Health and Aging (Seniors Health)

Welcome to the Horizon Health Network’s Health & Aging Network

The Health & Aging Network is a diverse program that meets many of the major health needs of the older adult in an inpatient and outpatient environment. Our Network Programs target the older adult who has multiple interacting health problems. These problems can be related to medical illness, memory and cognitive issues, mobility problems, psychological issues and social difficulties.

Our Mission:
Within a safe environment and with respect for the dignity of those we serve, the Health & Aging Network will deliver quality, holistic health care to patients, their families and the community.
Interdisciplinary teams work with older adults to restore or maintain maximum functional independence, promote optimal health, and maintain or improve quality of life.

We believe:

Older adults have a combination of physical, mental, social, emotional and spiritual needs.
Health education and accurate information will support older adults and their families in making informed choices.
Older adults and their families have a right to receive information on injury prevention and health promotion.

Healthy Lifestyle Patient Services Health Information Resources Research

Balance Clinical Nutrition Exercise

What is balance?

Visual
Vestibular – balance centre
Somatosensory – body/sensory
Musculoskeletal

These 4 systems overlap to maintain balance, but as we age, the overlap reduces.

Why do we need to do balance exercises?

As you get older, you may start having trouble with your balance due to:

Weakness
Dizziness
Chronic conditions (arthritis, osteoporosis, Parkinson’s disease, etc.)
Medications

Important information for fall prevention

Each year, more than 1/3 of people age 65 or older fall. Falls and fall-related injuries, such as hip fracture, can have a serious impact on an older person’s life. If you fall, it could limit your activities or make it impossible to live independently. Balance exercises, along with certain strength exercises, can help prevent falls by improving your ability to control and maintain your body’s position, whether you are moving or still.

You can do balance exercises almost anytime, anywhere, and as often as you like, as long as you have something sturdy nearby to hold on to if you become unsteady. In the beginning, using a chair or the wall for support will help you work on your balance safely.

Balance exercises overlap with lower body strength exercises, which also can improve your balance.

Modify as you progress

The exercises which follow can improve your balance even more if you modify them as you progress. Start by holding on to a sturdy chair for support. To challenge yourself, try holding on to the chair with only one hand. With time, you can try holding on with only one finger, then no hands. If you are steady on your feet, try doing the exercise with your eyes closed.

Safety tips

Have a sturdy chair or a person nearby to hold on to if you feel unsteady.
Talk with your doctor if you are unsure about doing a particular exercise.

Our Mission

Our mission is to deliver high quality, patient and family-centred nutrition service within Horizon. Our mission is accomplished through assessment, planning, treatment, education and outcome evaluation. We are committed to research and ongoing education.

Our Values

We believe in providing evidence-based interventions, working with others to promote the well-being of individuals and groups, in a fiscally-responsible environment. We respect the rights and dignity of all individuals. We believe in working with our clients, their families, community partners and other stakeholders to improve the health of our clients and the population in general.

Our Vision

To facilitate the highest possible quality of nutritional care to any individual or group seeking service through Horizon.

Role of the Clinical Dietitian in the Health & Aging Network

Nutrition Risk Screening and Assessment
Determine Appropriate Nutrition Intervention
Implement the Nutrition Care Plan
Nutrition Discharge Planning

You have probably heard that exercise and activity is good for you. In fact exercise is one of the healthiest things you can do for yourself, especially as you get older. Being physically active can help you stay strong and fit enough to keep doing the things you like to do as you get older. Making exercise and physical activity a regular part of your life can improve your health and help maintain your independence.

Be as active as possible

It can be tough to make exercise part of your daily routine. Staying active can produce long-term health benefits and even improve health for some older people who already have diseases and disabilities. Try and think of exercise like you do your medications…be consistent.

