Dementia Caregivers Learn Tips for Navigating Hospital Stays

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Dealing with a loved one in hospital can be challenging and stressful for any family. But for dementia patients and their caregivers, the experience may trigger even more anxiety and tension than usual.

Understanding what to expect during a visit to the emergency department or a longer stay in hospital was the focus of the fifth annual World Alzheimer’s Day educational session held by the Cyril & Dorothy, Joel & Jill Reitman Centre for Alzheimer’s Support and Training at Mount Sinai Hospital. The session, held in recognition of World Alzheimer’s Month, was attended by caregivers and clinicians.

“When someone with dementia arrives at the hospital, they’re almost always there for an acute medical condition, but their dementia can truly impact the care they require,” said Dr. Joel Sadavoy, Head of Geriatric Psychiatry at the Reitman Centre, who opened the session.

Attendees heard from Carla Loftus and Mavis Afriyie-Boateng, Clinical Nurse Specialists at Mount Sinai Hospital; Matthew Royal, Clinical Nurse Specialist/Nurse Practitioner at Mount Sinai Hospital; and Carolyn Pichot, Nurse Practitioner for Crisis Outreach Service for Seniors.

The panel shared the following tips and considerations for caregivers who need to bring a loved one with dementia to hospital.

  • Bring familiar comfort items from home. Whether waiting for test results, waiting to see a doctor, or waiting to be admitted/discharged, waiting is an inevitable part of a hospital stay. Bringing items to keep loved ones occupied is a good way to prevent boredom, which can lead to acting out and aggressive behaviour.
  • Communicate! Caregivers should communicate as clearly as they can with hospital staff and with their hospitalized family member. Nurses and doctors can be very flexible to meet the needs of every patient, and will work as closely as they can to ensure that they perform only tasks that are medically necessary.
  • Bring sensory aids to the hospital. Any medical aids, like dentures, eyeglasses or hearing aids can be extremely helpful in providing a sense of stability to the patient, and allow them to participate in their care. Keep nurses informed about these sensory aids.
  • Label everything. Things can go missing at hospitals, such as eyeglasses left on a meal tray, or a blanket tossed in with soiled linens. By having personal items labelled, it’s much easier for nurses and other hospital staff to return lost items to their rightful owners.
  • Use hospital whiteboards. Most hospital rooms are equipped with whiteboards that patients and their family members can use to communicate with staff. Caregivers should use these whiteboards as much as they can (or make their own signs) with vital information. If the patient speaks another language, writing basic words and their phonetic spelling can be useful to nurses to bridge the language barrier.
  • Share the patient’s daily routine. Hospital staff are often open to modifying a patient’s care to match their home routine. If a patient normally wakes up at 11 a.m., it’s helpful for nurses to know not to wake that patient earlier if possible.
  • Consider hospital alternatives. For many people with dementia, going to an emergency room introduces a level of disruption in their routines that can lead to aggressive behaviour. For non-urgent care, COSS operates the Toronto Seniors Helpline: 416-217-2077. Patients are seen, usually within 48 hours, by healthcare professionals in the comfort of their own homes.

Volunteer Commitment Celebrated at Annual Awards Presentation

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VolunteerAppreciation2017_002The commitment, dedication and talent of our more than 350 volunteers is a hallmark for our organization, and a constant source of pride. Across our organization, we have been able to rely on this special group of people who make a tremendous impact on our clients and how we conduct business.
Last week, we gathered at Temple Sinai to honour this dedicated group, and also to recognize a few special people whose contributions have particularly stood out. The recognition awards they received are a small token of our appreciation for their important volunteer work.
VolunteerAppreciation2017_001The evening was highlighted by a presentation from Brain Fitness Expert Jill Hewlett, a licensed educational kinesiologist and Brain Gym® consultant. During her engaging talk, she led attendees through an interactive demonstration on how to “train the brain to use it to its fullest potential.”
The presentation was well received by those in attendance. “Having Jill present this wellness message was a real gift to those who volunteer,” said one attendee. “In serving others, it is still vital to ensure we look after our own emotional, mental and physical health.”

