About Bridgepoint Active Healthcare
Bridgepoint Active Healthcare, which is part of Sinai Health System, is an internationally recognized, 464-bed rehabilitation and complex care hospital affiliated with the University of Toronto. Bridgepoint is the single largest organization in Canada to focus exclusively on research, care, and teaching for people with complex health conditions. We provide remarkable care in the hospital and community through partnership, expert care, practical research, and education. Clinical areas of focus include inpatient and outpatient rehabilitation, palliative care, dialysis and specialized complex care. Bridgepoint holds Exemplary Status from Accreditation Canada and its stroke program has twice achieved Stroke Distinction status.
Our award winning, state-of-the-art campus remains the number one referral site in the GTA.
About Sinai Health System
Patients and their families are at the centre of everything we do. Health care is changing because the needs of our patients are changing. That’s why we created Sinai Health System, by bringing together Mount Sinai Hospital, Bridgepoint Active Healthcare, Lunenfeld-Tanenbaum Research Institute and Circle of Care. Together, we are delivering exceptional care in hospital, community and at home.
Where Your Money Goes
It’s the generous support of our community that enables everything we do from compassionate care to scientific discovery. Every donation counts towards improving the quality of life for people who rely on Bridgepoint and Sinai Health System during their time of need. Donations to Bridgepoint support things like patient programs, facilities, research, and education to help those with complex health needs.
Meet one of our Heroes: Duncan
Above: Physical therapy assistant Debie Sahadeo leads Duncan through a series of aquatherapy exercises, which are tailored to strengthen his affected arm and leg.
Before his stroke, Duncan was fit and used to being active. When he arrived in the inpatient stroke unit at Bridgepoint Active Healthcare, part of Sinai Health System, on December 10, it was on a gurney. He was unable to move his right hand and had only limited motion and feeling in his right arm and leg. He also struggled with swallowing, and was restricted to a pureed food diet.
Still, he approached his arrival at Bridgepoint with characteristic optimism.
“The first time I met Dr. Heather, I told her I was going to dance out of here,” recalls Duncan, laughing. “She just kind of smiled at me. And I said, ‘I didn’t say how well I’d dance out of here!’”
Duncan entered the care of Dr. Heather MacNeill, a stroke physiatrist, or rehabilitation doctor, in Bridgepoint’s neurorehabilitation unit. Dr. MacNeill — known to her patients as Dr. Heather — looks at a patient’s whole system of function to assess which physical, cognitive and emotional skills have been diminished by stroke. Working in tandem with each patient’s interdisciplinary care team, she assesses a patient’s ability to perform daily tasks like dressing and walking, as well as higher level abilities like driving, cooking and shopping — activities that require greater cognitive and physical function — to develop a treatment plan that restores as much lost function as possible.
“Many people tend to think of rehab as a last resort,” says Dr. MacNeill, “but it is actually a very powerful therapy just like medication would be. There’s a frequency, a dosage and a response we look for that lets us know if the therapy is working and to what extent.”
When patients arrive at Bridgepoint, they are placed into one of two treatment “streams”. As part of the high-intensity stream, Duncan received daily physical and occupational therapy sessions and frequent speech therapy. The reconditioning stream offers a slower pace for those who are not able to tolerate the aggressive approach of the high-intensity program. High-intensity patients spend an average of one month as inpatients before transitioning to outpatient care, while those in the reconditioning stream may stay two to three months.
As they begin rehab, patients are supported by Dr. Tammy Sieminowski, Attending Physician for the neurorehabilitation unit, who monitors their general health and manages their medications and risk factors to reduce the risk of future strokes. Dr. Sieminowski and the entire interdisciplinary team also remain vigilant for common complications, such as falls, which can be a dangerous consequence of recovery.
“When people have strokes, they generally have a very sudden and abrupt loss of function,” explains Dr. Sieminowski. “Take someone who’s been walking their dog every day for years. Suddenly they have a stroke, and perhaps they can no longer walk or speak, or they’re confused. As they start to recover, they may feel more confident and want to get out of bed but no longer have the physical or cognitive ability to do so safely. If they fall, it can have serious consequences.”
