Medical Support Services for Long Term Care Medical Directors / Physicians
The following processes have been established to support a consistent approach to NSHA Medical
Support Service for LTC Medical Directors and Physicians. These are interim measures during COVID-19 and do not constitute permanent changes within NSHA.
MED-LTC Support Service Categories
Three categories of support will be available to LTC Medical Directors and Physicians:
1. Prognostication of Goals of Care
- Assessment of patient’s frailty status and trajectory of health preceding illness.
- Discussion of risks associated with interventions in the setting of respiratory and/or hemodynamic decompensation (risks specific to acute illness and risks specific to the patient).
- Co-development of a care plan with input from primary care provider, and patient/family to ensure care is delivered appropriately in an optimal setting.
2. Acute Medical Management Advice
- Confirmation that the goals of care remain meaningful and attainable given the clinical situation.
- Help with assessment of hemodynamics and volume status and with management of dyspnea and hypoxia.
- Help with assessment and management of delirium and/or behavioural symptoms of dementia.
- Recommendations on, if and when further investigations are necessary.
3. Coordination of Care and Disposition Planning
- Assessment of whether care plan can be achieved utilizing services within the LTC facility.
- Assessment of whether hospital transfer is appropriate and necessary.
Accessing MED-LTC Support During COVID-19 Pandemic
The support services outlined above can be accessed using the following processes:
1. Immediate advice from the Internist: Call 1-833-460-0848
2. Formal Consultation Services:
- General Internal Medicine, Geriatrics, and Goals of Care Planning consults are available.
- Fax referral form to 902-473-8430 specifying request is for MED-LTC team, and identifying appropriate Clinical Service from list above.
- Please send appropriate supporting documents (CGAs, most recent Advanced Directives, SDMs names and contact info).