Severe responsive behaviours in dementia represent a crisis of growing proportion affecting individuals in long-term care, acute care, and the community. In response, Baycrest developed the Virtual Behavioural Medicine Program, a novel virtual medical and behavioural support approach targeting responsive behaviours in dementia such as severe physical aggression. The model aims to (1) mitigate unnecessary transfers to emergency departments (ED) and acute care admissions due to responsive behaviours; and (2) reduce lengths of stay for patients admitted with responsive behaviours by providing direct support to acute care clinicians.
In late 2019, the model was piloted to proactively manage the waitlist for the specialized behavioural neurology inpatient unit at Baycrest. The Virtual Behavioural Medicine Program leverages the renowned clinical expertise of the Sam & Ida Ross Memory Clinic, in partnership with the regional Behavioural Support Outreach program, to provide virtual behavioural assessment, medical diagnosis, and pharmacological intervention for individuals with dementia in long-term care, acute care, and in their own homes. The results of this pilot showed that the model reduced the need for acute admissions from long-term care and the community by approximately 75-80%.
The onset of the COVID-19 pandemic in 2020 created a sudden and significant need for services to support older adults in situ. To meet this need, Baycrest rapidly scaled up the Virtual Behavioural Medicine Program model to provide service to more than 85 long-term care homes in Toronto and beyond. To date, the model has provided access to critical behavioural supports for approximately 90 patients.