Thank you to our 350 volunteers who contributed 37,500 hours of volunteer time last year. We have many fulfilling volunteer opportunities available. If you’re interested in making a difference in the life of an elderly person, visit our Volunteer page to find out more.


People Helping People – United Chesed

VolunteerAppreciation2017_010Individuals and groups demonstrate commitment to community service every day. But too often these good deeds go unrecognized. Circle of Care’s People Helping People Award is presented to community members who demonstrate the highest levels of excellence in volunteer service and dedication to the community and Circle of Care. This year we honoured United Chesed, an organization that assists Jewish clients by providing urgent, short-term assistance to individuals with low incomes who are in need of additional support on occasion. This organization has an extensive network to raise funds to respond to requests for medical equipment, furniture, professional advice, housing, clothing, food, and employment. Over the past several years our Social Workers have reached out to United Chesed on behalf of clients in need, and they’ve always responded to our requests. Bernice Chaplin accepted the award on behalf of the organization.


Community Partnership – Bernard Betel

VolunteerAppreciation2017_009The Community Partnership Award is presented to an organization whose work with Circle of Care has consistently demonstrated collaborative partnership to support individual independence and quality of life in the community. This year’s recipient is Bernard Betel. Circle of Care and the Bernard Betel Centre have worked together for over 40 years on a number of partnerships including the annual Passover Seder, meal provision for ADP, clinic days, support groups, and much more. Julia Migounova accepted the award for Bernard Betel.





Jewish Hospice – Shalom Shapurkar

VolunteerAppreciation2017_005For more than 15 years, Shalom provided support, comfort and companionship to numerous hospice clients. His readiness to take on new challenges, his exceptional communication skills and his ability to know how to say the right thing makes him the ultimate hospice volunteer. Shalom’s visits make a significant contribution to our clients’ end of life care. He provides service that truly stands out and makes the client feel important.
For his commitment, dedication and the immeasurable comfort he brings to his clients, we congratulate Shalom on receiving this year’s hospice volunteer award.



Community Hospice – Eva Angyal

VolunteerAppreciation2017_004For the past 12 years Eva has been a part of our Community Hospice program, offering companionship and assisting with grocery shopping for a woman with MS. During this time, Eva has watched her client’s health and mobility decline with the progression of the disease. Eva’s commitment to supporting this client over the years and making a real difference in her life is commendable. Thank you Eva.






Kosher Meals on Wheels (Sepha) – Robin Whitehouse

VolunteerAppreciation2017_007Robin’s contribution to KMOW is outstanding. Over here two years of volunteer service, Robin has contributed many hours of service to the clients in our community. Always ready to lend an extra hand by delivering a few extra meals, regardless of weather conditions, demonstrate Robin’s compassion and tireless efforts for our program. Thank you Robin.





Kosher Meals on Wheels (Baycrest) – Mark Levine

VolunteerAppreciation2017_008Since starting as a KMOW driver in 2014, Mark has always been committed to our clients. As a driver, he Mark took the time to get to know the clients on his route who came to truly value his company. Capitalizing on Mark’s incredible organizational skills, he took on the role as a KMOW captain. Now Mark comes to Baycrest four times a week, to prepare routes for delivery and to make sure everything runs smoothly on delivery days. You can see Mark schmoozing with drivers early in the morning, explaining routes, and delivering when needed. Thank you Mark.




Friendly Visiting – Rachel and Matthew Lysenko

It is a great pleasure to see young people taking an active role in volunteering with seniors. This brother-sister duo has been matched with one of our Russian speaking clients for just over a year now. Their visits have made such a difference to our client, who looks forwards to the time she spends with them. Additionally their ability to be role models has paid off and their younger brother will now be joining his siblings as a friendly visitor with Circle of Care. Congratulations and thank you Matthew and Rachel.

Adult Day Program – Selma Elzas

VolunteerAppreciation2017_006Selma has been a part of our ADP family since 2014. Her warm and empathetic nature makes her a perfect fit for our clients and our program.  Selma is always obliging, ready and willing to do whatever is asked of her, from helping set up for lunch, assisting with serving the meal, and encouraging client participation during our Morning Schmooze program. Selma has built a strong rapport with other volunteers, staff and students and always makes everyone feel special and heard. In addition, Selma has developed a special program called Inspirational Stories. It is a small group discussion-based program and under her direction, this program has grown each week. It is so popular, she has almost outgrown the space where she facilitates this program! Thank you, Selma.



