Dr. Sudip Saha is featured in the second episode of the OMA’s Centred on Care video series
If you walk into the Acute Care for the Elderly unit at Brampton Civic Hospital, one of the first things you’ll notice is the vivid colours on the walls and doors.
The home-like space is unlike most acute-care settings, full of colourful, engaging games, puzzles and books. This is part of a new care strategy led by Dr. Sudip Saha, medical director of seniors’ health at William Osler Health System, who is reimagining ways to address the growing need for specialized dementia care in acute-care hospitals.
There are about 600,000 people with dementia in Canada, a number that could grow to one million by 2030, according to the Alzheimer Society of Canada. Brampton Civic’s ACE unit provides focused care to senior patients who require acute medical treatment while also experiencing acute changes in their physical, cognitive and functional status.
“People living with dementia are at higher risk for developing worsening confusion when they come to a hospital,” Dr. Saha said in an interview with the OMA.
Anxiety can heighten confusion and lead to aggressive behaviour, slowing recovery and delaying discharge or necessitating alternate levels of care.
Under the leadership of Dr. Saha and his team, Brampton Civic Hospital is the first acute-care hospital to implement The Butterfly ApproachTM, a model of care that is being used in some long-term care homes in Canada, the U.K., the U.S., Ireland and Australia.
This emotion-based, person-centred model of care for those living with dementia recognizes that the patient’s emotional needs are as important as their physical needs.
As dementia progresses, patients lose their ability to understand facts and logic.
“However, their emotional brain, or feeling brain, is not affected until much later on in the disease,” said Dr. Saha.
The Butterfly Approach engages with their feelings through, for example, the use of vivid colours in the hospital to compensate for patients’ diminished ability to perceive colour.
“We know that people who have dementia interpret colour five times lighter than an average person,” said Dr. Saha, who said the vivid colours and imagery used throughout the unit help in orientating patients.
The non-sterile atmosphere in the unit defuses anxiety, he said. Staff members are specially trained to take care to learn more about the patient’s background and life pre-diagnosis to understand “the whole person and their lived experiences. This gives staff insight into behaviours that may seem out of the ordinary,” he said. Their training also includes removing controlling words, actions and other features that take away power, choice and independence from patients.
“We know that people who have dementia interpret colour five times lighter than an average person” — Dr. Sudip Saha, medical director of seniors’ health at William Osler Health System
The ACE unit has seen positive signs after adopting The Butterfly Approach, including less utilization of anti-psychotics, a lower incidence of falls and a reduction in behaviours driven by anxiety, he said.
Meaningful Care Matters, the U.K. consultancy and developer of The Butterfly Model, has accredited the ACE unit with its highest designation.
The Centred on Care video series is documenting some of the groundbreaking innovations of select Ontario doctors improving the delivery of health care and positively impacting patient lives beyond the clinic, hospital or operating room.
Connecting to the OMA’s important advocacy efforts, the showcased work aligns with the OMA’s landmark Prescription for Ontario: Doctors’ 5-Point Plan for Better Health Care report, its 2023 progress report outlining urgent health-care priorities – the primary-care crisis, home- and community-based care and burnout and administrative burden – and a newly published report outlining solutions required for health-care reform.
The second episode in the series is part of the Value of Doctors campaign, which will continue to run next year after the OMA elections. Read the first and third articles in the Centred on Care series.