By Dr. Mark Wahba, Physician Executive of Integrated Urban Health and Emergency Room Physician
A few weeks ago before the snow descended upon us, I was biking with my kids to school. It was about two degrees outside.
As we were riding, I told my six-year-old daughter she was “hard core.”
“What’s that?” she asked.
“Super tough and dedicated,” I told her.
She then got a big smile on her face and pedalled faster.
It made me proud to be her dad. It also reminded me why the four of us were biking to school instead of driving: we’re enthusiastic participants of the Saskatoon Public School’s Move To Grow campaign. The campaign, which launched in September, is about encouraging students and their families to pursue active transportation when travelling to and from school.
I had the honour of being asked to speak at the campaign launch event at Roland Michener School earlier in the school year. As a parent and physician, I jumped at the chance to talk to kids about the benefits of being active. It was great to see a few light bulbs go off when I told the kids how exercise can actually make us smarter. That’s because the sections of our brains dedicated to memory and learning are larger in people who are physically active.
My involvement in the campaign has given me a lot to think about in the weeks since it launched both as a parent and as a physician.
As a parent, it’s made me more cognizant of the things I can do to support my kids in being active, whether it’s riding my bike to school with them in the morning or on the weekend when we have more time. You can see some great tips for families on how to Move To Grow
Dr. Wahba with his daughter, sons and wife
As a physician, the campaign has caused me to ask what else we can do as health care providers to help our patients be more active.
A few weeks ago, I was at an event related to patient care. At one point, I mentioned my involvement in the Move To Grow campaign as an example of a healthy initiative that’s getting kids and their parents to think differently about something as simple and routine as how they get to school every day.
Later in the day, one of the participants came up to me and said, “‘We need a Move To Grow campaign in the hospital to get patients up and walking around. This will prevent them from getting weak and needing alternate level of care services.’”
We may not have a campaign underway (yet), but in the weeks following the event, I’ve heard of at least two initiatives across the province dedicated to getting patients up and moving.
The first is in Saskatoon, where the geriatric program has been partnering with the Emergency Department for more than a year to implement care aids in the emergency room to help older adults. The initiative focuses on assisting patients with the basic elements of care, including mobility. It came out of the development of a Connected Care strategy, which asks acute care teams to go back to basics and ensure that patients are moving, sleeping, eating, etc.
The Department of Medicine is also in the initial phases of putting together a mobility initiative on its acute care units to address this issue.
The second initiative is in Swift Current at the Cypress Regional Hospital. On March 1, 2019, the hospital will launch a 90-day initiative aimed to get patients up, dressed and moving. The initiative is inspired by #EndPJParalysis, a project that originated in the U.K. and is gaining great momentum internationally, just like the Connected Care strategy.
#EndPJParalysis encourages hospitals to “get patients up, dressed and moving.” It focuses on the quality of patient time and experience and asks, “If you had 1,000 days to live, how many of them would you like to spend in hospital?” The hope is that with the launch of #EndPJParalysis at the Cypress hospital, we’ll see better outcomes for patients during their hospital stay, especially for older patients who are most vulnerable to functional decline.
Although mobility is such a basic concept for most, for our older patients it can mean the difference between going home or going into a home. Here’s why: in people over the age of 80, only 10 days of bed rest in hospital can lead to the equivalent of 10 years of ageing in the muscles. That’s why it’s so important for our patients, especially our geriatric patients, to move while in hospital – the sooner they mobilize and the more they mobilize, the better the outcome.
Dr. Jenny Basran, a geriatrician in Saskatoon who is part of the geriatric program, has this to say about the importance of mobility: “As a geriatrician who has worked in both acute care and in the community, I see the longer term impact of illness, particularly those with multiple chronic conditions. If I had to pinpoint one key activity that differentiated those who age well and those who struggle, it would be mobility. Older adults who get out and walk regularly benefit not only from improved muscle functioning and increased social engagement but also increased brain function.”
Dr. Jenny Basran at Royal University Hospital
In other words, mobility in older adults is an indicator of current health status, and it provides a sense of well-being and independence. A loss of mobility is associated with functional decline, and no place is this more evident than in our acutely-ill and hospitalized geriatric patients, who often have little opportunities for mobilization. Dr. Basran recently led a study in Saskatoon which showed that geriatric patients in hospital only spend about five per cent of their time standing or walking. It’s not surprising then that up to half of older adults will have a new disability coming out of hospital, even though the medical problem that resulted in their hospitalization was resolved. Dr. Basran says this is why Canadian geriatricians often refer to mobility as a “vital sign” and have put together a simple, yet highly effective approach to combat this issue:
geriatric patients are helped to mobilize at least three times a day and it is everyone’s responsibility to ensure this happens. This simple act may be the difference that enables someone to go back to their own home instead of a nursing home.
At the end of the day, it’s not just our geriatric patients and kids who need to be active to Move To Grow. We do, too. That’s why I’ve started riding my bike to work again. It doesn’t happen every day, but I find that on the days it does, it’s a great way to get my blood flowing before work and to unwind before I get home. This may be a little harder now that the snow is here, but I’ve got my six-year-old daughter’s hard-core attitude to motivate me.