Being inactive can be risky

Some older adults are reluctant to exercise as they think it is too hard or will harm them. Some think they need special equipment or to join a gym. Yet studies show that ‘taking it easy’ is risky and can cause you to lose your independence. Older adults who are inactive lose ground in 4 important areas that are important for staying healthy: endurance, strength, balance and flexibility. Lack of exercise can lead to more visits to the doctor, more trips to the ER and greater use of medications.

Prevent or delay disease

Scientists have found that staying active can prevent or delay many diseases and disabilities. For example studies show that people with arthritis, heart disease or diabetes benefit from regular exercise. Exercise also helps with high blood pressure, balance problems or difficulty walking.

Manage stress and improve mood

Regular moderate exercise can help manage stress and improve your mood. Activity can help reduce feelings of depression and improve your cognitive function.

4 types of exercise:

Endurance

Endurance activities include walking or swimming which increase your breathing and heart rate. It improves the health of your heart, lungs and circulatory system. They can make it easier for you to:

Push your grandchildren on swings
Vacuum
Work in the garden
Rake leaves
Play a sport

Strength

Strength activities include lifting weights and using resistive bands. They can make it easier for you to:

Climb stairs
Carry groceries
Open jars
Carry laundry up/down stairs
Carry smaller grandchildren
Lift mulch in garden

Balance

Balance exercises like tai chi can improve your ability to control your body when you are moving or still. Improving balance can help you to:

Prevent falls
Stand on tiptoes to reach high
Walk up and down stairs
Walk on uneven ground without falling

Flexibility

Flexibility exercises can help you to stay limber which helps you move more easily. Improving flexibility can help you to:

Look over your shoulder to back the car up
Make the bed
Bend over to tie your shoes
Put a sweater over your head
Swing a golf club

Narrative Care Program at Veterans Health Unit Patient and Family Centred Care St. Joseph’s Hospital Ethics Spiritual & Religious Care

Memories are a priceless gift. The goal of the Narrative Care program is to look at each person’s unique life experiences, life lessons, values and traditions and capture these in their own words. It offers every participant an opportunity to share his or her legacy with families and friends. The program simplifies the task of recording an autobiography with an organized and thought-provoking set of questions. It is a fantastic opportunity to make life-story writing fun and manageable.

Interested veterans are paired with staff members and/or volunteers to record stories, select pictures to help tell the story and any other memorable mementos of the past. Upon completion, the veteran is presented with a bound book to share with their loved ones. The program is a remarkable journey to complete.

Patient and Family Centred Care involves patients, family and the health-care team working together in the planning, delivery and evaluation of health-care services. “It is founded on the understanding that the family plays a vital role in ensuring the health and well-being of patients of all ages.”

The Health & Aging Model of Care includes six goals: Quality and Excellence, Patient Safety, Health Promotion and Wellness, Accessibility, Inter-professional Collaboration and Efficiency and Effectiveness. These goals direct our approach to Patient Centred Care.

Information Sharing, Participation, Dignity and Respect, and Collaboration are the four components of Patient and Family Centred Care. These four components ensure that the five key actions of: Assessment and Management, Leadership, Advocacy, Research and Education support our philosophy of quality holistic Patient and Family Centred Care.

Patient and Family Centred Care is associated with a higher rate of patient satisfaction, involvement of family, better outcomes and more cost-effective care.

Individual Plan of Care
Goal Attainment Scaling
Creating a Safe Environment
Interdisciplinary team approach to care

Individual Plan of Care

The individual plan of care is based on the admission and ongoing assessments and will include referrals to and interventions as planned by the various team members. The plan of care is integrated with the discharge and/or the long term placement plan. Mutual goals are set with the patient/family and interventions are geared toward rehabilitation and improving the patient’s level of functional independence (Goal Attainment Scaling). The information needs of the family and the availability of community resources are assessed and considered at all phases in the plan of care. The plan of care is reviewed by the team at team conferences, in conjunction with the patient/family, and at family conferences.

