close to building entrances, including short term drop off. “Courtesy” wheelchairs are available at all main entrances for persons who require assistance with walking.
  • Accessible garden areas, including elevated garden planters for client use.
  • Fire alarm strobe lights were installed in all Terrace apartments for hard of hearing clients.
  • Transportation buses all have wheelchair lifts for easy client access. A wheelchair accessible Shuttle Bus service is used throughout the campus grounds to connect buildings.
  • Annual program to grind exterior concrete and walkways that pose an impedance or trip hazard.
  • Terrace Redevelopment Project – initiative underway to upgrade all Terrace resident apartments to improve lighting, mobility, easy of use, etc.- 80 of the 203 apartments have been completed
  • Specifications have been developed for furniture and equipment to meet the diverse needs of clients.
  • The entrance door to the Terraces of Baycrest Dining Room was heavy and did not support easy wheelchair accessibility nor for persons with less physical strength (elderly). A new automatic door opener was installed.
  • An auto door opener was installed on the Wagman members east entrance door.
  • New, replacement automatic powered sliding doors were installed at the Bathurst and Brain Health Complex Main entrances.
  • Thirteen (13) new “special needs” parking spots were designated in the main car park to provide for closer access to the main buildings.
  • The height of the main entrances(s) benches, were adjusted to assist persons with mobility impairments.
  • The Terraces of Baycrest and Wagman Centre fire speakers were modified and upgraded to improve volume and clarity for persons with hearing loss.
  • A bathroom was modified to include access to a raised toilet seat and hoyer lift for a wheelchair bound student researcher doing a one-year placement at Baycrest.
  • A new Parking Control System was introduced at Baycrest that improved access through the removal of parking gates, removal of the use of parking tokens resulting in more user friendly access.
  • A more accessible keyboard tray was installed on the computer resource centre computer.
  • Considerations for accessibility are applied to all space and renovation planning.
  • A new, ergonomically designed meal belt conveyor was installed in the Main Kitchen.
  • New, adjustable Shipping / Receiving dock plates were installed to improve loading and unloading trucks.
  • The concrete sidewalk area leading to the Apotex Centre main entrance was cut and sloped to provide for better access for persons with sight impairments, wheelchair and walkers.
  • A new wheelchair accessible washroom was constructed in the Brain Health Centre – 6th floor Posluns building.
  • Client lifts (both portable and ceiling mounted) were installed, providing improved access in client rooms and throughout Client Care areas.
  • Colour coded doors and frames, including wall painted directional arrows, and other signage and floor graphics were installed in the Apotex Wintergarden location. This was done to improve the wayfinding for clients attending Psychology and Community Geriatric Assessment appointments. Our clients with various degrees of cognitive conditions were experiencing difficulties in finding their intended destination.
  • The pathway located at the Child Care Centre and Wagman Building was expanded to provide better wheelchair and walker accessibility.

Informational and Communication

  • Baycrest provides a variety of communication mechanisms which are tailored to ensuring people have access to messaging. Examples include hotlines for clients to get information on changes and happenings (one for the Terraces of Baycrest/Wagman Centre and one for the main complex) a hotline for staff to get verbal updates and a hotline for families and Community members to call for updates. These lines can be accessed at anytime from any place and the messages are adapted to suit the needs of the audience.
  • The Baycrest website is a primary source for a variety audiences and is access by 12,000-14,000 people per day. It includes an extensive Family site which allows people to access information on events, policy changes, and other important information.
  • There are newsletters for a variety of audiences and are tailored to their specific needs including Terraces of Baycrest/Wagman Centre Newsletter, Family Newsletter, Staff Newsletter, Community Newsletter. These are presented in a manner most appropriate for the audience need.
  • To ensure that information media is user friendly for persons with disability, improvements were made to the Baycrest Intranet Internet Website, as well as the main telephone messaging system.
  • An “Internet Café” has been implemented on the main floor level of the Apotex, and is available for general use. The area allows our clients the ability to have access to the Internet, including the Baycrest Website.
  • Developed and installed new “friendly” signage at the main floor Hospital elevator as a prototype for evaluation.
  • Switchboard staff (Communication Attendants) were provided training to enhance their ability to communicate with hearing and cognitively impaired persons. This included the telephone, public address system, and face-to-face interaction.
  • New “Communication Kits” were purchased and are in the process of being implemented, along with education for staff regarding their use. They are to be available on the Patient/Resident Units and in the Clinics. Our clients with speech/language problems use the “Kits”.
  • The main floor public telephones were replaced and upgraded to include features for hard of hearing, sight and mobility impairments, and wheelchair accessibility. These included pay, taxi and courtesy telephones.
  • The common area televisions used throughout Baycrest were programmed to include “close captioning” as the standard option.
  • Wellness Centre computers (audio output) have been made accessible to hard of hearing clients by the installation of amplifying head phones.
  • An individual FM system was purchased for use by hard of hearing clients, to supplement those already on loan in audiology.
  • Consent forms were reviewed and modified as necessary to support clients with communication related impairments.
  • Clear, contrasting, protruding “street signs” identifying service shops in the Apotex were installed.
  • A Wayfinding Evaluation project was undertaken at the Main Centre of Baycrest. The report, along with recommendations was complete fall 2005 with a multi-year implementation plan.
  • Baycrest’s new “Branding” Project included new exterior sign faces with improvements to wayfinding upon arrival to the site.
  • The “Canadian Hearing Society” conducted a review of Baycrest as a resource and to help enhance our Accessibility Plan. Recommendations from their report included Accessibility signage for the deaf and the installation of a direct communication line at Baycrest. In their report, the C.H.S commended Baycrest for accessibility plan and our efforts with Accessibility initiatives at the Centre.

