MileAGE Podcast AGE-WELL National Innovation Hub APPTA

In this episode, Dan speaks with Dr. Vipan Nikore, founder and CEO of Homecare Hub.
 
What is Homecare Hub?
Homecare Hub is a purpose-driven team with a bold vision to keep people out of large institutional nursing homes by building creative solutions that decrease the cost, and improve the quality and experience of receiving home care services.
Our healthcare system is overwhelmed, and people with complex healthcare needs face challenges to preserve their current living situation. Homecare Hub was created to address the housing and home care needs of these individuals offering exceptional housing with more personalized, higher-quality care at a lower cost when compared to large nursing home or retirement facilities.
Homecare Hub creates small, high quality 2-12 person shared care homes on-demand at an affordable price by matching people by care needs, language, disease process, and interests. For those not interested in our co-housing solutions, we offer other options through our suite of care solutions designed to help people age safely and comfortably at home for as long as possible.
 
Dr. Nikore's bio
Vipan is a software engineer turned physician and global leader in Health Innovation. In addition to his role at Homecare Hub, he is the Chief Medical Director of TD Bank as well as a practicing internist at Trillium Health Partners and Cleveland Clinic Main Campus in Ohio and Toronto. Prior to Homecare Hub he was the Site Medical Director for the Department of Medicine at Trillium's Credit Valley Hospital, overseeing 15,000 admissions a year. He is an Assistant Professor at the University of Toronto Faculty of Medicine where he teaches Leadership, Emotional Intelligence, Innovation, Healthcare Quality and clinical medicine on the hospital wards, and is an investigator at the Institute for Better Health. He previously was co-course director for MIT’s Global Health Informatics course where co-edited one of the first comprehensive Global Health Technology books.
 
Vipan has led and founded various organizations and groups, such as the non-profit uFLOW (now LYFE), which empowers underserved youth to start their own health service projects, which he expanded to Chicago, Cleveland, New York City, Boston, and San Francisco. He is a former software developer at IBM, and also led projects at Sun Microsystems, Citibank, UCLA, WHO in Geneva, UNICEF in India, the Ontario Ministry of Health, and Lux Capital in NYC.
 
He is an advisor at the Health Education Project in Haiti and has worked clinically in Haiti, Peru, Ghana, Nepal, and India. He has served as an advisor and mentor at the Creative Destruction Lab, the Center for Social Innovation’s Agents of Change program, Blueprint Health in NYC, and the Harvard Innovation Lab. He has authored chapters on e-Health, medical devices, and genomics, and given talks on healthcare technology, innovation, global health, and leadership across the globe.
 
Vipan completed his internal medicine residency training from Cleveland Clinic's main campus, MD degree at the University of Illinois-Chicago (UIC), MBA at the Yale School of Management, and his BSc in computer science and software engineering at the University of Western Ontario. At Yale he led the student body as the President of the Yale Graduate and Professional Student Senate and as a resident he was selected as the sole recipient among all Cleveland Clinic residents for the Michener Leadership Award for leadership and dedication to community service and humanity. He is a former recipient of Canada’s “Top 40 under 40” award, the country's most coveted award for young leaders.

Daniel Smiley, Research & Logistics Specialist, is your new host as Jenna takes on more responsibilities at the APPTA Hub. He welcomes Dr. Patrick Patterson to discuss his recent publications on long-term care policies pre- and post-COVID-19.
 
We’re all aging, and everyone’s talking about it!
 
Key Takeaways
 
[:41] Daniel Smiley introduces himself as your new host and welcomes Dr. Patrick Patterson and asks him to share a top-level summary of his paper.
 
[1:38] Dr. Patterson talks about how Canadian differences in pandemic responses guided the focus of this research paper.
 
[2:51] The BC vs. Ontario choice came down to demographics and the existing long-term care framework.
 
[6:10] Hours per resident per day — or HPRD — is a data point that has existed for decades, Dr. Patterson shares what it actually measures.
 
[9:25] Dr. Patterson talks about two pre-pandemic initiatives to increase hiring in LTC in Ontario and BC as well as their results.
 
[13:16] The challenges of long-term care support differ from that of other healthcare sectors, Dr. Patterson explains how.
 
[18:06] Pandemic single-site orders for LTCs had different impacts on different provinces, with Ontario being far more heavily disrupted than BC. Dr. Patterson untangles some of the reasons for this.
 
[24:14] Varying types of LTC also were vulnerable in different ways to single-site orders.
 
[26:49] Recapping the factors discussed, Dr. Patterson talks about how BC and Ontario each fared during the first wave of the pandemic.
 
[31:33] Dr. Patterson adds geography, demographics, and occupancy as factors that aggravated Ontario’s situation.
 
[33:16] Dr. Patterson talks about what he thinks the future holds for the long-term care sector. He also offers some thoughts on what should be done to strengthen the system.
 