Goal Attainment Scaling (GAS) is a goal setting and evaluation tool that measures individualized outcomes for geriatric and rehabilitation inpatients. Goals are set in areas where improvement is anticipated. Goals can include mobility, treatment, activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

GAS helps direct the interprofessional team to set achievable goals that are focused on the patient’s discharge plan; the tool keeps the team focused on the goals of the patient records the patient progress, and identifies any challenges for discharge.

The GAS tool is initiated for all admissions in the clinical areas of geriatrics and rehabilitation. The GAS is initiated within the first week of admission and then updated weekly during team rounds. The scores are measured on admission, throughout the hospital stay and on discharge from the unit. The team determines the goals after discussion with the patient and/or family, based on what the hope for discharge will be.

Creating a Safe Environment

Creating a special environment that is not only safe but also allows for freedom of movement, mobility and socialization are priorities in unit design and construction. Safer environments can be created by designs which consider the unique needs of the population, and the integration of creative and technological solutions when possible and appropriate. A homelike atmosphere is enhanced by separate dining areas, ‘wander’ routes, television and social areas, and rehabilitation areas.

Interdisciplinary Team Approach to Care

The patient, family and caregivers are provided opportunities to play an active role in the plan of care and are an integral part of the team by communicating concerns to health professionals, and becoming involved in the patient’s health maintenance and functional improvement. All patients are encouraged to be active participants in their care so that they can make independent lifestyle decisions and health choices. The interdisciplinary team will provide patients with complete information regarding their health and, with the patient’s permission, discuss this information with their family/caregivers.

St. Joseph’s Hospital has an Ethics Committee that is made up of several staff and members from the community. The committee meets regularly to discuss both clinical and organizational ethics issues. Clinical issues relate to the care of patients while organizational issues include discussions that are more general in nature and affect the whole hospital.

You may contact the Ethics Committee for a formal consult by using our Ethical Issue Referral Form which is available at each nursing station and through reception at the main entrance (506-632-5555). Patients, their loved-ones and staff are welcome to bring an issue forward to the Ethics Committee.

An excellent resource for making end-of-life decisions is available at the Canadian Hospice Palliative Care Association website www.advancecareplanning.ca. Take a moment to visit the site, watch the video and download the workbook.

Spiritual & Religious Care coordinates and provides emotional and spiritual support, as well as counseling, to people of every belief and value system. We offer a wide variety of services to patients and their families in an open, honest and non-judgmental environment. Where end of life support is needed, a ministry of presence and support is available.

Brain Health Constipation Delirium and the Older Person Dementia Frailty Grief Parkinson’s Disease Urinary Incontinence

The Alzheimer Society

Ninety-five percent of people have between 3 bowel movements a day and 3 bowel movements a week. Infrequent bowel movements are considered ‘constipation’ if you need to strain, if the stool is hard and pebbly or if you are having bowel movements less than 3 times a week.

It is essential that you see your health-care team if you are unexpectedly losing weight, have blood in your stool or there is a change in your stools (pencil-like stools or infrequent stools without a change in diet or lifestyle). Your health-care team will need to rule out colon cancer as a cause of your constipation.

Many people have long-term (or chronic) constipation without a serious underlying disease. This can often be caused by a decrease in exercise/activity, insufficient fibre in the diet and/or a decreased fluid intake. Constipation can be uncomfortable and can also have some long-term effects on your health including hemorrhoids, impaction and diverticulitis (infected outpouchings in the wall of the colon).

There are a number of helpful websites with information about constipation and lifestyle changes. If diet and lifestyle changes do not result in comfortable, regular bowel movements, you should talk to your health-care team about as-needed or daily laxatives.

Links:

Did you know?

Delirium in the older person is a medical emergency
Delirium occurs in up to 50% of older persons admitted to acute care settings
Delirium is a sudden change in mental status or confusion
Delirium is not a mental illness
Delirium is not the same as dementia
Delirium is a medical condition that causes a temporary problem with mental function

Delirium is a sudden change in mental status, or sudden confusion, which develops over hours to days. Early diagnosis and treatment offer the best chance of recovery.