Attitudinal

Integrated into the fabric of Baycrest and its "Values" is "Respect". Respect comes with the understanding that each person is unique with intrinsic dignity and worth.

  • In the fall of 2002 Baycrest undertook a process to provide Harassment and Discrimination Training for all staff. The program is designed to help each staff identify what is discrimination and harassment, and what measures one should take to change their own attitudes and actions as applicable. To date most of the staff from the management group, have received formal training.
  • Baycrest also has administrative policies that address issues of abuse. All staff receives formal training on "abuse" which is part of their annual core curriculum and performance appraisal.
  • Neil I’m not sure the above two points fits in an accessibility report

Technology

  • Baycrest supports an onsite "Ability Store" for the sale of assistive devices, which help with daily living activities for persons with disabilities.
  • An Adaptive Communication Service is provided through Occupational Therapy and Communications Disorders for clients who require the ability to communicate but are not able to do so through speaking or writing.
  • Occupational Therapy provides customized environmental control systems for clients to enable them to do such things as call their nurse, access their radio/TV, etc.
  • Occupational Therapy provides consultation re:computer accessibility e.g. modified keyboards,screens, voice activated options,etc.
  • Baycrest Hearing Services promotes and dispenses assistive technology for clients with hearing loss, which clients can try in a display and demonstration center.
  • Baycrest provides various technological devices to facilitate access to programs and services by clients with communication problems:
    • We have a supply of loaner Pocketalkers in Hearing Services which are provided to clients whose hearing aids are being repaired, or those who want to try this type of device
    • Pocketalkers are also available at every nursing station in the hospital and Apotex as part of a hearing ‘kit’ that staff have on hand for cleaning and troubleshooting HAs. They are intended for short-term use by patients and residents who require amplification for communication with staff and visitors, but who do not have functioning hearing aids.
    • Pocketalkers are also used in other departments such as psychiatry, where they are used to perform patient interviews and assessments of cognitive function.
    • FM systems are provided on loan for client programming, for example in social and therapy groups. 10 transmitters and 35 receivers are available for short term loan from Hearing Services, where they are recharged, cleaned and maintained. 11 transmitters and 79 receivers are on permanent loan to programs such as the Community Day Center and Day Treatment, where they are used by Therapeutic Recs, Social workers, nursing, OT. PT, etc.
  • Voice amplifier equipment is utilized in the Day Treatment Program, Psychiatry Day Hospital, outpatient groups, and ambulatory clinics.
  • Various other devices and techniques are used to support safe positioning, facilitate care provision, and alert caregivers in situations of risk:
    • Customized shower chair for severely physically involved individuals or those with severe cognitive impairment.
    • Specialized bed and chair sensors and specialized lower beds.
    • Lifeline System at the Terraces of Baycrest

Policy and Practice

  • In-house legal counsel was used to review the Centre´s by-laws to ensure compliance with the Disabilities Act - 2001. As part of ongoing practice, Baycrest supports two active multidisciplinary committees which help to ensure issues of accessible are considered for all new purchases and/or building renovations. These include the Product Standardization Committee and the Environment Team. The Environment Team will ensure that accessibility planning is incorporated into the Centre´s annual operating and capital business planning process.
  • Communications Disorders introduced new policy and practice for the provision of sign language interpreters where necessary for effective communication in the delivery of medical care and service. This is in compliance with the Supreme Court decision that failure to do so is a breach of the Canadian Charter of Rights and freedom.