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Amy MacSween is a familiar face at Cape Breton Regional Hospital in Sydney. She is a recreation therapy associate by background and a member of the Nova Scotia Health Frailty and Elder Care Network’s Early Mobility Program.
Prior to joining the mobility team in fall 2023, MacSween spent nearly 13 years as a recreation therapy associate in long-term care at Nova Scotia Health. Approximately 39 full-time mobility assistants, who have backgrounds as recreation therapy associates or rehab assistants, were hired in 2023 through the province’s Action for Health Plan to support patients to mobilize at nine regional hospitals across Nova Scotia.
The goal of the Early Mobility Program is to identify older adults (65+), within the first 24 - 48 hours of admission to hospital, who are at greatest risk of increased frailty due to immobility while in hospital and offer support for purposeful mobilization. A patient’s risk is assessed using the Clinical Frailty Scale, which was developed by Dr. Kenneth Rockwood, QEII Health Sciences Centre internist-geriatrician, clinical scientist and medical director for the Frailty and Elder Care Network.
“In Canada, more than one-third of all older adults (65+) in hospital lived with frailty prior to admission and are more likely to have a longer stay in hospital,” said Rockwood.
Eligible patients are referred by registered nurses, physicians and rehabilitation staff to the program to maintain or improve their mobility over the course of their stay. The Early Mobility team works on inpatient units and in emergency departments to ensure eligible patients are walking up to three times each day.
Mobility assistants, like MacSween, walk with identified patients who are 65 years of age or more to help maintain or improve their physical activity and independence while in hospital to support them in returning home sooner. In addition to regular updates on a patient’s chart, they record each patient’s steps in metres, as well as other data. This not only measures the patient’s progress, but also provides valuable data to evaluate the overall success of the program.
Mobility assistants are a vital part of a patient’s circle of care. They support other care team members, such as physiotherapists, so they can devote their time to more complex patients while still ensuring patients are being mobilized. “It is so rewarding being part of a team where everyone has the same goal…. to improve a patient’s quality of life,” said MacSween.
MacSween notes that patients look forward to visits from the Early Mobility team. “In addition to helping patients with their physical health, our visits seem to help some patients with their mental wellbeing as they have someone to talk with,” said MacSween. She also adds that knowing a loved one will receive visits provides comfort for family members at times that they aren’t able to be present.
“What an excellent service to now have available. After a number of days having a dedicated team to mobilize her, my mother-in-law was able to be discharged back to her apartment. Without this service, I truly believe she would have been destined for restorative care (or a nursing home) due to declining mobility while in hospital,” said one family member.
Since the program began in Nova Scotia Health’s Eastern Zone (Cape Breton Island and Antigonish and Guysborough counties) in October 2023, a total of 545 patients have been referred to the program at the zone’s two regional hospitals - Cape Breton Regional Hospital in Sydney and St. Martha’s Regional Hospital in Antigonish. Of the total patients that participated in the program, 70 per cent returned to the place they call home.
“Patients are getting home sooner,” says Dr. Meaghan Keating, hospitalist at Cape Breton Regional Hospital. “There are some patients who have avoided a rehab stay entirely because of the extra attention to their mobilization. They look forward to seeing the mobility team multiple times a day and the socialization aspect is so beneficial. This has been such a positive and effective intervention for our acute care patients,” said Keating.
Photo of Amy MacSween.