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CAMH Stories Centre for Addiction
and Mental Health

Geriatric mental health at CAMH: Delivering care and compassion to a complex patient population

​CAMH’s Geriatric Mental Health Services treats a medically complex patient population with a mix of skill, caring and compassion. It consists of two inpatient Geriatric Assessment Units with a total of 48 beds, as well as outpatient services.

“I currently have patients on the unit ranging from those with schizophrenia to depression, bipolar disorder to dementia, substance use and alcohol use,” explains psychiatrist Dr. Sanjeev Kumar, Head, Geriatric Inpatient Services. “Because we treat geriatric patients, we are also accustomed to seeing additional medical issues such as heart disease, diabetes or general frailty with risk of fractures.”

Dr. Sanjeev Kumar
Dr. Sanjeev Kumar, Psychiatrist and Head, Geriatric Inpatient Services

Despite the medical complexity of the clients, Dr. Kumar remembers many patient success stories. “We had a patient who was catatonic and suffering for months with depression and Parkinson’s disease. She was barely eating and not speaking and would sit still as a stone,” he explains. “She had been in a mute state for four months. After treatment, she recovered enough to be discharged to live back with her husband.”

Making a difference

Rong Ting, Manager of Geriatric Inpatient Services and Intake, knows her team of over 70 staff members makes a difference in the lives of patients with a complex range of needs.

“We focus on recovery-based treatment so patients can function at their optimal level,” says Ting.

GAU team
(L to R) Geriatric Inpatient Services Manager Rong Ting, Social Workers Efrem Rone and Samantha Holowacha, and RNs Liza Augustine and Sandria Allen.

“There are three pillars to success in our complex care environment: medical knowledge, communication and compassion,” says Dr. Kumar. “We are fortunate that all of our team members are inherently compassionate and empathetic. We bring the human aspect to care, which is the most critical part.”

Team approach to care

“For each patient, we do a risk assessment to understand what they are dealing with. We share information with the rest of the team about the patient’s risks,” says Liza Augustine, RN. “We discuss goals and interventions to help the patient.”

“We recently attended a dementia symposium education session. This training helps us learn to get more information about the patient. Rather than just focusing on the patient’s behaviour, you focus on intellectual, physical, social and mental issues and address the causes of the behaviour,” adds Augustine.

Liza’s colleague RN, Sandria Allen, agrees it is important to look at the causes behind behaviour. “Sometimes patients come in with aggression, but we may find out physical symptoms are the cause or contributing to aggression,” explains Allen. “We focus on holistic care as a team approach to caring for a patient.”

There are dozens of ways the interprofessional team cares for patients, ranging from 60 to 90 years old, to help them recover and reach their goals. The approach to care is multifaceted and personalized based on patient needs.

“I check-in with patients daily on what activities are available, what they have energy for that day,” says Man-Man Choi, a Recreational Therapist with the Geriatric Assessment Unit. “I facilitate activities for patients focusing on their physical, cognitive, emotional and social wellbeing and health.”

Man-Man Choi and Efrem Rone
Man-Man Choi, Recreational Therapist, and Efrem Rone, Social Worker on the GAU.

Activities for inpatients range from art, music and dancing to pet therapy and mindful breathing.

“Sometimes our patients’ abilities and strengths may be masked by their illness,” explains Choi. “I feel motivated and energetic when I see patients doing more than I thought they could. For example, we do a music circle and we have each person shake an instrument when it is their turn. One patient had trouble knowing when it was her turn in the circle, but then there was a time when—unprompted—she knew it was her turn. That was my reward.”

Connecting and communicating 

“When I say good morning to a patient, right off the bat I can tell how they are doing at that time,” says Brittany Mills, Personal Support Worker with GAU. “We do rounds every hour to check on all patients. Some patients we check on every 15 minutes for their safety.”

Mills often communicates and coordinates with colleagues including occupational and recreational therapists, physicians, psychiatrists, housekeeping, environmental services, nurses, social workers, and medical lab personnel to help support patients’ needs, she explains.

Brittany Mills

Brittany Mills, Personal Support Worker, GAU.

Supporting patients

“We ask patients what strength-based interventions have worked for them in the past to see if we can get them to continue those interventions, such as book club or swimming, while they are an inpatient,” Efrem Rone, a Social Worker with GAU. “A lot of my work is individual talk therapy or counselling with patients.”

“I volunteer for monthly group outings with the patients to places like Dufferin Mall and St. Lawrence Market,” says Rone.

“Our interprofessional team works closely with patients and their families to find a range of resources and solutions to address their multiple, complex needs,” says Ting. “It is through this commitment, compassion and caring that our team helps to advocate for and support our patients through their recovery.”


Published on June 22, 2017

 

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