[42:02] Find Dr. Patrick Patterson’s paper here: https://www.utpjournals.press/doi/full/10.3138/cpp.2022-011.
 
[43:05] Daniel thanks Dr. Patrick B. Patterson for sharing the findings from his latest research. Thank you to all listeners!
 
If you enjoyed today’s episode, make sure to subscribe, rate us, and visit our website at agewell-nih-appta.ca/mileage-podcast for more information.
 
Project Team Biography
 
Dr. Patrick B. Patterson is a Knowledge Broker for the APPTA Hub. Patrick is a social anthropologist, with a background in using qualitative research methods to study organizations and policy formation. Within the APPTA Hub, his primary focus is supporting research and knowledge translation activities by looking at contexts, people, and processes that lead to policy decisions.
 
Mentioned in this episode
 
The MileAGE Podcast
Healthy Seniors Pilot Project
Dr. Patrick Patterson at APPTA
Long-Term Care Staffing Policies Pre-COVID-19 and Pandemic Responses: A Case Comparison of Ontario and British Columbia
 
More about your host
 
Daniel Smiley at APPTA
Daniel Smiley on LinkedIn
 
Tweetables (edited)
 
“Turnover is really high in long-term care. In Ontario, recent numbers show that pre-pandemic up to 25% of experienced support staff would leave the long-term care workforce in any given year.”
 
“Folks in long-term care are doing really important work, taking care of our loved ones when they can’t take care of themselves anymore.”
 
“A hundred percent of long-term care workers lose 100% of their patients, that can’t be easy.”
 
“The care center operators need to take it on board to reduce the turnover, converting part-time positions to full-time can give stability and career opportunity for workers.”
 
“The best long-term solution may be to proactively invest in building health and disease prevention throughout adulthood before people reach old age so that when people are older adults, they are healthy older adults who can stay in their homes longer.”
 

Jenna welcomes Dr. Grant Handrigan, professor at the Université de Moncton to talk about his long-running project Dance Your Way to Health and the upcoming results.
 
We’re all aging, and everyone’s talking about it!
 
Key Takeaways
[:41] Jenna welcomes Dr. Grant Handrigan and asks him to share how his project Dance Your Way to Health came about, four years ago, and how it was anchored with the Grouille ou Rouille community group, founded in 1981.
 
[5:11] Dr. Grant explains sedentary behaviour and lists the multiple benefits of regular physical activity.
 
[8:11] The programs’ participants were identified prior to even launching the project, Grant explains who they are, where they come from, and how many of them have participated throughout the years.
 
[10:44] Fredrickton and Saint-John now have the program as well as the original Moncton, Grant touches on how this happened and some other smaller communities he has had a chance to visit.
 
[13:07] Grant explains where the project is currently — intervention, evaluation, results — and talks about the struggles getting the project off the ground and during COVID-19.
 
[17:11] Grant breaks down the data points he is sharing and what information the results will include. He also talks about where the performance data was collected and how.
 
[20:27] The program is running on its own already, Grant explains what further steps will be taken to ensure sustainability.
 
[22:43] Jenna thanks Dr. Grant Handrigan for sharing how far this program has come. Thank you to all listeners!
 
If you enjoyed today’s episode, make sure to subscribe, rate us, and visit our website at agewell-nih-appta.ca/mileage-podcast for more information.
 
Project Team Biographies
Grant Handrigan: Grant Handrigan is an associate professor at the École de kinésiologie et de loisir at the Université de Moncton. He has a PhD in kinesiology from Université Laval where he was supervised by Professor Philippe Corbeil and Professor Martin Simoneau. His MSc degree is from Memorial University in exercise and work physiology where he was supervised by Dr. Fabien A. Basset. He also holds an undergraduate degree in kinesiology from Memorial University. 
 
Lucille Wilson: Lucille Wilson is a certified kinesiologist and owner of Kinfit50. Kinfit50 is a company that offers exercise programming for older adults in New Brunswick. Lucille Wilson obtained an Bachelor of Science (Kinesiology) from the Université de Moncton.
 
Mentioned in this episode
The MileAGE Podcast
Healthy Seniors Pilot Project
Grouille ou Rouille
Université du Troisième Age du Sud-Est du Québec
Lucille Wilson — KinFit50
Plain language summary
Canadian Frailty Network
New Brunswick Health Research Foundation
 
More about your hosts
Jenna Roddick at APPTA
Jenna Roddick on Twitter
Jenna Roddick on LinkedIn
 

Jenna welcomes Dr. Grant Handrigan, professor at the Université de Moncton and principal investigator for the Implementing Virtual Reality in Advanced Fall Prevention, Building Resilience and Balancing Risk research project. They discuss the relative lack of fall management and prevention programs, the fear of falling as a barrier to a more active life, and the need for sustainable programs for both seniors and youth with regard to falls.
 
