A 92-year-old patient’s story

Community healthcare supports allowed Doris Bourque, above, to return home a week after having surgery to remove a tumour the size of a grapefruit growing from her bowel.

At 92 years of age, having surgery wasn’t something Doris Bourque would ever have considered — until she didn’t have much choice.

After quietly ringing in 2010 by sharing a fondue dinner with family and watching television highlights of New Year’s Eve activities, the St. Catharines woman went to bed well before midnight but later than usual.

When a nurse at Tufford Manor Retirement Home checked in on Doris the morning of January 1 as part of their usual routine, she discovered Doris was experiencing severe abdominal pain and could not get out of bed.

An ambulance was called, and Doris was taken to the St. Catharines General Site Emergency Department to be checked out.

Numerous tests were ordered by ER physician Dr. Tim St. Amand, including blood work and a CT Scan. Consultation followed with the on-call surgeon, Dr. Chris Blewett, and Internist Dr. Juan Velasquez. The diagnosis: Doris had a tumour the size of a grapefruit growing from her bowel and pushing on her organs.

Doris was admitted to the 4th floor surgical unit, and Dr. Blewett performed bowel surgery on Doris several days later, removing the cancerous tumour.

“I lived most of my life in Montreal and only moved to St. Catharines last year to be near my family,” says Doris. “I found being in the hospital scary and confusing at times. I wasn’t familiar with the surroundings, and I was really worried about having surgery. I don’t see very well, which makes it difficult to make out faces or find my way around.”

Doris was admitted to the Telemetry Unit at St. Catharines General Site after her surgery so her heart and overall condition could be closely monitored.

Over the course of the next week, she was cared for by surgeons, nurses, internists, cardiologists, physiotherapists, and finally discharge planners when it came time for Doris to go home.

The hospital’s discharge planners and Community Care Access Centre (CCAC) played a key role in Doris’s discharge. Working together, they identified and arranged the supports Doris would need in order to leave the hospital.

When she arrived home to her room at the retirement home, a special bed rail was already installed to help her get in and out of bed. Arrangements were also made for a personal support worker to come to the home twice a day to help Doris – in the mornings to get dressed and in the evenings to get ready for bed – as she continued to recover from her surgery. This was in addition to the extra attention she received from the staff at Tufford.

“I was afraid to go home because I didn’t think I would be able to cope, but the staff here at Tufford, in the hospital and with CCAC were all so kind and so helpful,” says Doris.  “I am so grateful to everyone and can’t thank them enough for helping me get through my surgery. I am so happy to be back home.”

From left, Regional Director of Utilization Jane Cornelius works closely with Sandra DeLazzer, a Discharge Planner at St. Catharines General Site, and Medical Unit Charge Nurse Christena Watterson, to ensure patients’ care needs can be met in an appropriate and safe environment when they leave the hospital.

Like Doris’s journey, a patient’s journey can be long, complex and at times very intimidating.

“In healthcare today, a hospital patient will interact with multiple caregivers as their journey unfolds,” says Interim Chief of Staff Dr. Joanna Hope. “Increasingly, patient needs are complicated. They often come to hospital with more than one condition.”

Being in hospital is just one step along the journey. More and more, healthcare providers of all kinds are working as part of a bigger system of care.

In the past, patients would stay in the hospital until they fully recovered from an acute condition. Today, hospitals across the province, including Niagara Health, are becoming more clearly defined as the key providers of acute care. At the same time, community healthcare providers, like CCAC, are becoming clearly defined as the key providers of care that can be delivered in the community while a patient recovers from an acute event.

“Care providers in hospital and in the community are working together to ensure patients get the hospital care they need and return to their homes to receive care from community providers,” says Jane Cornelius, Regional Director of Utilization.

“The concept of hospitals being the provider of the majority of healthcare needs is indeed a thing of the past,” says Jane. “It just isn’t possible anymore given the increasing demand for care and associated costs; medical advances in the way care is provided; changes in technology; a persistent global shortage of doctors and nurses; and other trends in healthcare.”

Among many new initiatives, Niagara Health is doing things differently by  creating centres of excellence in which specialists work more closely together with the best technology. There is greater focus on health promotion and investments in management of chronic diseases like diabetes and stroke.

“Every hospital has to take all of these realities into consideration in order to provide people with the best possible care,” says Dr. Hope, “not only today in 2010 but in the future.” «