2006 Archive

An umbrella of care for the frail elderly Pioneering Capital Health program keeps seniors in their homes longer

Choice participant Ernie Golka (right) with his daughter Ellen Golka-Moxham and son Dan Golka.

By the time Ernie Golka discovered the CHOICE program two years ago, the 80-year-old had experienced a heart attack, several surgeries and was exhausted from the frequent trips to the region's hospitals to be treated for his multiple medical conditions.

His family was equally exhausted. They were trying to juggle all his appointments with various specialists, ensuring all the monitoring was kept up, with their own hectic lives. "For both dad and for us, CHOICE has been a godsend," says Ellen Golka-Moxham, Ernie's daughter. "We don't know how we would have managed without CHOICE and we seriously doubt if dad would be doing as well as he is today without it."

Traditionally, the options for seniors needing support have been limited – get help from family, hire a caregiver or move to a nursing home. "Dad wouldn't hear of moving from his home," says son Dan. "And he did not want to have to rely solely on Ellen and me. So when the CHOICE program was suggested to us, we knew it was the best option for us."

Developed a decade ago by Capital Health, CHOICE was the first program of its kind in Canada.  CHOICE - an acronym for Comprehensive Home Option of Integrated Care for the Elderly – is a comprehensive community-based model of coordinated care that helps to support older people who are experiencing multiple, ongoing health problems, to remain living independently in their own homes longer.

 "The program is like an 'umbrella of care' for frail clients with complex needs, essentially combining support from a multi-disciplinary team of professionals providing health clinic, day centre and home support care," says Karen Yukes, Director of the Capital Care CHOICE Program.

Eligible clients are transported by bus to a CHOICE centre, usually two to three days a week, Monday through Friday, where they receive a full range of medical, personal, social and supportive services. "Being able to access all these services in one location," says Yukes, "helps to relieve a lot of stress for caregivers because care is coordinated and provided from one location. This approach helps our clients receive the care they need."

Two program reviews, the most recent completed in 2003, consistently demonstrate that the pioneering program has had positive effects for clients, families and the health system. Since the introduction of the CHOICE program in 1996, clients have: 

• Decreased acute care use (in-patient days) by 70%
• Decreased sub-acute use by 84.7%
• Decreased Glenrose use by 70%
• Decreased Emergency visits by 62.9%;
• Decreased Ambulance trips by 51.5%;

Capital Health credits the success of the program to the multidisciplinary team case management approach, where physicians, nurses and pharmacists work together with social workers, physical & occupational therapists and activity conveners to provide a full range of social, medical and rehabilitation services on an ongoing basis.

"It's a model of comprehensive community care," says Marguerite Rowe, Vice President and Chief Operating Officer for Community Care, Rehabilitation and Geriatrics. "This program helps to support seniors to remain at home, where, given the choice, most would prefer to stay as long as possible."
CHOICE clients stay in the program, on average for six months to two years.

Currently there is a 40 per cent turnover in participants over the year. "The goal of the program," says Rowe, "is to help people learn the best ways to manage their medical conditions so that they can live at home as long as possible."

 For Ernie Golka and many clients like him, CHOICE has meant a heightened quality of life. "My father and all the other CHOICE participants are thriving from all the care and support and encouragement," says Ellen Golka-Moxham. "The program has given them all a quality of life that would have been impossible to achieve if each participant was trying to do it alone."

In addition to the medical support provided, Ellen says that another important aspect of the CHOICE program is the way it instills hope in each participant. "It's the opportunity to make friends and participate in social activities, to learn and to play. It's that quality of belonging to a larger family. It's a home away from home."

There are currently five CHOICE programs operating in the Capital Health region, including a specialized mental health and dementia care program, with a total of 360 program spaces.

To find out if you are eligible for CHOICE, call Community Care Access at 496-1300 and ask for an assessment. Or, talk to your Home Care Case Manager.