Geriatrician Dr. Jo-Anne Clarke said she takes satisfaction in “stopping the down-spiraling trajectory” of frail seniors, and making sure they get the support they need to stay in their homes as long as possible.
Clarke, the clinical lead of North East Specialized Geriatric Services, celebrated the grand opening of the service along with colleagues and local dignitaries Nov. 9.
The service, located on the “senior's campus” on the Pioneer Manor site, is funded by the North East Local Health Integration Network (NE LHIN) and administered by the City of Greater Sudbury.
Clarke works within a multi-disciplinary team, including a physiotherapist, occupational therapist, two nurses, a social worker, a program education co-ordinator, a program manager and two administrative staff.
The staff works together to make sure their patients get the best care. She gives the example of a senior who comes into the office with cognitive impairment (which could be mild dementia), depression and bad osteoarthritis.
One of the nurses working at the geriatric service will do an hour-long assessment with the patient, and then Clarke will spend another hour with them, working out a plan for their treatment.
“The first thing I do is look at their cognition...I say 'Is it your medications?' and look at their medications and see what I can change that may be impacting them. If there is dementia, do they warrant treatment, and is treatment with medication is appropriate?,” she said.
“Also, what things can I put in place to keep you in your home? I treat their depression. I treat their pain for osteoarthritis. I'll have the physiotherapist take a look at them and do some balance and strength training exercises to get them more mobile in their homes.
“I have the occupational therapist to look at them and see if they need a walking aid, and how we can arrange their homes to improve their ability to function and remove barriers. We also talk to their caregiver and see what supports we can put in place. Do they need help from the (CCAC) Community Care Access Centre?”
Patients need to be referred to the service by their family doctor. Clarke said sometimes she'll set up a plan for the family doctor to carry out, and in other cases, where she feels the patient needs more intervention, they'll continue coming to her office.
The geriatric service is open to people from across the northeast. Clarke has visited many communities in the northeast to see patients. The clinic also has the ability to see patients via tele-conferencing.
Clarke said she works closely with other health care agencies in the city, including the Sudbury-Manitoulin Alzheimer Society, the Community Care Access Centre and Sudbury Regional Hospital to get seniors the best care.
The geriatric service is just one step in ending the alternate level of care (ALC) crisis in northeastern communities, said Clarke. ALC patients are those who no longer require acute care, but remain in hospital because there aren't enough nursing home beds or other community supports.
Clarke said she aims to keep seniors in their homes as long as it's appropriate, so that should alleviate the problem.
However, she stresses that solving the ALC crisis will take a co-ordinated approach.
“Any one intervention does not make all the difference. These people are old and frail, and they get sick. You can put all of the interventions in the world in the community, and if they get sick and you have nothing in the hospital (for them), then all your gains are for nothing,” she said.
“It's also vice-versa. You can also put all of the resources in the hospital that you want, but if you have nothing in the community, there's nowhere for these folks to go. So addressing the ALC crisis is a big picture process, and this (the geriatric service) is one piece of the picture.”
Clarke, originally from the Lively area, moved back to Sudbury in March with her husband, Kristopher Longston, and their two young children, after finishing her specialist training in London, Ont.
She is the only Fellow of the Royal College of Physicians and Surgeons (FRCPS) geriatrician in northeastern Ontario. There are a few family physicians in the northeast who have certificates in geriatrics, she said.
Clarke said there are relatively few geriatricians around, and thus fewer doctors are trained in the specialty because there aren't many people to mentor them.
One of Clarke's goals is to expose students from the Northern Ontario School of Medicine, as well as students from other medical professions, to her specialty.
“Definitely part of our program is to have trainees, so that I can show them (students) the difference we can make in this group (seniors).”
For more information about the service, phone 688-3970.