What does delirium look like?

Delirium is described as an acute change in reasoning. A person with delirium may or may not display all of these symptoms. Symptoms may come and go throughout the day and often increase at night. Some of the common signs and symptoms associated with delirium are:

Confusion and or unusual behaviour
Paranoia – suspicion of others
Delusions or hallucinations
Disorientation – being unaware of time and place
Reduced ability to concentrate
Emotional upset – anxiety is very common
Increased restlessness and irritability

What is causing the delirium?

Delirium in an elderly person may be caused by one or many factors. Some of the most common causes for delirium are:

Infection (i.e. urinary tract infection or respiratory tract infection)
Severe illness (i.e. dehydration or severe diabetes)
Chronic health problems such as heart failure
Post operational (post heart surgery, hip or knee surgery)
Medications (multiple medications, new medication, side effects from medication)
Discontinuing drugs (prescribed or recreational) and alcohol

Who gets delirium?

Though delirium can develop in anyone, it is more common in older adults. Delirium is one of the most common and preventable conditions affecting older adults during a hospital stay. Some of the factors that may put people at risk for developing delirium are:

Age – especially those who are 80 and older
Multiple medications
Surgery – especially where an anesthetic was used
Hearing and or vision loss
Illness
Individuals with memory impairment or dementia have an increased risk of developing delirium

How is delirium treated?

The cause(s) of delirium need to be figured out before treatment begins. Health-care professionals will look for underlying causes by doing careful assessments and tests. Despite in depth testing at times causes for delirium are unknown. Generally delirium clears within a few days; however some cases may not clear for weeks or even months. It is also important to note that not everyone who suffers from delirium returns to their usual state.

What you can do to help

It is important for family members to help health-care professionals recognize the signs and symptoms of delirium. Family members know their loved ones best and are able to provide valuable information about changes in behaviour. Some of the things that family members can do for a loved one with delirium are:

Be calm and reassuring
Encourage proper nutrition and fluid intake
Promote physical activity; encourage walking if it is safe to do so
Ensure that hearing aids and or glasses are in place if necessary
Promote healthy rest and sleep; sleep lights low and reduce noise and distractions
Keep track of changes in behaviour

Delirium in older adults often goes unrecognized by health care professionals. Studies have shown that up to 67% of delirium cases were not recognized by physicians and 43% of cases were not recognized by nurses caring for the patients. Delirium is an under recognized but surprisingly common problem.

It is important for you as a family member to talk about changes in your loved one even if no one asks.

If you have noticed gradual changes in memory and thinking, it may be helpful to read about dementia. As time goes by you will likely have new questions. The Dementia Trilogy is a set of three booklets about dementia.

Introduction to Dementia

An Introduction to Dementia lists the earliest signs of dementia. It helps answer some of the more common questions like, “What is the difference between dementia and Alzheimer’s disease?”

The Dementia Compass

The Dementia Compass offers some tips to help a person with dementia with their day-today activities. It also describes some personality changes that can be symptoms of dementia.

Later in the Dementia Journey

Later in the Dementia Journey provides helpful yet sensitive information to help focus on comfort in the later stages of dementia.

Everyone has a combination of abilities and disabilities. As we age, our disabilities may increase. We may need help from others to manage day to day. When a person’s disability and health problems overwhelm their ability to live independently, consider ‘frailty.’ A frail older person often has problems with walking and daily function. They may be on many medications and have serious health problems. They may also have difficulty with memory, or vision and hearing. A frail person would be at risk if left alone for extended periods.

Why is frailty important? Frail adults are at increased risk of becoming sick and having difficulties during hospitalization or major medical interventions. A frail person will have more difficulty recovering after an illness, and they have a higher chance of losing mobility and function. Persons with frailty may have a shortened life expectancy.

Consider ‘frailty’ when making health or future care decisions.