A Team Effort
Bridgepoint’s stroke rehabilitation program, recently awarded Stroke Distinction status from Accreditation Canada for the second time, is a team-driven care model that puts the patients’ goals front and centre. For Duncan, getting back the use of all four limbs was paramount. He told his care team that, in the short term, his right leg was the first priority; his arm was second.
“The team leader is always the patient,” says Dr. MacNeill, “but we all work together in providing the care. And that’s because when something is as complex as stroke, one person can’t do everything that’s needed.”
Patients like Duncan benefit from the expertise of a whole cadre of specialists who collaborate closely to deliver coordinated care designed around patients’ goals. Using dedicated physical therapy gyms and an aquatherapy pool with a view onto Riverdale Park, physical therapists focus on helping patients rebuild strength, balance, and coordination in their legs and feet and on improving their ability to walk, climb stairs and exercise — both on land and in water.
Occupational therapists use a variety of strategies, including simulating home activities and chores, to help patients restore arm and hand strength and dexterity, as well as cognition, so they can resume daily tasks like doing laundry, taking their medication, cooking for themselves and returning to work and/or driving.
“They really try to get you ready to go home,” says Duncan. “You handle something hot, something sharp. I’ve cut vegetables, made myself coffee, loaded and unloaded the washing machine, folded laundry. My therapy ‘homework’ one day was to iron shirts with my affected arm.”
For those patients who rely on a wheelchair, experts in the seating clinic work with their occupational therapy colleagues to build customized wheelchairs that accommodate patients’ long-term needs. And in some cases, vocational occupational therapists work with employers to help get patients back to work as smoothly and as quickly as possible — a service unique to Bridgepoint’s program.
Bridgepoint is also one of the only rehab facilities in Toronto to have a state-of-the-art Augmentative Communication and Writing Aids Clinic, a specialized service that occupational therapists and speech-language pathologists use to evaluate patients’ abilities to communicate after stroke and teach them how to use the tools or devices that can help them better express themselves. Speech-language pathologists also work closely alongside dietitians to help patients regain the ability to swallow and return to eating a normal diet.
Nurses, social workers, pharmacists and providers for spiritual care, recreation therapy, geriatrics, psychiatry and internal medicine, among others, also collaborate with the patient’s core rehab team as needed.
“My recovery has been rapid, but the therapy is aggressive,” says Duncan. “They practice ‘tough love’. When you demonstrate even the slightest ability, they give you something new to do. They push and push and push to get you to be as independent as possible.”
A step in the right direction
Duncan and his wife were astonished by the speed of his progress. Two weeks after he first arrived at Bridgepoint, on a gurney and with significantly impaired function, Duncan went home for a visit with his family on Christmas Day. He was able to play with his daughter’s dog and get back up from the floor on his own. He had also graduated to a minced-food diet.
“My wife had a hard time keeping up with my progress,” says Duncan. “She was expecting the worst — that I’d be in a wheelchair for the rest of my life. And by New Year’s Eve I was walking without a cane.”
Duncan and his wife Carole (on his right) in 2013, dancing, at the Tartan Ball, hosted by the Royal Scottish Country Dance Association of Toronto. Photo credit: Ian White
By mid-February, Duncan was a month into his outpatient therapy and had regained strength and full-range of motion in his right hand and arm. His right leg and foot were close behind.
His progress was initially slowed a bit by his foot, which he couldn’t articulate fast enough to walk without shoes. Now, after intense practice during his physical therapy sessions, he can not only walk but also kick and dribble a soccer ball in bare feet.
“I’m even more motivated that the right foot is working now,” says Duncan. “There’s observable improvement every day, and I can see it, even if my wife or therapists don’t. I notice every twitch in every finger and toe.”
His stroke has changed his timeline, but not his retirement goals. In May, Duncan and his wife enjoyed a visit to their daughter and her family in Arizona that they had postponed when he became ill. Next up: a triumphant return to Scottish country dancing.