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South East



Maintaining Independence

It's Thursday morning and the 89-year-old Etter has obliged to squeeze in an interview at his Quinte Gardens retirement suite before a surprise visit from his grandson.

The door on his third floor quarters swings open and the affable World War Two Merchant Navy Veteran sports a welcoming smile and extends a gripping embrace to nurse Carol Taylor, a care provider he would later credit for supporting his battle to live relatively independent.

Numerous oxygen storage tanks and a network of tubes including one protruding from his nostrils betrays Etter's attempts to disguise his deteriorating health due to pulmonary lung disease. He also struggles with urinary tract issues.

“It (lung disease) has made me progressively weaker but I feel good today,” Etter admits. “It's important for me to maintain as long as I can.”

Taylor, a care co-ordinator with the South East Community Access Care Centre, concurs Etter's health status varies and constant monitoring is necessary to add supports such as additional nursing visits when required.

“Phil actually looks great today,” she said, while seated next to the gregarious Etter. “I saw him in the fall and he looked pretty grey which is a sign that he's not getting enough oxygen.”

Etter proudly displays the passing grade on a physiotherapy assessment backing his bid to remain in the independent living suite at Quinte Gardens.

“I'm still capable of living independent with the help of CCAC,” he said.

Taylor's supportive care unit manages palliative care for patients, like Etter, in all disease stages, including those nearing the end of life. Etter's longest hospital stay in five years was about three days.

“Phil is a good example that the system works,” she said.

Her department eats up the majority of the resources designated for the Belleville CCAC, an agency at the heart of local efforts to facilitate a transforming Ontario health care formula now shifting to caring for certain patients at home to avert the need for hospital admittance.

“The acute care provided at the hospital is not the place for somebody that's dying,” she said. “Most people prefer dying at home.”

A team of seven care co-ordinators handles patients, primarily seniors battling life-threatening ailments such as cancer, end stage cardiac disease and lung disease.

“I work with patients until they die,” she said. “The mandate of this team is to keep people out of hospital.”

Taylor's case load alone averages about 70 clients including Etter. With close to 50 years in nursing, Taylor said, the last 14 spent as a care co-ordinator with CCAC has heightened her awareness about climbing community demand.

“I had no idea the number of people that live with severe chronic illnesses in their own homes and die in their own homes,” she said. “Most people, until they have been confronted by that urgency they don't even know we exist.”

Taylor vouches for the services provided helping people like Etter stay out of hospital and remain independent longer before he has to resort to finding scarce accommodations at a long term care home. Taylor provides his family with updates on his health status and shares advice about the next stage in advance.

“He's (Etter) doing really well but he's right on the brink of long term care,” she said. “A big part of our work is those difficult conversations about a senior's health failing.”

Once someone is released from hospital, “we connect with them as soon as possible to make sure the transition (to own home, retirement facility or long term care home) has happened and the services they have are appropriate.

“We then adjust the service plan as needed,” she said. “There comes a point when treatment doesn't work anymore and symptom management becomes the focus.”

Constant monitoring of patients' health and their ability to function fairly independently dictates how care is delivered.

“It's our job to go out assess the patient and explain to them what services we provide and what other services are out there,” she said. “If they know we're there around the clock to provide the services they need then they wouldn't be so quick to bring people to the hospital when they don't need to.”