Links:

Loss and Grief

Simply defined, grief is the normal and natural reaction to significant emotional loss of any kind. Death and divorce/separation are obvious painful losses. Within the Health and Aging Program, loss from dementia or frailty leads to multiple losses of independence, relationships (spousal, family and friends), driver’s licence, home/apartment and many others, including losses that family, caregivers and loved ones experience.

The Problem

There are a number of myths associated with loss and grief. One of the most significant myths is, ‘Just give it time.’ We often will isolate ourselves and at times, others isolate us intentionally or unintentionally. This isolation is counterproductive and can often lead to more frailty, loss of hope, support and possible addictions and mental illness.

The Solution

We are all advised to ‘Let Go,’ and ‘Move On,’ after losses of all kinds. Most of us would do that if we knew how. It is almost impossible to move on without first taking a series of actions that lead to completion. The Grief Recovery Program began in the USA, 35 years ago, and is a proven program to help and support those experiencing loss and grief associated with it.

If you or someone in your family has been diagnosed with Parkinson’s disease you are not alone. Parkinson’s disease affects 1 in 100 people over the age of 60 and there are approximately 8,400 people in the Maritimes living with Parkinson’s disease. Parkinson’s disease causes problems with movement and coordination. People can experience tremor, muscle stiffness, slowness of movement, feeling off balance plus many other symptoms. Parkinson’s disease will slowly worsen overtime. So what can you do about it?

First, see a doctor and make a plan on how to manage your disease. Take medications to control your symptoms as directed.
Secondly, stay physically active and live a healthy lifestyle which includes eating a healthy diet and reducing stress.
And lastly, learn good coping strategies and maintain a positive attitude. Join support groups and involve family in your care to help you cope with this disease.

Over 3 million individuals suffer from Urinary Incontinence (UI) in Canada. Unfortunately, most individuals suffer in silence due to the taboo nature of this topic. UI continues to be under reported, under diagnosed and under treated even though it can often be cured.

UI is defined as involuntary leakage of urine and is associated with reduced quality of life for seniors. Although not life-threatening, UI can have a negative impact on physical, social, and emotional well-being, and add to personal care expenses. (Statistics Canada – Health Report, October 2013)

There are 5 main types of UI: stress UI, urge UI or overactive bladder (OAB), mixed UI, overflow and functional incontinence.

There are many different treatment options for UI. These include behavioral approaches, lifestyle changes, ‘Kegel’ exercises, medications, pessaries and surgery.

There is an array of good, accurate websites available with information on UI and treatment options. Get informed today! No one should suffer in silence.

Overview

The care that we strive to provide to our seniors is informed by clinical research and best evidence. As part of our commitment to providing the best possible care for seniors, we are committed to research within the Health and Aging. To this end, the Geriatricians and nurses in the Department of Geriatric Medicine have been involved in a number of research activities over the past decade including Clinical Trials and original research, some of which has been presented and published nationally and internationally.

Since 1994, we have participated in over 20 Clinical Trials as an investigational site nationally and internationally. We have been involved in the testing of over 10 existing and investigational medications in the treatment of Dementia, primarily Alzheimer’s disease. We are one of several sites in Canada that form the Consortium of Canadian Centres for Clinical Cognitive Research (C5R). We have also been involved in Canadian Institute of Health Research Grants (CIHR) as an investigational site and as collaborating investigators. Most recently, we are the only New Brunswick site for the Compass ND study, which is part of the Canadian Consortium on Neurodegeneration in Aging.

The original research we have been involved in is targeted to improving clinical care and measuring outcomes that have informed the establishment of best practices. We have received grants from the New Brunswick Health Research Foundation, Horizon Health Network and the former Atlantic Health Sciences Research Foundation for some of this work. We have presented over 50 research posters at national and international meetings since 1997. We have also published over 10 research papers in peer reviewed journals as primary and/or coauthors.

