Psychogeriatric Resource Consultant Program

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Psychogeriatric Resource Consultant Program
in Toronto  
Community
Meetings
April 30 May 2, 2001
Bendale Acres Castleview-Wychwood

Agenda     1. Welcome - Mr. Nello Del Rizzo 2.
Overview of Alzheimer's Initiatives - Ms. Rhona
Phillips 3. Overview of Resource Consultant
Program Dr. David Ryan 4. Questions Answers
Dr. David Ryan, Dr. Rory Fisher, Ms. Marlene Awad
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Service Locations   The Psychogeriatric Resource
Consultants, allocated according to population
statistics will be managed by RGP and the
following host organizations within Torontos
CCAC regions   North York North York
General
Baycrest Centre

SWCHSC
Toronto CAMH PACE (Central)

St. Michael's Hospital

Toronto Rehab
Institute Scarborough Providence
Centre
The
Scarborough Hospital York/East York
Toronto East General Etobicoke CAMH
PACE (West)

Queensway site Trillium Healthcare Centre  
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The next few slides provide answers to
several frequently asked questions about the
Psychogeriatric Resource Consultant
Program
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At what stage of development is the program now
and when will its services be available?
The program is in the recruitment phase. Fifty
health professionals responded to our recruitment
ads. Twenty very experienced and skilled
applicants have been short listed for the 11
positions. The interviewing process is underway.
We hope to have people in place in 60 to 90
days. The next steps will be 1 to 2 weeks of
program development with the consultants. At the
same time our communication plan will be
initiated. At the end of the two week period
the consultants will begin to contact you and you
will know who and how to connect in your region
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Where will the consultants provide their services

• In long-term care facilities
• Community Support Services such as Seniors Day
  Programs, Alzheimer's Day Programs, and Respite
  Care Programs.
• In patients homes

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What is the focus of the consultants work?

• The focus of the consultants work are the
  learning needs of the care-givers in long-term
  care facilities, CCACs and Community Service
  Agencies who are caring for
• People suffering behavioral disorders associated
  with a dementing illness or other acquired brain
  injuries
• Seniors with mental illness who have significant
  functional limitations and require complex care
• Vulnerable adults who may be less than 65 years
  of age such as those with Developmental
  Disability, Downs Syndrome, or early onset of a
  dementing illness
•  

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Are medical referrals necessary?
No, medical referrals are not necessary because
the psychogeriatric resource consultants do not
provide direct patient care/contact. As a
result referrals can be accepted from appropriate
staff at long-term care facilities, community
care access centres and community service
agencies.
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The referral process can be initiated by and in
collaboration with

• Pieces trained psychogeriatric resource people
• Community Care Access Centre Case-Managers
• CSS agencies managers eg.Adult Day Program
  Managers
• Family and long-term care physicians and other
  staff
• Geriatric Psychiatrists and affiliated health
  professionals
• Schedule 1 facility admissions and discharge
  planners
• The specialized geriatric services affiliated
  with the RGP

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What help will the consultants provide?

• Guide the development, implementation and
  evaluation of care-plans and programs.
• Assist in making referrals to other services
• Facilitate access to clinical and learning
  resources
• Respond to requests within 24 hours of receipt
• Provide an initial report within 36 hours of
  consultation

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What help will the consultants provide?

• Assess learning needs and develop a regional
  Learning Needs Atlas
• Provide needs based education and training
• Continuously improve the model of
  psycho-geriatric resource consultation and
  follow-through.

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Will consultants assess clients?  
No the Psychogeriatric Resource Consultants do
not provide clinical assessment services. Their
role is to help in-place caregivers develop the
skills and knowledge that they need to develop
and implement effective care plans, to recognize
when and where to refer to an existing service
and to do so with information that will
facilitate a timely and efficient response.
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Will they work in crisis situations?  
The consultants can provide guidance, coaching
and support to in-place caregivers in crisis
situations. But the consultants will not
replace existing crisis and emergency services
13
Will consultants be available on the weekends and
on legal holidays?  
The consultant program will provide a response
within 24 hours of a request for service
14
Can the consultants provide in-service training
sessions on weekends, which is when the care
team has less access to additional internal
resources, and is often part time staff?  
Yes the consultants will manage their work
schedules flexibly to meet the needs of their
clients.
15
Can the consultants accept referrals from staff
in hospitals?  
No this is not a service for hospital staff. We
will however redirect hospital requests to
appropriate in-house services.
16
Can members of the public, who are managing care
for their relatives at home, get help from the
consultants directly?  
The consultants will provide educational services
to lay care-givers, however these services will
primarily be group rather than individually
focused and wherever possible they will be
integrated within existing caregiver support
programs or treatment team meetings.
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How will we know who to call?
Each Psychogeriatric Resource Consultant will be
allocated to specific LTC facilities, CCACs
CSAs. Allocation of consultants will be a
primary focus of initial program development and
will be clearly communicated to all stakeholders
in a concise and timely manner A central access
point will provide access to consultants over
weekend and holiday periods. As well, a program
website will be constructed to facilitate
knowledge transfer. For now please call Rhona
Phillips at 416.327.8956 or Dr. David Ryan at
416.480.6100 ext 3369
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  Professional CCAC Staff dont know how to
advise contracted homemaking staff about how to
handle the anxious behaviour of a client who
lives alone despite being in the mid-stage of
Alzheimer disease. What can and would the
consultants do to help? When would they do it?

• Two learning needs are identified in this
  scenario
• 1. The homemaking staff needs are immediate.
  
• CCAC staff learning needs.
• These two needs have distinct time-demands and
  will require different educational approaches.

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The next few slides present several scenarios
that we have been posed and includes responses
developed by both ourselves and participants at
the community meetings.
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  Staff at a local long-term care facility are
having trouble managing a resident at 530 p.m.
on a Saturday night. What can and would the
consultants do to help? When would they do it?
Could the consultants provide training and
consultation in the evening to help this
particular complement of staff?
There are both immediate and more persistent
learning needs in this situation. Helping staff
to resolve this particular situation and teaching
them how to manage it in the future. Consultants
can respond flexibly to meet the workshift
requirements of caregivers.
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A networked action-learning consultation
Immediate Review the situation Locate and review
the care-plan? Review care plan
adherence? Action-focused problem solving
dialogue. Medium Term Convene the team to
care-plan and facilitate the care-planning
process for this patient. Long Term Implement
care-planning workshops systemically. Build the
learning atlas.
22
Staff at an adult day program for frail seniors
is having trouble managing a client. They suspect
the client is not taking her medications properly
at night. What can the consultants do in this
situation and when would they do it?
The consultant would help the caregiver identify
the appropriate people to talk to ie. The family
or the family physician.
23
A group of about 40 community agencies meets
every second month to discuss common issues and
learn about new developments in the field. Would
the consultants be available to do one or two
training sessions?
Yes, enthusiastically
24
A CSS agency gets a call from the relative of an
elderly man whose father is threatening to commit
suicide. What would the consultants do to help?
When would they do it?
The psychogeriatric resource consultant program
is not a crisis intervention service. If called
in this situation the consultant would help the
caregiver to identify the appropriate services to
call to manage this emergency and then assist the
caregiver to learn how to evaluate suicide risk.
The consultant would consult with agency
management to determine whether an educational
consultation on the assessment of suicide risk
and management might be worthwhile for agency
staff