Jane Stokaluk gets fit again after a stroke

Videoconferencing technology is improving the lives of people recovering from stroke in more remote areas of Ontario.

Developed by Baycrest, the MOST (Moving on After Stroke) self-management program brings rehabilitation expertise to distant communities where resources are scarce and opportunities for group support are few.

The St. Joseph’s Care Group in Thunder Bay is a hub for the program in Northwestern Ontario, providing videoconference links—via the Ontario Telemedicine Network—to smaller communities in the region. Stroke survivors and their care partners attend group sessions to learn about exercise, goal setting, coping strategies, medications, activities, pain management, nutrition, and community resources.

Program participant Jane Stokaluk says the program helped restore her confidence in her own abilities after she had a stroke. “I was really glad to have participated in the MOST program because it was very informative, very optimistic. It made me feel important as a person, and when I met others with the same problems, I felt less isolated.”

Physiotherapists Steven Wong and Maggie Jablonski were part of the team that helped Syda Szuster walk again after a brain operation left her partially paralyzed.

After brain surgery left her paralyzed on one side and unable to walk, 65-year-old Syda Szuster was admitted to the complex continuing care unit in Baycrest Hospital where she received physical and occupational therapy, followed by a stint of intensive therapy on the rehabilitation unit. Despite the bleak initial prognosis, she eventually learned to walk again.

“It used to be that people with complex medical conditions came here to live out the rest of their lives,” says Joy Richards, vice-president, Collaborative Practice,  Quality and chief nursing executive. “We cared for them but there was no expectation that they would get any better. Now we know that many people have the ability to improve. People who couldn’t walk are walking, and some patients are able to move to a nursing home. In a few instances, we’ve even discharged
patients back to their homes.”

Nursing director Marilyn El Bestawi credits Baycrest’s Renewal Program for helping to improve outcomes for CCC patients. The intensive education program is primarily for nurses but involves all care staff in sessions on teamwork and leadership. “Teams in CCC are trying to see if a patient has the potential to improve and then focusing on how to make that happen,” she says. “Before Renewal, we often assumed that patients would remain the way they were.”

Earlier this year, Baycrest senior social worker Paula David traveled to Israel for the launch of the Hebrew edition of Caring for Aging Holocaust Survivors: A Practice Manual.

David co-edited the original English version, which was published by Baycrest in 2003. The launch was part of a one-day conference organized by JDC-ESHEL, the Association for the Planning and Development of Services for the Aged in Israel.

The manual, which is a rich source of information and reflects Baycrest’s world-renowned expertise in caring for aging Holocaust survivors, is intended for health-care professionals, families and caregivers of aging survivors. The information is presented in a way that sensitizes and educates caregivers about the challenges associated with this special population. It provides invaluable advice and strategies that may be adapted to help victims of any war or genocide. “This was an exciting trip with some great learning and sharing opportunities,” David says. “It is always a terrific experience to present Baycrest to our colleagues around the world and to actually see the impact of the work that we do.”

For 90 years now, people of all ages and backgrounds have been volunteering at Baycrest, making an enormous contribution to the care of tens of thousands of our clients. Today, young people are helping ensure that the volunteer tradition at Baycrest will remain equally strong in the years to come.

In the summer program, more than 200 young volunteers took on the challenge of working in a medical environment with their peers, health-care professionals and our clients. Many enjoy the experience so much, they return year after year—no doubt some will be here in 10 years to celebrate a century of volunteering at Baycrest.

In collaboration with the Association for the Planning and Development of Services for the Aged in Israel, Baycrest has established an interprofessional knowledge exchange which is leading to improved care for the aged worldwide.

A multidisciplinary team from Baycrest visited Israel earlier this year and focused on cognitive rehabilitation, technology for the elderly, Jewish culture and heritage, programs for Holocaust survivors, and caring for clients with dementia.

Team members were both participants and presenters as they attended educational seminars and visited inpatient, outpatient and community programs across the country. They also met with colleagues from across the world at the World Council of Jewish Communal Service 11th Quadrennial Conference in Jerusalem.

“One thing that struck me is how similar the problems are between the two countries and how there are different ways to deal with them,” says Baycrest psychologist Dr. Larry Leach. “I came away from the experience with a better appreciation of how the same problem can be approached differently from a different cultural lens. The professionals in Israel set up innovative, effective programs for individuals with dementia that met the individual and cultural needs, but with more reliance on volunteers than we see in Canada.”

People with dementia do well in care environments designed to help them function to the best of their ability. That was the central message of a guest lecture delivered at Baycrest in January by the Mayo Clinic’s Dr. Eric Tangalos, a noted geriatric specialist and Alzheimer’s researcher.

Dr. Tangalos talked about the memory and problem-solving difficulties that Alzheimer’s patients are subject to, particularly as the disease progresses and their ability to speak and perform tasks declines. The environment of care should therefore be designed to maximize “functional successes” while minimizing opportunities to fail, he said. “We want people to function, and caregivers need to pay attention to non-verbal cues from their patients.”

He demonstrated how a curved sidewalk in one nursing home helps walkers return safely to where they began. He noted the value of teaching Alzheimer’s patients to relearn meaningful tasks such as folding clothes. And he described how assistive technologies such as tags in clothing, monitors, motion detectors and amplifiers for the hearing-impaired can improve patient safety and functional ability.

Dr. Tangalos praised Baycrest’s day program for dementia patients, noting that the Centre has the advantage of being a single campus with a common focus.