Phone Pal – Xavier Pinto

Xavier has two clients, one who calls weekly to provide companionship and the other he calls on daily, Monday to Friday, to provide security checks. There have been a few occasions where Xavier has alerted us to concerns regarding one of his clients. Both clients speak highly of Xavier and enjoy their interactions with him. Thank you Xavier.

Years of Volunteer Service Milestones

5 Years: Michael Diamond, Leslie Daiter, Aviva Wonznica, Barbara Berman, Faye Swartz, Michael Somer, Cristina Reiner, Claudia Kugelmass, Bernard Keyes, Eli Katan, Calvin Avertick, Barry Shulman, Samuel Druck, David Altman, Caren Ludwig Shoychet and Jack Steiner
10 Years: Frances Sadoway, Robert Sive, David Silverman, Barry Holtzkener
15 Years: Judith Laxer, Sharon Sussman, Helen Switzer, Shalom Shapurkar, Ed Glina
20 Years: Bernice Royce, Harold Margles, Gillian Sarfin, Hyla Rubenstein
35 Years: Yona Barzilay and Ruth Margles
40 years: Vered Tal

Volunteer Advisory Committee

Finally, thank you to the members of this special committee who represent all of our volunteer supported programs.
• Bernice Royce and Cara Lubarsky: Adult Day Program volunteers
• Janet Chippin & Akemi Kato: Hospice volunteers
• Barbara Caplan: Kosher Meals on Wheels volunteers
• Barbara Cheng: Administrative volunteers
• Doreen Benou: Association of Jewish Seniors


PSW Learning Event Focuses on the Aging Brain

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Dr Lachmann explains dementia and Alzheimer's to Circle of Care's PSWs

Dr Lachmann explains key concepts related to dementia and Alzheimer’s disease to Circle of Care’s PSWs.

Every day, Circle of Care’s 1,000+ Personal Support Workers (PSWs) make their way throughout the community, providing care and support to seniors in their homes. And while the job at hand may sound routine, coming face to face with the ever-changing symptoms and impairments of an aging brain is anything but.

Helping PSWs understand the physiology behind dementia, mental illness and behaviour was the focus of Circle of Care’s recent learning event for all PSWs. Attendees at the annual event heard from Dr. Mark Lachmann, Geriatric Psychiatrist and Physician Lead at Bridgeport Active Healthcare, who spoke about the complex subject in a way that was engaging and relatable.

“My goal today is to help us learn together, and also to help you understand what is going on with your clients,” Dr. Lachmann told the group. “I want you to understand why your clients are feeling confused, and losing their memories and sometimes acting with anger or frustration.”

Since joining Sinai Health System in 2015, Circle of Care has partnered with Mount Sinai Hospital and Bridgepoint Active Healthcare on a number of initiatives that are improving the continuum of care for the populations we serve. “One of the best things about our affiliation with Sinai Health System is our access to resources and experts,” said Carey Lucki, CEO, Circle of Care, and VP, Sinai Health System. “Having access to experts like Dr. Lachmann, someone so well respected in his field, helps us excel as a learning organization by providing opportunities for our PSWs that support the daily work they do.”

A Problem With the Mail

Circle of Care PSWs engaged in talk by Dr Lachmann

PSWs wave their hands around as part of a demonstration by Dr. Lachmann to explain processing in the brain related to dementia.

During the session, Dr. Lachmann shared advice about caring for seniors with mental illness
and spoke candidly about the challenges of working with geriatric patients, drawing on his extensive experience in the field. Using interactive demonstrations that drew on audience participation, he explained the difference between dementia and delirium (two common conditions PSWs encounter in the community) with the concept of a dysfunctional post office. “In dementia, the mail doesn’t get from one part of the brain to the other. With delirium, the mail goes to all the wrong places,” he explained. “Most pathology in the brain is because there is a problem with the mail!”

