Shortly before Joyce turned ninety on February 8, 2018 she fell in her home and fractured her collarbone. Two and half years prior to that, her husband, Robert, passed away, and so Joyce was living alone.
Joyce admits it was a bit of a struggle after she fell, but she was able to get herself up. “I didn’t think of calling 911,” said Joyce. “No, I immediately cried…it was painful.”
She eventually was able to call her son, Chris, who immediately called 911. Joyce relies on Chris, who also lives in Toronto and provides his mother with the support she needs. Chris generally spends quality time with his mother; he takes her shopping for groceries and helps with her errands.
Joyce was taken to St. Michael’s Hospital (SMH), where an examination revealed a fractured collarbone. No surgical intervention was required; however, her right arm was put in a sling. No therapy was prescribed, though, because her arm needed to remain immobile to properly heal.
After Joyce was stabilized and received the appropriate care at SMH, a care coordinator there proceeded to find Joyce a suitable rehabilitation facility. Both Joyce and Chris decided on The Salvation Army Toronto Grace Health Centre (TGHC) and she was admitted on February 16, 2018.
Joyce had lived very independently and was quite active before her fall, taking long walks as well as occasionally taking the six flights of stairs up to her condominium. After the accident, she wanted to get her independence back as soon as possible and expressed her wishes to the TGHC’s interprofessional health care team.
The rehabilitation process was not as quick as Joyce would have liked. In the beginning she could hardly walk and it was frustrating and difficult.
While her collarbone was in the process of healing, the hospital rehabilitation team focused on her passive range of motion. Until Joyce was assessed at the fracture clinic there were no active range-of-motion therapy sessions. Despite, these limitations, Joyce began gaining her independence.
When Joyce visited the fracture clinic in March, doctors were able to determine that her collarbone was healing nicely. At that point, a physiotherapist began working with Joyce on more active rehabilitation and the strengthening of her shoulder area. An occupational therapist (OT) worked with Joyce on cognitive remediation. This would help with Joyce’s reintegration back to the community; it also helped to improve her memory.
On her admission, Joyce was assigned a social worker, who listened and understood that Joyce wished to return home as soon as possible. The social worker set about to complete the necessary steps to provide a seamless transition for Joyce’s return home. Chris has the power of attorney for his mother and worked with the social worker to confirm that all the safety precautions in the home were met. For example, he made sure that Joyce’s Lifeline system (a medical-alert service) was working. He even went so far as to upgrade the system to include a GPS — so that if Joyce became unconscious and was unable to push the button, she could still be located.
The social worker also supported Chris with initiating the Meals on Wheels program he wanted for his mother before Joyce returned home. Early on, the social worker also connected with a care coordinator from the Toronto Central Local Health Integration Network (TC LHIN). The care coordinator from the TC LHIN ensured that a safe discharge plan was in place, along with community support services. Joyce was eager to return home and was aware she was incapable of total independence but understood she could continue to live independently with the right support. She was discharged March 16, 2018.