Day Hospital helps clients regain strength and hope

“Here, it’s all laughter. They care about me,” says Deer Lodge Centre’s Day Hospital client Eva Kilopoulos (above)

By Ryan McBride

For 42 years he was her husband and her best friend. And then one day, he was suddenly gone.

The loss and grief took Eva Kilopoulos by storm. “I was aggressive to people. I got dizzy and frequently fell. Then came the pneumonia.” The doctor treating her pneumonia referred Eva to the Day Hospital at Deer Lodge Centre to regain her balance, her strength, and her will to continue. In early 2017 she came for her first assessment without much hope in her heart.

“I was lost to myself.”

Acute rehab for acute needs

The Day Hospital at Deer Lodge Centre offers rehabilitation for clients suffering from acute health conditions. Harriet Maynard, manager of patient care, says she and her staff help people recovering from strokes, fractures from falls, or simply bodies that have become frail and deconditioned from years of sitting or lack of exercise.

Like Eva, most clients “come one or two days a week for a few hours, and we treat them until they can manage again on their own.”

The goal of Day Hospital is simple: “To give our clients the tools they need to remain living at home, independently, for as long as possible.” Clients are referred to Day Hospital from a variety of sources: family doctors, hospital in-patient services and emergency rooms, home care coordinators and partner organizations such as the WRHA’s MyCare program. The user fee includes transportation to and from each session. A client’s first appointment is always with one of the Day Hospital’s three nurse case managers, who conduct a thorough assessment to determine the proper course of treatment.

“We offer intensive, highly specialized, one-on-one care,” says Wanda te Bokkel, one of the nurse case managers. “With us, our clients get the time and focus they may not receive from their family doctor, especially in more complex cases. After our first assessment they meet with a geriatrician, and then get another half hour or so with whichever specialists can help them regain whatever function they’ve lost.”

Balance and strength

For Eva, that meant seeing a physiotherapist to help with her problems with balance and strength. After her first few visits she could barely walk around Deer Lodge Centre twice. Eventually, she could walk seven circuits of the centre with no difficulty.
Mavis O’Donohue, the Day Hospital’s physiotherapist, says it’s enormously rewarding to see clients regain their independence over time. With the help of a rehabilitation assistant, Mavis not only helps clients regain balance and strength but teaches falls prevention courses.

When she first began working there in 2009 after a career in private practice, she was used to treating a much younger population. “But now, thanks to better healthcare services and home care, more people are aging in place longer. When they come to us, they’re much older.

We’re keeping people out of hospital beds for as long as possible, which is good for our healthcare system.”

The not-so-simple things

Depending on their needs, other clients may see Diane Rawluk, the Day Hospital’s occupational therapist. She specializes in improving a client’s ability to perform everyday activities. Sometimes that involves therapeutic exercises that build dexterity in the hands, for instance, or giving clients strategies that help make daily activities easier.

“The simplest thing like getting dressed is a huge challenge when you’re suffering from arthritis and can’t use your hands,” she explains. “For one client I made a dressing stick that helped him put on and remove his clothes more easily.”

Because many clients arrive at the Day Hospital with some degree of cognitive impairment, Diane also provides memory strategies to help them remember things that help them get through the day. “Or I visit their home to make sure it’s safe to live in. I watch them cook to see if they do so safely. What I’m after is a clear vision of their ability to problem-solve or manage in an emergency. When I see a problem, I offer a solution or refer them to other specialists as needed.”

Diane says the toughest part of her job can be performing driving assessments, which are passed on to the client’s family physician, who decides if a client’s driving license needs to be revoked. “You’re taking away their independence, and that’s hard because our goal is to do just the opposite. On the other hand, finding solutions to problems is hugely rewarding.”

Coordinating care

Eva Kilopoulos didn’t need the help of an occupational therapist, but she did go to Day Hospital social worker Marnie Deck for help dealing with her loss. “I called her at home to check in on her often,” says Deck. “Now I’m helping her apply for an apartment that is smaller and easier for her to manage on her own.”

Marnie often helps Day Hospital clients with future planning: finding a place to live, helping low-income clients with maintenance and home care, connecting clients with mental health specialists and resources in the wider healthcare community, and dealing with legal aspects of care, such as power of attorney. “Getting clients and their families to arrive at mutually beneficial solutions to problems such as housing can be one of the more challenging aspects of my job.”

She also refers clients to outside programs such as Adult Day Care and PRIME, which offer ongoing support after rehabilitation is complete.

Day Hospital clients might also visit the program’s onboard pharmacist, speech language pathologist, clinical dietitian, neurologist, or geriatrician.

Special people, day after day

Zinovy Pechersky, one of the program’s nurse case managers, says the Day Hospital’s greatest strength is the collaborative spirit of its multidisciplinary team. “We all specialize in the geriatric knowledge of our separate disciplines, and we all bring something different to the table. We consult together to get a much more comprehensive picture of each of our clients, which allows us to provide a more complete, holistic level of care to them and their families.”

Harriet Maynard agrees. “I came here 18 years ago from a background in nursing and I never wanted to leave. Here there’s a real sense of community working together to make a difference in people’s lives.”

For Eva Kilopoulos, lost for so long in the grief of losing her husband, Day Hospital has made all the difference in the world. Eight months after her treatment began, she’s celebrating her last appointment by planning future return visits to the specialists she now calls her friends.

“Here, it’s all laughter. They care about me. I’ve regained my inner strength. I’m more patient with myself, less aggressive. I’ve regained my balance and the weight I lost. They’ve helped me to move on and let go. These are special people.”