Exceptional care, empowered teams, inspired innovation – that’s what Adolf Karakochuk received in the final years of his life. Adolf’s positive healthcare experience also illustrates how staff are embracing and living the Region’s long-term vision.

“I call them my angels, my stars from up above – that’s what they are to me,” says Adolf’s wife, Margaret, of the team that cared for her husband in their home in Wynyard.

Back, from left: Paramedic Stephen Koroluk, Continuing Care Assistant Melody Stefanson, Judy Karakochuk. Front: Adolf and Margret Karakochuk.

Back, from left: Paramedic Stephen Koroluk, Continuing Care Assistant Melody Stefanson, Judy Karakochuk. Front: Adolf and Margret Karakochuk.

Margaret and her family were so grateful for the inter-collaborative care they received from home care, community paramedicine, occupational therapy and physical therapy that they invited the entire team to Adolf’s funeral in February 2016, and even asked one of the paramedics who worked closely with Adolf to be an honourary pallbearer at the funeral.

“They had the whole team sitting at the family table for dinner afterwards,” says Kelly Prime, paramedic chief of Midway Ambulance Care in Wynyard, whose team provided paramedicine support to Margaret’s family. “That showed that they embraced us as part of their family.”

Adolf passed away earlier this year, surrounded by his family. He was able to remain at home during his final years, because of the dedication and commitment of a team of inter-disciplinary professionals who chose to come together for the benefit of one man with a desire to continue living at home.

Inspired innovation

“Home care called us in October 2014,” says Sherri Julé, who works in pre-hospital emergency medical services for Saskatoon Health Region. “They said they had a client who would like to continue living in his home, but they needed support with moving that person. On average, he needed to be moved four times a day, and he required a lift.”

According to TLR (transfer, lift and repositioning) standards, when a client needs to be moved using a lift, two staff members must be present.

“Home care didn’t always have two continuing care aids on staff at the same time, so they asked if a paramedic could help move Adolf when they only had one staff member available,” Julé says, explaining that a community paramedicine model was established in Wynyard 2011.

Community paramedics work within their scope of practice in non-traditional community-based environments, outside the usual emergency response/transport model.

“Community paramedicine is about helping to fill gaps of care, regardless of where it is. It’s about helping people to live the best life they can,” Julé explains.

“Sherri Julé and I had worked together before, so we’d had conversations about the community paramedicine model and how we can deliver care in the community differently,” says Kelly Tokarchuk, manager of home care in Wynyard. “Without that collaboration with the paramedics, we would have been unable to provide a portion of the service we were delivering to Adolf, especially in the evenings, because we generally only have one staff member working at that time.”

Home care’s continuing care aids and the community paramedics also worked closely with an occupational therapist and physical therapist to ensure that Adolf’s mobility concerns were addressed and that the right equipment and tools were used to keep Adolf safe when transferring him, so he could continue to successfully live at home.

“They came out to the house on numerous occasions,” says Tokarchuk of the occupational and physical therapists. “They re-positioned his wheelchair to fit him better and changed out the back to give him better support. They also worked to get a hospital bed and exercise equipment into Adolf’s home. Their resources and knowledge enabled us to provide better and safer care.”

“We also had fantastic support from Prairie Mobility,” Tokarchuck adds. “They brought out the equipment and were so responsive to Adolf’s needs. One day they brought out a lift that we determined wasn’t the right lift, and the very next day they were back installing a new one.”

Tokarchuk says the success of Adolf’s inter-disciplinary care would not have been possible without the strong support of Adolf’s family.

“It was the family who made this successful,” says Prime. “Their open-mindedness allowed this partnership to grow.”

“The family was very active in Adolf’s care. They were phenomenal,” Tokarchuk adds, emphasizing that having Adolf at home allowed his family to spend more time with their husband, dad and grandpa in his final years.

“It was a gift I wish we could give to everybody,” Tokarchuk says, explaining that she considers honouring people’s wishes a form of respect. “The goal of home care is to keep people as independent as possible and to really help them fulfill their wishes. It really is showing respect to someone by saying, ‘If this is what you want to do, here’s what we can do to help you get there.’ Our home care continuing care aids are very professional. When they walk into a house, they see a person not just a task, and they build meaningful and long-lasting relationships with the clients and families they serve.

“We’re going to see more and more clients like Adolf with heavier needs but want to stay home, so it’s really going to push us to figure out how to do this over and over again,” she adds. “The inter-collaborative process is about asking, ‘What resources do I have, what resources do you have, and if we put these resources together, can we provide better care than what you and I can provide separately?’”

Empowered teams

The collaborative process that Tokarchuk initiated with Julé is an inspiring example of how one community’s creation of an inter-disciplinary team is leading to more accessible, compassionate care for clients and their families – an example of how putting people first is allowing all involved to achieve excellence in quality of care.

“It was Adolf’s wishes that he stay in his home for as long as possible – he did not want to go to long-term care,” says Julé. “We wanted to accommodate the family, to find a solution, so we all came together (continuing care aids, paramedics, occupational and physical therapists) and had a meeting to determine how we could meet Adolf’s needs at home – what kind of lifts he needed and how we were going to transfer him at certain hours of the day.”

This inter-disciplinary approach to care began in Wynyard in 2011 when Julé, Prime and Rod Mackenzie, director responsible for emergency medical services, started to build partnerships between various healthcare professions, including acute care, long-term care, palliative care, home care, lab services and paramedics.

“We had built those partnerships, so when Adolf’s situation arose in 2014, the manager of home care (Kelly Tokarchuk) said, ‘Wait a second, I know people who can fill our gap,’ and she brought us into Adolf’s circle of care,’” Julé says, adding that their approach to care puts the patient at the centre.

“It’s all about the patient,” she says. “It’s about developing a pathway based on the particular needs of each individual.”

“We’re in the process of building a healthcare system for patients, residents, clients and their families that we can all rely on for exceptional care,” says Saskatoon Health Region CEO and President Dan Florizone. “This shows that we’re not just envisioning a system where healthcare providers, patients and families work together as empowered teams – we’re living it, each and every day.”

Exceptional care

From December 2014 to February 2016, Prime says it was rare to have a day when one of his paramedics was not at Adolf’s home for at least a few minutes.

“Even if we weren’t scheduled to be there, someone always stopped in and checked on Adolf and his family,” Prime says, adding there were times when Adolf’s family would invite them in for supper. “Everybody embraced everyone as family.”

Prime says the relationship between the paramedics and home care’s continuing care aids is also much stronger as a result of having worked together so closely with Adolf and that this cohesion between care providers is having a positive impact on patient care.

“Patients see that mutual respect and collaboration between these two professional groups working together to care for them,” he says, explaining that as important as it is to build partnerships among medical professionals, it’s just as important to build relationships in the community with patients and their families.

Tokarchuk describes this collaborative, team-based approach to care as energizing.

“It’s energizing to have the ability to say ‘Yes, let’s talk about this further,’ then to get to do something about it and to actually help,” she says.