PSWs listen to the engaging talk by Dr Lachmann

PSWs listen carefully to Dr. Lachmann as he explains various other mental illnesses that affect seniors.

While most people consider dementia to be an issue about memory loss, Dr. Lachman was quick to point out that for caregivers, the bigger issue has to do with behaviour. “It’s problems with language, or aggression or anxiety or wandering. In fact, the most common reason for admission to long-term care has to do with behavior issues that stem from dementia.”

This is where PSWs play such a pivotal role in the health care system, says Carey Lucki. “By having PSWs who are trained to respond to the needs of clients with dementia or mental illness, client needs are addressed more quickly, caregivers are able to get the respite they often desperately need, and clients are able to live longer lives in the community.”

Holocaust Education Event Focuses on Survivor Experiences

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Dori Ekstein poses with her late father, a Holocaust survivor who was imprisioned at Auschwitz concentration camp.

Dori Ekstein poses with her father, a Holocaust survivor who was imprisioned at Auschwitz concentration camp, before he passed away in December, 2016.

Circle of Care is one of the ten largest recipients world-wide to receive home care funding from the Conference on Jewish Material Claims Against Germany in support of Holocaust survivors.

On April 24, Circle of Care employees connected with children of Holocaust survivors to better understand the unique challenges and circumstances faced by survivors and their families. The education event was held in recognition of Yom HaShoah – Israel’s day of commemoration for the approximately six million Jews who perished in the Holocaust.

During the session, guests including Dori Ekstein (pictured at left with her father) shared details of their parents’ experiences during the war as a way of providing context for the emotional trauma and physical limitations that persist among many of Circle of Care’s 1,400 Holocaust clients. Whether forced into hiding from Nazi captors, sent to meet their fate at notorious concentration camps, or separated from their families and evacuated to safety with other children – every survivor came away from the war with a distinct experience that continues to impact their personal relationships, coping abilities and related health conditions, particularly as they age.

“It’s an honour to be able to provide care and support for our aging survivor clients,” says Carey Lucki, CEO of Circle of Care and VP, Sinai Health System. “Taking time to hear these courageous stories, and respecting the memories that live on, will allow us to continue to meet the needs of our Holocaust clients with the dignity they deserve.”

A Smoother Passage from Hospital to Home

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Toward the end of a hospital stay, it can be common for patients and caregivers to feel anxious about the transition back home due to a lack of understanding around care management and how to access community supports that will aid in the recovery process. To help address this gap, a collaborative pilot program was launched at Mount Sinai Hospital that leverages Circle of Care’s expertise in the home health care sector.

Through a generous donation from the Max and Larry Enkin Family Foundation, a community social worker from Circle of Care was assigned to Mount Sinai Hospital as a dedicated Social Work Care Navigator. In this role, Revital Shuster works with patients and families pre- and post-discharge to make sure the appropriate community supports are put in place to ensure a successful transition home, and to reduce the risk of readmission.

“We know that patients ultimately want to be back home with their loved ones,” says Shuster, “But it can be overwhelming to figure out who to call for help. By connecting people to resources and advocating on their behalf, the transition from hospital to home is being significantly improved.”

The Social Work Care Navigator pilot is one of Sinai Health System’s first integration initiatives. Typically, a hospital social worker provides recommendations for resources and supports in the community upon discharge, but for patients with complex health issues and/or multiple social support requirements, the coordination of these services is often difficult and overwhelming. By connecting the Care Navigator with patients who require significant post-discharge support, the intended result is a more seamless transition that paves the way to better outcomes.

“Our Social Work Care Navigator’s role extends beyond the hospital walls and follows the patient back into the community,” says Carey Lucki, CEO, Circle of Care and VP, Sinai Health System. “This warm hand-off ensures hospital staff feel confident about their discharge plan, and the likelihood of a return to a crowded Emergency Department or hospital readmission is reduced.”

In fact, since the program began, over 90% of complex patients who had involvement with Shuster have remained at home. Data collection is ongoing as we continue to evolve and develop this role.

