Letting in the light

Eighty-four year old Lily Martin* is comfortable living in the digital age. On days when arthritis keeps her confined to her Fort Frances home in Northwestern Ontario she uses a cell phone, email and Facebook to stay connected to her large family, which includes 17 great-grandchildren. For entertainment, she listens to music on her new iPod.

But it wasn’t always so. In 2010, when Martin’s husband died of a stroke, she withdrew completely from family and friends and suffered through many months of profound sadness before finally agreeing to see a psychiatrist.

“There’s an ad on TV that says depression hurts — well, it does,” she says.

Martin had cared for her husband through his long struggle with Alzheimer’s disease.

“I felt so bad because we had promised one another that we wouldn’t let each other hang in there without hope for any life at all… it was a very, very hard time,” she says.

Martin’s daughter Erin* noticed that her mother’s grief was not lessening with time — in fact, she was becoming more withdrawn and unhappy. At the urging of Gerri Yerxa, a geriatric mental health worker with the Canadian Mental Health Association, Fort Frances Branch, Erin convinced her mother she needed a psychiatric assessment.

Grand-daughter Julie* also helped persuade her grandmother to walk just two blocks to the local hospital where she was assessed by Dr. David Conn via a computer network. Dr. Conn is a leading geriatric psychiatrist, vice president of Education at Baycrest and head of its tele-psychiatry program. He recommended a treatment plan that Martin and her family agree has made a remarkable difference in her health and quality of life.

“We felt quite helpless because you never want to see someone you love feel that badly. She was also dealing with immense amounts of (physical) pain,” says Julie of the time before her grandmother began treatment. “She had refused to travel, so if she had had to go to Thunder Bay or Toronto for treatment, it probably wouldn’t have happened.”

Martin continues to live independently in her condominium. “I don’t know what would have happened to me if I hadn’t done this. I feel so much better,” she says.

Daughter Erin can see the difference. “She is in a much better mood and much more able to cope with life. The change has been wonderful.”

As this family’s story illustrates, Baycrest’s tele-psychiatry program provides a much-needed service in Northern Ontario, not only for patients but for local health-care providers. Seniors and their families have access to specialty consultation and assessment without the cost of travel, notes Gerri Yerxa. They can attend the sessions with a geriatric mental health worker who can later explain the diagnosis and the treatment.

Armed with an appropriate treatment plan, Yerxa and Martin’s family doctor are continuing her care in the community.

In areas of the province like Fort Frances (population 8,000) an absence of specialist services is challenging for local health-care providers and their patients. Baycrest’s tele-health program is a time and cost-efficient way to support care delivery to people located many miles away from the nearest city.

Recognized as innovative by the International Psychogeriatric Association and widely regarded as a model for the system, this groundbreaking program has been operational for nine years. A recent comprehensive evaluation informed by patients, families and healthcare providers found it to be highly effective.

The need is great. As Dr. Conn points out, there are only 200 geriatric psychiatrists in all of Canada — and currently only one west of Thunder Bay. “That is what our program is really about, trying to correct, even in a small way, some of the disparities that exist in terms of access to care.”

*The women in this family requested that we not use their real names because of the sensitive nature of the topic.

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