Reaching out to Seniors and their Families

Baycrest’s Telehealth service shares expertise with international as well as remote Canadian communities.

Depression is difficult enough to treat at any age, but for seniors who may be dealing with multiple health issues as well as the loss of family members and peers, the disease can be even more debilitating. Donald (not the patient’s real name), a resident of the small Northwest Ontario community of Dryden, has suffered from several bouts of depression during his lifetime.

Now retired and in his seventies, Donald became ill to the point of needing to be hospitalized. After a time, he was discharged with medication and returned to his wife and home. “But he wasn’t responding to the medication or to our team’s attempts at intervention and I became concerned,” says Natalie Legros, social worker in Dryden for The District Mental Health Services for Older Adults. “I scheduled a psychiatric teleconference [live, two-way video conferencing] with Dr. David Conn at Baycrest and after discussing the case with our staff, he recommended Donald go to Toronto and be admitted for treatment in Baycrest’s psychiatric unit.”

Conn, psychiatrist-in-chief and medical director of Baycrest’s Brain Health Centre Clinic for mood and related disorders, also directs their Telehealth service, which has been holding geriatric teleconferences with outlying communities in Ontario as well as with medical institutions in Africa, the Middle East and South America. These landmark events, broadcast from Baycrest’s Telehealth suites, are geared at sharing Baycrest’s world-renowned expertise. Top-of-the-line medical professionals from diverse parts of the world consult on issues as diverse as pain management, and neurological and psychiatric conditions or a combination of complex and debilitating diseases.

One recent teleconference linked Baycrest with medical professionals in Argentina, Brazil, Ireland and Romania. “The International Psychogeriatric Association asked us to arrange its first-ever international teleconference, which was held in March of 2006,” Conn reports. Cases were presented to the multi-national audience and an interactive discussion followed.

The World Health Organization has shown great interest in a new Baycrest Telehealth initiative aimed at helping people in the Middle East and Africa.

Another teleconference connected professionals at medical facilities in Israel, Jordan, the Palestinian authority, Switzerland and South Africa. Conn reports that, “There is a new project in the works, regarding a comprehensive Canadian educational outreach program to the Middle East and Africa.” He adds that The World Health Organization has shown great interest in such a program.

Closer to home, Conn says, “I have a special relationship with six communities in Northwestern Ontario and I provide teleconferences on a weekly basis. These small towns are 18 to 20 driving hours away from Baycrest and five of the six communities are actually in a different time zone.” The communities span an area of 12,000 kilometres and there is no geriatric psychiatrist for the entire region, a fact that makes their link to Baycrest even more vital.

Telehealth outreach is made possible, Conn explains, through Baycrest’s membership in the NORTH (Northern Ontario Remote Telecommunications Health) Network. Baycrest also provides teleconferences to other northern communities such as Timmins, Elliot Lake, Cochrane, Kirkland Lake, Chapleau and Sudbury. When necessary, translators are used for Aboriginal patients and their families.

Treating the elderly for depression is much more complicated than it is for a younger population, Conn explains. That’s where Baycrest’s expertise and Telehealth service come in handy. “Many people suffer from multiple illnesses and are often taking several medications at a time. Wherever possible, we use a bio-psychosocial approach, using all available treatments. In Donald’s case, he suffered from multiple somatic [physical] complaints and he had a lot of pain and fatigue, as well as a clinical depression,” he says.

So, how is Donald doing now? Natalie Legros, Donald’s social worker in Dryden, is optimistic. “I actually just called Baycrest yesterday. The social worker there said they modified his medication and administered other treatments. She tells me he’s smiling and participating in the psychiatric inpatient unit’s activities. I can tell you that a month ago, that would not have been possible.”

Telehealth outreach to communities including Timmons and Elliot Lake is made possible through Baycrest’s membership in the NORTH (Northern Ontario Remote Telecommunications Health) Network.

“When I first took on this position,” Legros recalls, “I was given an empty desk and a pile of paper and told, ‘Go develop a program.’ Believe me, there was very little out there! As a professional,” she says, “I don’t even know how to express to you how much this arrangement with Baycrest has furthered my knowledge.

“We’re fairly isolated here, but because of our connection to Baycrest, we have many opportunities for geriatric education that is specific to our program needs. We receive training directly from Dr. Conn at regularly scheduled teleconferences and we also have educational programs for families and caregivers. We’re all thrilled to be getting this level of ongoing training.

“I’m in awe of what Baycrest has done for us in terms of furthering our education and, of course, those advances enormously benefit our seniors and their families.”