We’re all aging, and everyone’s talking about it!
 
Key Takeaways
[:41] Jenna welcomes Dr. Grant Handrigan to talk about his most recent project involving virtual reality.
 
[1:39] Grant shares how he came to work with virtual reality as well as what this project is looking to evaluate.
 
[4:48] Falls get left out despite the fact that they are an important cause of hospitalisation and often lead to a shift in independence levels.
 
[8:26] Grant talks about what he hopes this research provides in terms of implementing the use of VR for fall prevention and the management of fear of falling.
 
[11:52] Based on the most recent literature, the project is developing a program and beginning the recruitment of participants.
 
[13:41] Sustainability is hard to predict in the very early stages of a program, Grant shares the possible barriers he sees.
 
[16:15] Jenna thanks Dr. Grant Handrigan for sharing the beginnings of this project and signs off until the next episode. Thank you to all listeners!
 
If you enjoyed today’s episode, make sure to subscribe, rate us, and visit our website at agewell-nih-appta.ca/mileage-podcast for more information.
 
Project Team Biographies
Grant Handrigan: Grant Handrigan is an associate professor at the École de kinésiologie et de loisir at the Université de Moncton. He has a PhD in kinesiology from Université Laval where he was supervised by Professor Philippe Corbeil and Professor Martin Simoneau. His MSc degree is from Memorial University in exercise and work physiology where he was supervised by Dr. Fabien A. Basset. He also holds an undergraduate degree in kinesiology from Memorial University. 
 
 
Dr. Jalila Jbilou: Dr. Jalila Jbilou is an associate professor at the Centre de formation médicale du Nouveau-Brunswick and the School of psychology at the Université de Moncton. She holds a medical speciality certificate in public health (2006) and a PhD in community health (2010). Dr. Jbilou has expertise in qualitative and quantitative research as well as implementation science. Her main interest in research is on how to design, implement and evaluate synergistic interfaces between preventive medicine and primary care services. 
 
Professeur Mark Chignell: Professor Mark Chignell has been a professor from the Mechanical & Industrial Engineering faculty at the University of Toronto since 1990. He is a leading expert in human factors, with a particular focus on the design and evaluation of interactive systems that support human performance and decision-making. His research is highly interdisciplinary and draws on theories and methods from engineering, psychology, computer science, and other fields. He has published over 400 articles on topics such as human-computer interaction, user experience, and information visualization. Professor Chignell's latest startup company, Centivizer Inc funded by the AGEWELL National Centre of Excellence, creates exergaming and cognitive assessment products to support healthy aging.
 
You Zhi: You Zhi is a first-year PhD student studying human factors engineering at the University of Toronto. With a background in cognitive psychology, she has expertise in evaluating the efficacy of online cognitive assessment games aimed at assessing the cognitive abilities of older adults. Her current research focuses on the development and evaluation of virtual reality applications combined with psychotherapy to promote mental wellness.
 
Other individuals in this project include Danic

Jenna welcomes Karine Levesque, Co-lead of the Enhanced Community Pathway program, currently in its pilot phase. They discuss the importance of offering a comprehensive and centralized health and social development proposition for frail seniors in crisis.
 
We’re all aging, and everyone’s talking about it!
 
Key Takeaways
[:41] Jenna welcomes Karine Levesque to talk about her project and the inspiration for it, but first, she asks her to define Enhanced Community Pathway.
 
[2:53] Karine talks about the combined health and social system approach her project takes with the participation of the Extra-Mural nurse and social worker to visit a client at home.
 
[4:31] With a system that is difficult to navigate, in-crisis frail seniors are particularly at risk.
 
[6:13] The objective of this project is to propose a preventative approach that bridges the gap between health and social development.
 
[6:44] Capturing the right patient at the right time. Karine describes an at-risk patient.
 
[8:35] Reaching the right patients is a multi-faceted approach, Karine explains the different partners involved in making the information public.
 
[9:48] The pilot has begun in Zone 1 (Moncton) and is hoping to gather about 100 participants.
 
[10:31] Karine touches on the key elements they’re hoping to accomplish with the program.
 
[11:55] Sustainability is a goal, Karine explains how this might be accomplished.
 
[12:25] Jenna thanks Karine Levesque for coming on the podcast to talk about this pilot phase of the Enhanced Community Pathway program, and signs off until the next episode. Thank you to all listeners!
 
If you enjoyed today’s episode, make sure to subscribe, rate us, and visit our website at agewell-nih-appta.ca/mileage-podcast for more information.
 
