Baycrest Health Sciences

Dr. Morris Freedman

The word dementia typically makes us think of memory loss. However, dementia’s impacts are much broader and can lead to changes in personality, behaviour, and emotional responses, such as aggression, agitation, and hallucinations.

In fact, severe symptoms of dementia are often the driving factor in people living with dementia being transferred to emergency departments, specialized behavioural units, or acute care hospitals to receive treatment and care. Unfortunately, this move can often worsen the behaviour.

To address these challenges, we launched Baycrest’s Virtual Behavioural Medicine (VBM) program in 2020. This innovative dementia care program allows clinicians to assess and manage patients with severe neuropsychiatric symptoms of dementia while the patients remain in their homes, whether in the community or long-term care. According to a recent study, VBM can reduce the need for hospital admissions by 60 percent.

How VBM works

Patients are referred to the VBM program from long-term care and acute care facilities, as well as from private residences and retirement homes. Patients and their families, caregivers, and healthcare teams meet virtually with a VBM physician, who assesses the patient and prescribes interventions. The VBM team, including behavioural neurologists, a nurse, a pharmacist, a neuropsychologist, a social worker, and the Behaviour Support Outreach team, then regularly reviews patient progress during virtual follow-up appointments.

There are also bi-weekly rounds to talk about each patient as a team. The program also supports family members in the community, helping them develop and implement care plans and access behavioural and social support.

“Our innovative dementia care program is instrumental in helping clinicians to assess and manage patients with severe neuropsychiatric symptoms of dementia while the patients remain in their homes.”

VBM is a collaboration between the Sam and Ida Ross Memory Clinic at Baycrest, a global leader in research, innovation, education, and care for older adults, and the Toronto Central Behavioural Support for Seniors Program (TC-BSSP). Baycrest is the health services lead for the TC-BSSP as appointed by Ontario Health Toronto Region and works with health partners to help coordinate behavioural care for Ontario seniors, their families, and caregivers.

The program is available across the province of Ontario and has recently been granted a $2.6M investment to sustain and expand VBM as part of Ontario’s Plan to Stay Open: Health System Stability and Recovery.

Improving care and quality of life for older adults everywhere

Since its launch, VBM has helped countless individuals living with dementia, their caregivers, and care teams. For example, a long-term care home recently admitted a new resident with behavioural symptoms of extreme aggression, both verbal and physical, requiring security and extra staff 24 hours a day. The VBM team was called in for support, avoiding the need to move the resident out of the home.

After two months of sustained work using medications and non-pharmacological interventions, the resident went from having almost no quality of life to being a completely changed person. She was pleasant and able to have a conversation and take part in activities. And it was all done virtually.

The number of people diagnosed with dementia worldwide is expected to triple from 50 to 150 million by 2050, meaning more and more individuals and their families will be impacted by severe dementia symptoms. As a fully virtual program, VBM can be adopted worldwide and therefore has the potential to help people living with dementia everywhere to live their best possible lives.

To learn more about VBM and other innovative programs at Baycrest, please visit Baycrest.org.