Ontario extends paramedic house-call program for seniors

As part of a pilot project, specially trained paramedics make scheduled house calls to seniors, where they perform non-emergency care such as bedside blood work, help with medications and connect their patients to other community supports. The Ministry of Health and Long-term Care invested $6 million to increase the reach of the program to nearly two dozen communities across Ontario in 2014.

But with the seed money set to expire on Thursday and the future of the program in question, Health Minister Dr. Eric Hoskins told the Star on Wednesday that it will continue.

“In order to ensure that Ontarians continue to have access to these services, I am pleased to say that we are extending this program and continue to work with our partners as we develop a long-term plan that provides these important services to as many Ontarians as possible,” he said.

It’s good news for Donald Murdock, a 69-year-old former furniture mover who welcomed the day a woman wearing “a paramedic badge on her shoulder” arrived at his apartment unit’s door.

There stood Siobhan Carlin, one of three Toronto medics who treats, educates and helps seniors coordinate care with other community supports, all within the comfort of their homes.

The first lesson Murdock learned was why walking around his bachelor pad sock-footed is a bad idea.

“The first time Siobhan visited me she pointed out I was wearing socks (which) can be slippery on tile,” he said, referring to a late-night tumble at home he experienced last year.

“So she told me to make sure I wear shoes or slippers with rubber on the bottom or I could slip, fall and hurt myself again, and that I do not need.”

Permitting paramedics to use their skills outside their traditional role as a first responder is a key pillar of the government’s plan to meet the future homecare needs of a rapidly growing tsunami of baby boomers.

“Now, we’re going to check your blood sugar… to check how sweet you are,” Carlin jokes, reading Murdock’s glucose levels. “(Did you) have a lot of chocolate this past Easter weekend?”

Doctors believe such community-based health care will help seniors live independently longer. Toronto’s trial run — called Independence at Home — has been underway since October 2014. Three paramedics have rotated through two positions solely dedicated to making house calls for senior Torontonians who live in social housing.

Dr. Samir K. Sinha, director of Geriatrics for the Sinai Health System and University Health Network hospitals, said he was “completely blown away” by the program’s results.

“We actually reduced 9-1-1 calls and emergency department transport in particular,” said Sinha, the former lead of Ontario’s Seniors Strategy.

The reduced number of emergency calls made by seniors, so-called “super-users” of the 9-1-1 system, translates into fewer ambulance trips and fewer beds occupied in the emergency department.

“Whether you care about the health-care system’s bottom line or about the care of our seniors, this is one of those rare models that does both,” he said.

“Working with our health care partners, we have been able to get many of our most vulnerable patients the right care at the right time,” said Paul Raftis, chief of the Toronto Paramedic Service.

An advanced care paramedic with 25 years’ experience, Carlin said her new, albeit non-traditional role, is just as rewarding, despite the change of pace.

“With front-line emergency care, you are often racing against the clock to save a life but don’t get to know the outcome,” she said. “Now I get to create a plan, help put the resources in place and see the patient thrive.”

Carlin added she threw her support behind community paramedicine because it keeps Toronto’s seniors safe, secure and independent in their own homes — “A place, I think, that we all want to be in during our golden years.”

By the numbers

More than 400 seniors have participated in Toronto’s Independence at Home (IAH) initiative, a community paramedicine program where paramedics make scheduled house calls to low-income, high-need seniors living in TCHC buildings.

Since launching in November 2014, the pilot project has recorded:

49%

Decrease in 911 calls made by enrolled patients

89%

Of patients lived at home

55%

Were taking five or more medications

24%

Had reported having seen their primary care provider in the past six months.

Across the province’s 30 pilot programs:

14%

Overall decrease in the volume of 911 calls

19,077

Patients have been enrolled

49.4%

Were 65 years and older

17%

Lived alone

8%

Were already receiving services from Community Care Access Centres at the time they were first assessed by a paramedic