Although there are still six months to go before it concludes, an innovative residential care pilot project in Chilliwack is already enjoying success and delivering a noticeable reduction in ER visits by frail, care home residents with dementia. The pilot program – funded by the Ministry of Health – was launched in January 2012 under the direction of the Chilliwack division of family practice. It has been allotting three hours a day for a physician to visit care homes and attend to resident needs.
The lead physician for the program in Chilliwack, Dr. Ralph Jones, says the goal is to keep the care in the care homes as much as possible.
“Residents still have their family doctors who visit them on a regular basis. What the Residential Care Program (RCP) provides is an added layer of medical support; and any resident who needs patient care can receive it,” said Dr. Jones. “Urgent cases will always go to the ER, but many things can be dealt with in the homes,”
A key objective of the pilot project is a reduction in the number of ER visits by frail, care home residents, and according to Dr. Jones there has been a clear reduction at some sites along with an improved quality of care for residents.
“The ER is not a good place for a frail senior with dementia,” said Dr. Jones. “The bright lights, ambulances, and general commotion of an ER are very hard on people with moderate to severe dementia. As much as possible, we want to care for these people where they are the most comfortable.”
Similar pilot projects are taking place in Abbotsford, Prince George, Surrey-White Rock, and the Cowichan Valley, largely in response to the drastically changing population seen in care homes.
“The typical stay in a care home is now 18 months to 2 years, whereas a few years ago it might have been 5 years,” said Dr. Jones. “People are staying in their own homes longer now with care supports, often until they are so frail and demented that it is no longer safe for them to be at home. Maintaining quality of care for these people as they move to residential care is paramount.”
Starting on October 1, the program in Chilliwack will run a bit differently. For the final six months of the pilot, instead of daily visits by the RCP physician, family physicians will be provided with incentives to go into the care homes more frequently to do comprehensive reviews of their own patients. These visits will be supplemented two days a week by visits from the RCP physician.
Once the pilot project ends in April 2014, the next step will be to analyze the data and bring it together with data obtained from the four other residential care pilot projects.
The hope of Dr. Jones and many others is that a “best model” of care, with the best quality of care outcomes, will emerge from the pilot project data and offer a scalable model that can be implemented province-wide.
