2 Hospital News, August 2010
News
By Margaret Goulding For many seniors with mental illness and addictions, their wish to 'age at home' is not an easy one to grant. Not only are such clients often unready for long-term care placement, their sometimes challenging behaviours can mean they are not preferred tenants in traditional forms of independent seniors' housing. Through an exciting partnership with LOFT Community Services, CAMH's Stepping Stone Project has been able to house geriatric clients with mental health and addiction issues who might otherwise have remained in hospital. The majority typically has a schizophrenia diagnosis, but their symptoms are mostly stabilized. Many have been in the mental health and addiction system for a long time, either institutionalized or marginally-housed with few family or community supports. Now entering its second year at John Gibson House in Toronto's west end, LOFT and CAMH's Stepping Stone Project provides high-support housing for at-risk and frail older adults in the community. Six beds at John Gibson House are reserved for CAMH client referrals and six others are for other community hospitals. CAMH staff - including a psychiatrist, a nurse, and an occupational therapist - visit weekly to provide the intensive level of specialized support needed. As much as possible, CAMH staff members remain involved with the clients after they move into permanent housing to maintain the continuum of care. Dr. Tarek Rajji in CAMH's Geriatric Mental Health program believes the Stepping Stone Project is important because it allows seniors to live more independently while the supports built into the project prevent future hospitalizations. "Some of the clients have been institutionalized since the 1990s, and there were concerns they wouldn't be able to adapt to community living. However, through the continuity of care offered to the clients, we were able to prevent their functional, social and psychiatric decline as they transitioned to the community." Saving the sandwich generation While many people in the 'sandwich' generation are struggling to ensure the needs of their children and their elderly parents are met, imagine the worries they have if their senior family members have serious mental health issues. Dr. Rajji has seen family relationships renewed or improved once the seniors' housing has been stabilized in www.hospitalnews.com
Stepping Stone partnership between CAMH and LOFT: a first step to aging at home
By Bill Melville Bed bugs have made headlines with their resurgence in hotels, but they're also popping up in health-care facilities across North America. While an April 2009 article in the Journal of American Medicine concluded that bed bugs do not transmit communicable diseases, most would agree that these pests,
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Pulling back the sheets on bed bugs in health-care facilities
whose bites can result in itchy welts, cannot be tolerated in health-care environments. Unlike other pests, bed bugs have nothing to do with sanitation. As blood feeders, bed bugs are only concerned with being close to a human host. Areas where patients stay for long periods of time and bring in luggage - namely maternity wards, long-term care facilities, and hospice areas - have more ???????????????????????????????????????????? Focuses on: The Professional, The Client, The Relationship ??????????????????????????????????????????????????????? ???????????????????????????????????????????????????????? ???????????????????????????????????????????????????????????
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William Shin, coordinator, Stepping Stone project, with Maury, a client who now lives in the community thanks to an exciting partnership between CAMH and LOFT Community Services. potential to become infested with bed bugs. The pest management experts at Orkin recently released a white paper, "Pulling Back the Sheets on the Bed Bug Controversy: Research, Prevention and Management in Hospitals and Long-Term Care Facilities," to answer questions about bed bugs and their implications for health-care and longterm care providers. Following are some of the tips outlined in the white paper: * Check mattresses - inspect bedding as it is brought in for evidence of bed bugs. * Require mattresses and box springs to be encased - This prevents bed bugs from hiding, and prevents their escape if they've already found shelter in the inside of the mattress. * Perform an inspection of incoming furniture; like bedding, plush furniture can also harbor bed bugs. * Utilize monitoring technol- ogy or bed-bug sniffing dogs - Discuss available options with your pest management professional. There are non-chemical and environmentally conscious ways to treat bed bug infestations: disposal, laundering and heat. Launder items harboring bed bugs - heat and soap will kill bed bugs and remove any eggs. Dispose of furniture or other items. Bed bugs like moderate temperatures, so pest management professionals can also kill bed bugs by heating rooms to a temperature of 49 degrees Celsius, or by "spot-treating" areas of the room or furnishings with dry steam. A wide-spread infestation may require a more aggressive, chemical approach, which should only be applied by a licensed, trained pest management professional. This includes fumigation, non-residual and residual chemical treatments. Discuss options with the community. In one case, he saw the relationship between a female client and her son and grandchildren greatly improve once the client was found a placement through the LOFT system. Getting the Stepping Stone Project off the ground was the result of a great deal of strategic planning and cooperation by CAMH's Physician-in-Chief and Clinical Director of the Geriatric Mental Health Program Dr. Benoit Mulsant, and LOFT's CEO Terry McCullum. Both were committed to improving the quality of life for clients who don't require acute hospital care and for whom assisted living is inappropriate. They worked together to create an innovative solution where no prototype or template had existed. As a result, the Toronto Central LHIN, funder of the program, has asked that the program place another 30 clients going into its second year. The diversion of clients out of hospital has led to a reduction in alternative level of care ("ALC") rates, improved system capacity and a new outlook on life for our senior clients. Margaret Goulding is the external communications coordinator at the Centre for Addiction and Mental Health (CAMH). your provider, who can recommend the best course of action. Bed bugs are unwanted pests, and should not be taken lightly. They can affect your facility's reputation and your patients' and residents' peace of mind. Prevention is key to avoiding bed bug problems, so it's important to develop a plan for your facility and train your staff accordingly. To read a full copy of Orkin's white paper on bed bugs in health care environments, visit http://www.healthcarepestcontrol.com/files/ashesbedbug-white-paper.pdf. For more information on treatment options in Canada, visit http:// www.orkincanada.com. For more information: bmelville@pcocanada.com or visit www.orkincanada.com. Bill Melville is Quality Assurance Director for Orkin PCO Services.
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