We have continued to develop research activities in the Department of Geriatric Medicine and the Health and Aging Program and continue to work together alongside other health care providers and university researchers. This has become a culture in our Program and many of our allied health professional fields have joined in the research activity in the past few years. We continue to strive to develop a culture in our department and program that fosters and encourages this type of activity so that we can continue to answer important clinical questions that will help us provide the best possible care to our patients.

Researchers Current Studies Publications

Department of Geriatric Medicine Saint John

Pamela Jarrett, MD, FRCPC, FACP – Physician Lead

Linda Yetman, RN, BN, Med, ACNP (dip), PhD – Research Coordinator

Elizabeth MacDonald, MD, FRCPC

Donna MacNeil, PhD, MD, FRCPC

Collaborating Researchers

Dalhousie Medicine New Brunswick

Dalhousie University

Horizon Health Network

London Health Sciences Centre

Maritime Medical Genetic Services

Maritime SPOR SUPPORT Unit

NB Trauma Program

Nova Scotia Health Authority

University of New Brunswick

University of New Brunswick Saint John

University of Toronto

Vitalité Health Network

Western University

Comprehensive Assessment of Neurodegeneration and Dementia (Compass-ND) Study
Caregivers of Persons with Dementia: What They Say is Meaningful and Important to Them
Timed Up and Go (TUG) Test for Discriminating Between Pre-Frailty and Cognitive Impairment
Creating a Healing Environment for Care of the Aging and Elderly: What Patients, Families, and Nursing Staff Say is Required
Who are the Fallers and why do They Fall? A Comprehensive Study of Falls in Older Adults in a Hospital Setting
Managing Constipation in the Older Patient with Dementia: A Mixed Methods Study
A Descriptive Study of the Use of Emergency Services and Acute Care Hospital by Residents living in Special Care Homes in New Brunswick
Description of a family with Autosomal Dominant Kufs Disease: A rare cause of dementia in young adults
Outcomes in Older Adults with Isolated Hip Fractures: A Descriptive Epidemiological Study across Regional Hospitals in New Brunswick
Retrospective Chart Review of Patients Diagnosed with Mild Cognitive Impairment in an Outpatient Geriatric Assessment Clinic
Experiences of Dementia Patients in a Collaborative Care Memory Clinic
Successful Aging in Place: Indicators from a Memory Clinic Population
Alternate Level of Care: Using the Patient and Caregiver Experience to Guide Health System Performance Measurement
Caring for Caregivers of Aging Canadians: Assessing and Prioritizing Promising Practices and Selecting Interventions for Future Implementation

Research Presentations and published abstracts

1. Falls on Geriatric Hospital Units: What Information Can We Learn from Reports from Nurses? 37^th Canadian Geriatrics Society Annual Scientific Meeting. Toronto, ON. April 2017.

2. Falls on Inpatient Geriatric Units: Which tools predict falls best? 37^th Canadian Geriatrics Society Annual Scientific Meeting. Toronto, ON. April 2017.

3. Canadian Geriatrician and Care of the Elderly Human Resource Update: 2016. 37^th Canadian Geriatrics Society Annual Scientific Meeting. Toronto, ON. April 2017.

4. Which Bedside Tools Predict Falls on Inpatient Geriatric Units? Interprofessional Health Research Day. Saint John, NB. March 2017.

5. Patient Falls in Geriatric Settings: Gleaning Information from Nurses’ Reports. Interprofessional Health Research Day. Saint John, NB. March 2017.

6. Why do older adults in assisted living facilities use the emergency department: Are all these visits necessary? Canadian Association of Emergency Physicians 2016 Conference. Quebec City, QC. May 2016.

7. Why Residents from Assisted Living Facilities are admitted to Hospital from the Emergency Department. 36^th Canadian Geriatrics Society Annual Scientific Meeting. Vancouver, BC. April 2016.

