Older adults with dementia and other cognitive impairments tend to experience longer stays in hospital, a challenge that an innovative program is aiming to address through individualized, behaviour-focused care in hospitals across the region.
In North Simcoe and Muskoka, the population is older than in other regions of the province, and, according to a recently released study by the Dalla Lana School of Public Health at the University of Toronto, cases of dementia across the province will increase almost 120 per cent by 2040.
Caring for people with dementia can become more difficult for loved ones and health care providers when the dementia is accompanied by behaviours that are challenging to manage. These can include wandering, agitation and aggression, which can complicate care and extend hospital stays among hospitalized older adults. These factors all highlight the importance of continuing to expand effective, compassionate care tailored to the distinct needs of aging adults in hospitals.
The Behaviour Success Agent (BSA) program, led by Waypoint’s North Simcoe Muskoka Specialized Geriatric Services (NSM SGS) program in partnership with area hospitals, addresses this need by supporting hospitalized older adults with dementia and behaviours. More than 600 patients have been served by the BSA program, which is more than double the target set when the initiative was launched in January 2023.
“We’re so proud of the impact this program is having,” said Annalee King, Manager of the Geriatric Mental Health Community team at NSM SGS. “The program support is essential to patients and their caregivers. We’re seeing real improvements in the quality and consistency of care, which can help reduce the time people spend in hospital. It’s also been gratifying to witness better communication amongst health care providers in the community and within hospitals and long-term-care settings. This program is a win for older adults and their loved ones, as well as for the health care system overall.”
BSAs are registered practical nurses, recreation therapists and other health care professionals specially trained to support the care of those with dementia and behaviours. Working directly with patients, BSAs strive to reduce the frequency and severity of behaviours and improve health outcomes and patient experiences — ultimately facilitating earlier discharges from hospital.
NSM SGS is a hospital- and community-based regional program designed to improve outcomes for frail older adults, their caregivers and the health system. Goals include helping older adults age safely in place, expanding regional services and skills, reducing avoidable emergency department visits and hospital admissions, and decreasing premature placement in long-term care.
NSM SGS trains, mentors and supports the BSAs to directly assess and support the patient, build patient-centred plans of care and help other members of the care team implement what they’ve learned. With the tools and knowledge they’ve gained, hospital staff ensure consistent care for these patients while also providing them and their loved ones with individualized support.
Last year, patients supported by the BSA program experienced a 77 per cent reduction in behaviours. For individuals where hospital stay was no longer required, the behaviour identified as the barrier to discharge was removed as a barrier in 65 per cent of the cases. This is important in enhancing patients’ quality of life while also helping to ease pressures on hospitals and improve access to care.
The BSA program is currently the subject of a study led by Dr. Katie Bingham, a geriatric psychiatrist and physician lead with NSM SGS. She was recently awarded a three-year $750,000 grant from the Canadian Institutes of Health Research — Waypoint’s largest CIHR grant to date — to study the impact of the program, with an eye toward expanding it to other hospitals.
