SENIORS IN FOCUS: Geriatric care model to change

Island Health is engaging people about service delivery in the region.

Island Health is engaging with the Saanich Peninsula and Gulf Islands to assess people’s needs in community geriatric care.

Two focus group sessions last week launched the public portion of a review of community geriatric care on the Saanich Peninsula and Gulf Islands.

Island Health is currently in the process of assessing the region’s need for local geriatric care in the face of new funding models.

Dr. Marilyn Bater, a physician specializing in geriatric care for 23 years, is the lead physician on Island Health’s committee looking to redesign community geriatric care.

“Island Health is in the middle of re-organizing and we are facing budget changes,” she said. “We have known for a while that we are going to have to look at how we deliver geriatric care in any case.”

That’s due to the changing demographic, she explained, meaning people are living longer and many are facing complex health conditions, some with variety of issues that become more pronounced as they get older.

Island Health currently provides community geriatric care on the Saanich Peninsula and Gulf Islands. Operating out the Peninsula Health Unit next to the Saanich Peninsula Hospital, Bater said an integrated team of physicians like her and geriatric psychiatrists, deliver service in two general areas.

The first is through an outpatient clinic. Bater said they see people who typically have multiple chronic illnesses or memory and mood issues.

The second is an outreach program that gets service providers into people’s homes.

“In recent years, geriatric medicine and psychology has become much more integrated,” she said, noting she thinks that has been a positive move — co-habitating all community geriatric services into one location in a respective area.

Bater said there is no geriatric team at the Saanich Peninsula Hospital. They do have a nurse available on an emergency basis for patients in acute care.

With a population in the region that’s decidedly older than some other places, Bater said Island Health hopes to reach elderly people, their families and caregivers before they reach a critical stage of need.

“People who are in need of services right now and into the future are spread out all over the Saanich Peninsula. So, what is it that we can do to actually be helpful to those who might need service in the future?”

According to an outline of the geriatric care review process, patients play a critical role in identifying problems and gaps that have been overlooked.

The proposed model, it reads, “indicates expectations  from a provider perspective — but the details of what service is provided and how it is provided must be determined by patient expectations and values.”

Last week’s two focus groups at the health unit started to open those doors. Bater said from there, the committee hopes to create working groups of health care professionals and citizens to help guide the team as they plan changes in local geriatric care.

In essence, the region is acting as a pilot project for Island Health and how the delivery of community geriatric care might look throughout Vancouver Island.

“We want to figure out how to make changes and how they can be done in a way that’s most valuable,” Bater continued. “Then, once we have done that, we can spread the model across Island Health.”

One of the additional goals of exploring geriatric care models, she added, is to look at doctor levels and how to keep people as healthy as possible, for as long as possible, before they face complex illnesses in old age.

“So, we must anticipate challenges 10 to 20 years down the road, so an aging population won’t have as big an impact.”

It is estimated that by 2023, the population of people over 75 is expected to increase  79 per cent on the Saanich Peninsula — 123 per cent on the Gulf Islands.

Bater explained that while Island Health’s funding of community geriatric care is changing, it is not necessarily changing the level of funding it gives to the area.

“It’s a focus on the funds and how to best support local needs and use them in a way, an innovative way.”

Bater told the PNR that she does not expect that this work will result in a loss of current services.

“Adults and seniors are going to need service,” she said. “We just need to find a way to do it, to do the things that are absolutely necessary.”

She emphasized that she doesn’t want anybody to worry about losing anything in this review.

In addition to focus groups, Island Health plans to conduct interviews with selected individuals and health care workers. Bater hopes that the work they do now to garner people’s input and their needs into the future, the committee will be able to secure additional support from Island Health to run those working groups.

By August, 17, she continued, Island Health staff and physicians will be interviewed and asked for their opinions. By the end of this month, Bater said she hopes to know if those groups will be able to proceed.

“These working groups are contingent on my report on all of this work at the end of August. We need to be patient-centric and we cannot presume what they want.”