Mentioned in this episode
The MileAGE Podcast
Healthy Seniors Pilot Project
Link for ECP Referrals: Referrals | New Brunswick Extra-Mural Program (extramuralnb.ca)
 
More about your hosts
Jenna Roddick at APPTA
Jenna Roddick on Twitter
Jenna Roddick on LinkedIn
 
More about our guest
Karine Levesque is a Registered Social Worker working as a Health Consultant for the Home Care Branch of the Department of Health. She has an extensive career in Community and Home Care settings as a former Extra-Mural Social Worker for over 22 years. She joined the Department of Health in Fredericton in August 2021 and is the primary Lead to the Enhanced Community Project, funded through the Healthy Seniors’ Pilot Project, which has recently launched in Zone 1 of the province and is ongoing until the end of March 2024.
 
Project Team members:
 
Karine Levesque **
Health Consultant, DH — Conseillère en soins de santé, MS
Co-lead — Co-responsable
 
Dawn-Marie Buck
Director EMP Operations South — Directrices des Opérations PEM Sud
Subject Matter Expert (SME) — EMP Liaisons — Expert liaisons PEM
 
Marise Auffrey **
Director EMP Operations East — Directrices des Opérations PEM Est
Director of EMP implementation area — Directrice PEM zone implantation
 
Janet Fogarty
RN EMP Driscoll Unit — II Unité Driscoll
CCC representative — Représante CCS
 
France Robichaud
EMP Clinical Coordinator East — Coordonnatrice Clinique PEM
Implementation South East — Implementation Sud-Est
 
Vicki MacGarvie-Gopal
EMP Project Evaluation Coordinator — Coordonnatrice d’évaluation de projets PEM
Project monitoring South East — Surveillance du projet Sud-Est
 
Annie Rickett **
Manager for Long Term Care and Adult Protection — Gestionnaire des Soins de longue durée et de protection aux adultes
Subject Matter Expert DSD, Central Office — Expert DS, Bureau Central
 
Garra Mitton
Supervisor SD — Surveillante DS
Subject Mater Expert SD — Expert DS
 
Patricia O’Dell
Supervisor SD — Surveillante DS
Subject Matter Expert SD — Expert DS
 
John Eatmon
Program Manager, SD — G

Jenna welcomes Judy Murphy, Executive Director at Elizabeth Fry New Brunswick, and Cecile Proctor from the University of New Brunswick to discuss their project using the creative arts to create intergenerational connections between low-income youth and seniors.
 
We’re all aging, and everyone’s talking about it!
 
Key Takeaways
[:41] Jenna welcomes Judy Murphy and Cecile Proctor to discuss the project they are co-piloting, Creative Pathways to Healthy Aging, Senior and Youth Engaged which works with older and younger generations.
 
[1:27] The Bridging the Gap project was the inspirational starting point for this research. Judy talks about the electric last day of Bridging the Gap.
 
[3:12] Low-income seniors face particular problems that this project attempts to tackle.
 
[5:12] Cecile talks about the goals of the project and how the research hopes to have an impact.
 
[7:48] The project team was unlike anything Cecile had ever worked with, she shares how the multidisciplinary sources of input created a wonderful depth of collaboration.
 
[10:05] Judy speaks about the way this project attempted to flatten the power balance and find a way to make everyone comfortable connecting. She touches on the adaptations COVID-19 required.
 
[15:00] Judy recounts a shared moment between school children and seniors when they found a connection despite uncooperative weather.
 
[17:41] The toolkit for adults was born out of the participation of both the youth and seniors in the project and is an interactive idea resource collection of the most popular activities.
 
[20:20] The program is completed, and Cecile shares how the data is being compiled and some of the results they are seeing.
 
[23:12] Judy explains what the toolkit requires to be finalized.
 
[24:20] Judy and Cecile share their parting thoughts and hopes for the program in the future.
 
[30:00] Jenna thanks Judy Murphy and Cecile Proctor for sharing the information and touching moments to come for this program, and signs off until the next episode. Thank you to all listeners!
 
If you enjoyed today’s episode, make sure to subscribe, rate us, and visit our website at agewell-nih-appta.ca/mileage-podcast for more information.
 
Mentioned in this episode
The MileAGE Podcast
Healthy Seniors Pilot Project
Elizabeth Fry New Brunswick
 
More about your hosts
Jenna Roddick at APPTA
Jenna Roddick on Twitter
Jenna Roddick on LinkedIn
 
More about our guest

Judy Murphy is the Executive Director at Elizabeth Fry New Brunswick and is excited to draw on her experiences in professional and volunteer leadership roles in national and provincial non-profits to work collaboratively with staff and volunteers at Elizabeth Fry New Brunswick and partners in the community. With her Masters’ in Adult Education, she appreciates a work environment that integrates a feminist, holistic, and participatory approach that is inclusive, creative, and kind. She is a dreamer of innovative projects that invite the whole person to learning, an advocate for Human Rights and social justice issues, especially for vulnerable, yet strong, women and gender-diverse people who yearn to have a voice for personal and community change. She loves having the opportunity to play outdoors with friends, family, and dogs.