Chief Executive Officer, Circle of Care and Vice President, Sinai Health System

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Carey Lucki, CEO Circle of Care and VP, Sinai Health System

Carey Lucki assumed the role of Chief Executive Officer, Circle of Care and Vice President, Sinai Health System on December 5, 2016. Prior to this, she held the role of Interim President/Vice President of Client Services at Circle of Care, Sinai Health System.

Carey’s health care background spans 27 years in both acute and home/community care settings. She began her career in clinical front line care as an occupational therapist, followed by various operational, administrative policy and programming, project management, quality and risk, and strategic planning roles. Carey led a three year candidacy initiative for Best Practice Spotlight Organization (BPSO) designation for the Registered Nursing Association of Ontario and has co-led and participated in many sector initiatives across hospitals, Community Care Access Centres (CCAC) and Local Health Integration Networks (LHIN).

As Chief Executive Officer of Circle of Care, Carey will be the operational leader responsible for delivering timely, efficient and safe care to over 13,000 clients, including oversight of all CCAC/LHIN contracts and home services programs including the Holocaust Survivors and Adult Day programs, centralized transportation services, Assisted Living, Meals on Wheels, Volunteers and Family Caregiver Respite/Crisis Intervention programs. Carey will also have oversight of Quality and Risk and Operational/Process Improvement for Circle of Care.

A key aspect of the mission of Sinai Health System is to provide exceptional care in hospital, community and home, focusing on the health conditions with the greatest impact on the overall health of the population. Carey, in her role as Vice President of Sinai Health System, will play a crucial strategic role in accomplishing our mission by providing guidance and leadership on integration of care in the home and community sector.

A graduate of the University of Toronto, Carey holds an Honours Bachelor of Science in Occupational Therapy as well a Masters of Business Administration with Distinction, from the Edinburgh Business School, Scotland. She is a member of the College of Occupational Therapists of Ontario, the Canadian Association of Occupational Therapists and the Ontario Society of Occupational Therapists.

Please join us in extending congratulations to Carey as she assumes this new role for Circle of Care and Sinai Health System.


Welcoming Pet Therapy to the Hospice Program!

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Welcoming Pet Therapy to the Hospice Program!

Circle of Care is pleased to have Corinne and her dog Teddy join us as volunteers. Corinne and Teddy are part of the St John Ambulance Pet Therapy Program and will now be visiting Hospice clients for Circle of Care.

Studies have shown that pet therapy can offer immediate physiological and psychological benefits, including lowering blood pressure, stress & anxiety in many patient populations, including those in hospice, the elderly and those with behavioral health issues.

Below is a portion of an article from the Visiting Nurse Service New York’s Hospice that reinforces the benefits of a pet therapy program as part of a Hospice program.

The Power of Pets

Gail Sirota, who manages the VNSNY’s hospice volunteers, enumerates the benefits she sees week after week when dogs are visiting their hospice clients.

1. The Power of Touch

When a hospice patient reaches out to pet the dog, or when the dog offers a gentle lick or lays his chin on a hand or forearm, the physical connection reverberates in many ways. “The warmth of touch is so important,” says Gail. “Touch validates that you’re still living, that you’re still a person worthy of love — and there’s nothing better than unconditional love. The dog doesn’t know that you’re sick, that you don’t look like what you used to look like.”

2. The Power of Memories

Whether or not the patient or family members want to pet or cuddle the dog, often the mere presence of an animal will start the memories rolling. “I used to have a dog, Alfie, oh, she was the best dog,” says Gail, offering a typical example. “They start talking about the pets they used to have, and it helps them open up.”

3. The Power of Diversion

“For the family members,” says Gail, “the dog provides a momentary break from their constant fears and worries.”

For more information or interest in volunteering, contact Lisa Rae at 416-635-2900 ext 284


Harvesting our Knowledge

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Robin Piccolo-Scarpetta

When people think of “fall,” there are typically a few key attitudes that individuals adopt to describe the season. You get the person that sees it as and ‘end’ – an end to summer, end to the nice weather, or a period of death and dying of all the luscious green foliage that once consumed our colourful flowers, plants and trees. Read More

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