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Our Clinical Programs
Since 1993, Ste. Anne's Hospital has been providing dysphagic (difficulty chewing and swallowing) residents with a reconstituted food program. This program is unique in North America and greatly contributes to stimulating the appetite of dysphagic residents who are relegated to eating purees and thickened liquids. Such a diet often leads to malnutrition and dehydration, thus making residents more vulnerable to infections. Ste. Anne's Hospital has opted to nourish and hydrate its dysphagic residents in the most normal way, that is, orally, with foods the texture and viscosity of which have been modified to make them more appetizing, recognizable and familiar, but also safer and easier to eat. Quality criteria for these specialized foods, including appearance and nutritional value, must be equivalent or superior to their normal counterparts.
The assortment of foods available include forty or so solid modified texture foods and as many liquids and beverages of controlled viscosity, which enables Ste. Anne's Hospital to provide its dysphagic patients with an exceptionally varied menu that is virtually identical to the regular menu. According to a survey conducted in 1997, about 80% of the residents at Ste. Anne's Hospital are affected, to some degree, by dementia. Dementia is defined as a progressive and irreversible deterioration of one's cognitive functions. Given the significant number of residents affected by this illness, training sessions designed for the entire staff have been implemented. Training has been adapted to the staff's particular needs, and is not only aimed at health care staff but also at the administrative staff, those in charge of recreational activities, volunteers, etc. These sessions are aimed at fostering awareness in employees with regards to the problems relating to dementia and arming them with sufficient knowledge to be able to deal with, prevent and manage disruptive behaviour. In addition, we are committed to improving their quality of life and promoting their autonomy and residual abilities for as long as possible. We also help families by providing information and support, so that they may adequately respond to the cognitive deficits of their loved ones. Falls are considered the most frequent environmental and clinical risk. While our fall level has remained stable over the last few years, we are conscious of the fact that as the average age of our population increases, so does the risk of serious consequences. Prevention is therefore a significant part of our strategic objectives and clinical vision. Moreover, in a context of restraint reduction, it is imperative that the rate of falls be closely monitored. The Falls Prevention and Risk Management Interdisciplinary Committee, formed in 1999, works to educate and raise the awareness of the various caregivers with regards to falls. Various awareness-raising activities are organized every year. Interventions are based on detailed risk analyses (profile of those at risk of falling, daily schedule, shift, high risk areas, etc.). At Ste. Anne's Hospital, we are committed to assuring quality care and services to veterans, while respecting their dignity and autonomy. This philosophy involves revising certain clinical practices. Amongst these practices is the use of physical restraints which can, undoubtedly, have an effect on their dignity and autonomy. With this in mind, we created a multidisciplinary committee on physical restraints and implemented a restraint reduction program as well. The objective of the program is to reduce the non-pertinent use of physical restraints. The program consists of four training sessions covering eight different themes and a weekly multidisciplinary follow-up to observe progress. Approximately 30% of the veterans hospitalized at Ste. Anne's Hospital for long-term care, suffer from chronic obstructive lung disease. This disease affects patients on the physical, psychological and social level. They avoid various activities that make them dyspneic. They oftentimes assume a sedentary lifestyle which, in turn, reduces their abilities and functional mobility. This is why we have decided to implement a respiration rehabilitation program. The objective of this program is to:
Awareness-Raising of Pain as the 5th Vital Sign Vital signs are serious clinical indicators. If pain were to be evaluated along the same lines as vital signs, chances of alleviating a patient's pain would be greater. This is why, at Ste. Anne's Hospital, we have integrated the concept of pain as the 5th vital sign into the clinical practices of our various professionals. Pain is now included as a parameter on the vital sign sheet and is regularly evaluated in all our patients, including those suffering from cognitive deficiencies. Since April 2000, Ste. Anne's Hospital is a member of the International Association "Partners Against Pain" (Ensemble contre la douleur). This association's Web site (available in French only) contains information concerning our Hospital. According to our design at Ste. Anne's Hospital, end of life care is intended to complement curative care and encompasses palliative care. End of life care requires an active approach as well as supportive care and attention with regards to treatments, alleviation of pain and support for those suffering from progressive or chronic diseases that pose a short or long term threat to a patient's life. This type of care helps provide pain relief and relief from other types of debilitating symptoms. With regards to end of life care, we also consider the patients' personal, cultural and spiritual values as well as their beliefs and lifestyle. End of life care includes support for families, even throughout the bereavement period. The objectives of end of life care include:
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The reconstituted meals resemble their normal counterparts so closely that their modified texture is only apparent when tasted. Residents who have not been able to enjoy brochettes or cakes for a number of years can rediscover the pleasures of eating. The benefits associated with this program are appetite stimulation and an increase in their interest for a wider variety of foods, which in turn helps them regain weight. The Quebec Hospital Association awarded Ste. Anne's Hospital its 1998 Prix de l'AHQ for this program.