P.E.I. needs to help frail, elderly decide if treatment worth it

Dave Stewart
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Dr. Laurie Mallery, right, co-founder of the Palliative and Therapeutic Harmonization (PATH) program in Nova Scotia, says better decisions can and should to be made when it comes to frail and elderly people. She was the guest speaker at the recent Alzheimer Society of P.E.I. conference in Charlottetown. Corrine Hendricken-Eldershaw, CEO of the society, says end of life needs to be celebrated as much as births, graduations and weddings.

There is such a program in Nova Scotia that helps people decide if treatments may do more harm than good.

A new program in Nova Scotia helps the frail and elderly decide whether to go through with medical treatments that may do more harm than good.

Dr. Laurie Mallery, co-founder of the Palliative and Therapeutic Harmonization (PATH) program, was the guest speaker at the recent fourth annual Alzheimer Awareness Conference in Charlottetown. Mallery is also the head of the division of geriatric medicine and the director of the Centre for Health Care of the Elderly at the QEII Health Sciences Centre in Halifax.

"I'm talking about reforming health care for older people with Alzheimer's disease and for those who are frail so they can have a better experience as they navigate the health-care system,'' Mallery told The Guardian in an interview following her address.

Complications such as cognitive decline and loss of function can land the elderly in nursing homes where other health problems, such as infections, can land them in hospital.

PATH involves assessing patients and helping them decide whether it makes more sense in opting for less aggressive treatments.

Since the program began in 2009, the number of operations and procedures at Dalhousie University and the QEII Health Sciences Centre have dropped dramatically.

Mallery said they also operate an anesthesiology clinic in Dartmouth where everyone over the age of 75 is screened for cognitive programs and frailty. Those who test positive are sent to their clinic for a more in-depth assessment to decide whether surgery is the best choice.

I'm talking about reforming health care for older people with Alzheimer's disease and for those who are frail so they can have a better experience as they navigate the health-care system. Dr. Laurie Mallery, co-founder of the Palliative and Therapeutic Harmonization (PATH) program

Overall in the health-care system, she says health-care professionals who work with frail adults with Alzheimer's disease need to be retrained so everyone speaks the same language. Mallery wants their scope of practice expanded so that the patient is assessed once and not repeatedly by various health-care professionals.

"We focus a lot on team-based care where we have one person who has a lot of complex issues and you have a team around them. Communicate with the patient and family and among themselves.''

Corrine Hendricken-Eldershaw, CEO of the Alzheimer Society of P.E.I., said Mallery also hit on having end-of-life conversations and whether the current model involves too many invasive procedures that also place a financial burden on the system.

"I don't want to be in a hospitalized setting,'' Hendricken-Eldershaw said. "We celebrate so many things, our births, our graduations, our weddings, why do we not rock out and celebrate end of life as well. What do I want that to look like?''

When her time comes, Hendricken-Eldershaw wants to be sitting in her Adirondack chair facing the ocean with a glass of wine in one hand and chocolate in the other.

dstewart@theguardian.pe.ca

Twitter.com/DveStewart

Organizations: QEII Health Sciences Centre, Health Care, The Guardian Dalhousie University Alzheimer Society

Geographic location: Nova Scotia, Charlottetown, Halifax Dartmouth

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  • jill
    February 02, 2016 - 19:29

    She may have that romantic ideal for her final day but reality is, it is very unlikely it will happen. We rarely are allowed to bow out with things playing out as we plan. Said that, I don't think someone who thinks this is a reality really doesn't have it together enough to tell others how it should end for them. Nobody does. We strive to live, we don't know what is around the corner. Sometimes things end up better then we think it well. Don't condemn someone who takes that chance.