2015

8. How well does a Memory Clinic Support Patients in a Community? 8^th Canadian Conference on Dementia. Ottawa, ON. October 2015.

9. What happens to Alternate Level of Care patients in hospital? Is Dementia a factor? 8^th Canadian Conference on Dementia. Ottawa, ON. October 2015.

2013

10. What do We Know about the Patients who are Alternate Level of Care in Horizon Health Network? 33^rd Canadian Geriatrics Society Annual Scientific Meeting. Toronto, ON. April 2013.

11. A Pilot Study Comparing the Screen for the Identification of the Impaired Medically at Risk Driver: A Modification of the DemTect (SIMARD MD) to Clinical Impression of Patients with Dementia or Mild Cognitive Impairment. 33^rd Canadian Geriatrics Society Annual Scientific Meeting. Toronto, ON. April 2013.

12. Quality Improvement Initiative on an Inpatient Geriatric Ward to Improve Documentation and Frequency of Bowel Movements. 33^rd Canadian Geriatrics Society Annual Scientific Meeting. Toronto, ON. April 2013.

13. The Dementia Trilogy: Development of Three Original Booklets about Dementia for Patients and their Families. 33^rd Canadian Geriatrics Society Annual Scientific Meeting. Toronto, ON. April 2013.

14. Alternative Level of Care: Patient and Family Perspectives. American Association for Geriatric Psychiatry 2013 Annual Meeting. Los Angeles, CA. March 2013.

15. Measuring Outcomes on an Inpatient Geriatric Evaluation and Management Unit: The Effectiveness of Goal Attainment Scaling in Patients with Dementia. American Association for Geriatric Psychiatry 2013 Annual Meeting. Los Angeles, CA. March 2013.

16. Long Stay Hospital Patients in Acute Care Hospital beds: What does Dementia have to do with this? American Association for Geriatric Psychiatry 2013 Annual Meeting. Los Angeles, CA. March 2013.

17. The Relationship between Dementia and Falling in Long-stay Hospital Patients. American Association for Geriatric Psychiatry 2013 Annual Meeting. Los Angeles, CA. March 2013.

2012

18. Journey across the Care Continuum: Patient and Family Perspectives. The Gerontological Society of America 65^th Annual Scientific Meeting. San Diego, CA. November 2012.

19. What do We Know about the Patients who are Alternate Level of Care in Horizon Health Network? 4^th Annual New Brunswick Health Research Conference. Fredericton, NB. November 2012.

2011

20. The Relationship between Dementia and Falling in Long-stay Hospital Patients. 6^th Canadian Conference on Dementia. Montreal, QC. October 2011.

21. Who are the Alternate Level of Care (ALC) Patients in one Atlantic Canada Community? A description from two New Brunswick Hospitals. 40^th Annual Scientific and Educational Meeting of the Canadian Association on Gerontology. Ottawa, ON. October 2011.

22. The Effectiveness of a Hospital Based Falls Prevention Program for Geriatric Patients. 40th Annual Scientific and Educational Meeting of the Canadian Association on Gerontology. Ottawa, ON. October 2011.

23. Challenges of using home health monitoring devices with frail older adults. 40^th Annual Scientific and Educational Meeting of the Canadian Association on Gerontology. Ottawa, ON. October 2011.

2010

24. An Evaluation of a Model of Care in a New Brunswick Nursing Home: Transition to Shared-Care with a Nurse Practitioner. The Gerontological Society of America 63^rd Annual Scientific Meeting. New Orleans, LA. November 2010.

25. The Feasibility of Using Home Based Technology in Frail Older Adults. Independent@Home: A Pilot Study. 2^nd Annual New Brunswick Health Research Conference. Saint John, NB. November 2010.

26. The Effectiveness of Using Goal Attainment Scaling as a Tool to Measure Individualized Outcomes for Patients on a Geriatric Evaluation and Management Unit. 2^nd Annual New Brunswick Health Research Conference. Saint John, NB. November 2010.

27. Are we Meeting Guideline Recommendations for Dementia Care in an Outpatient Setting? 2^nd Annual New Brunswick Health Research Conference. Saint John, NB. November 2010.

28. Effectiveness of a Review and Reduction Strategy for Patients Receiving Atypical Neuroleptic Treatment for Behavioural and Psychological Symptoms of Dementia (BPSD) on Transitional Care Units (TCUs). 30^th Canadian Geriatrics Society Annual Scientific Meeting. Ottawa, ON. April 2010.

29. Patient Related Outcomes of Geriatric Medicine Inpatient Services. 30^th Canadian Geriatrics Society Annual Scientific Meeting. Ottawa, ON. April 2010.

30. Effectiveness of Multi-Sensory Stimulation as an Intervention in Treating Behavioural Problems in Patients with Dementia on a Transitional Care Unit. Interprofessional Health Research Day. Saint John, NB. March 2010.

McCloskey, R., Jarrett, P., & Stewart, C. (2015). The Untold Story of Being Designated an Alternate Level of Care Patient. Healthcare Policy, 11(1), 76.
McCloskey, R., Jarrett, P., Stewart, C., & Keeping‐Burke, L. (2015). Recruitment and Retention Challenges in a Technology‐Based Study with Older Adults Discharged from a Geriatric Rehabilitation Unit. Rehabilitation Nursing, 40(4), 249-259.
McCloskey, R., Jarrett, P., Stewart, C., & Nicholson, P. (2014). Alternate level of care patients in hospitals: what does dementia have to do with this? Canadian Geriatrics Journal, 17(3), 88.
Wernham, M., Jarrett, P. G., Stewart, C., MacDonald, E., MacNeil, D., & Hobbs, C. (2014). Comparison of the SIMARD MD to clinical impression in assessing fitness to drive in patients with cognitive impairment. Canadian Geriatrics Journal, 18(2), 134.
Hogan, D. B., Borrie, M., Basran, J. F., Chung, A. M., Jarrett, P. G., Morais, J. A., … & Stultz, T. (2012). Specialist physicians in geriatrics-report of the Canadian Geriatrics Society Physician Resource Work Group. Canadian Geriatrics Journal, 15(3), 68.
McCloskey, R., Jarrett, P., Knudson, C., Quinn, S., and Stewart, C. (2009). Exploring the Role of a Nurse Practitioner in Long-Term Care. Canadian Journal of Geriatrics, 12(4), 10-15.
Rockwood, K., Fay, S., Jarrett, P., & Asp, E. (2007). Effect of galantamine on verbal repetition in AD A secondary analysis of the VISTA trial. Neurology, 68(14), 1116-1121.
Kamel, S. J., Jarrett, P., & MacDonald, E. (2005). Effectiveness of geriatric evaluation and management units in caring for older adults. Geriatrics Today, 8(3), 104.
Jarrett, P.G., Deschenes, P.J., MacDonald, E.A., Thompson, C. (2005). Pharmacy Review Rounds and Medication Appropriateness on a GEMU. Geriatrics Today, 8(1), 21-26.
Rockwood, K., Cosway, S., Carver, D., Jarrett, P., Stadnyk, K., & Fisk, J. (1999). The risk of dementia and death after delirium. Age and ageing, 28(6), 551-556.
Jarrett, P. G., Rockwood, K., Carver, D., Stolee, P., & Cosway, S. (1995). Illness presentation in elderly patients. Archives of Internal Medicine, 155(10), 1060-1064.
Rockwood, K., Cosway, S., Stolee, P., Kydd, D., Carver, D., Jarrett, P., & O’Brien, B. (1994). Increasing the recognition of delirium in elderly patients. Journal of the American Geriatrics Society, 42(3), 252-256.

More Health and Aging Services

Geriatric Assessment Services

Geriatric Outreach Services

Geriatrics and Restorative Care

Memory Clinic

Palliative Care