1. March of Dimes Canada – Hospital visitation program: Peers fostering hope
A Peer to Peer Support Program for Stroke Survivors, their Caregivers and Family Members

2. March of dimes Canada - history
Established in Canada in 1951 to help eradicate the threat of polio
Polio vaccine was discovered in 1955
March of Dimes continued to provide support to polio survivors
March of Dimes expanded its mandate to offer programs and services to anyone with a physical disability
Today we offer more than 20 programs
Serving over 75,000 Canadians with disabilities each year
Key notes in past 67 years has continued to develop mandate to offer programs and service to anyone with a physical disability. Main areas IL, ES and CEIS which is home to Stroke Recovery Canada.

3. March of dimes Canada stroke recovery program
Goal to support stroke survivors and their caregivers to maximize their independence, personal empowerment and community participation
Successful Transition from Hospital to Home
Successful Transition from Home to Community
Support to Regain Function & Encourage and Support Community Re-Engagement
Advocacy and Research
SRC implementing new strategic direction starting April 1, Today’s focus on bolded sections.

4. Transition from Hospital to home
March of Dimes Canada currently has Hospital Visitation programs in 30 hospitals in Toronto and the GTA, Waterloo/Wellington as well as the Lower mainland in British Columbia
West GTA currently 5 hospitals and 8 units with the program
What is the program?
Volunteers, who are stroke survivors and/or caregivers, trained in peer support.
Visit hospitals to speak with people who have recently had a stroke and/or their family.
Volunteers provide experiential and emotional support and most importantly, offer hope.
Peer volunteers, program recipients (patients/caregivers) and hospital staff recognize the benefits of the program and are driving growth into new units and hospitals.
Hospital Visitation as a whole is in 30 hospitals across the country, with a focus in ON. Area 5 hospitals as of March 1. We equip our volunteers with knowledge on how to offer peer support in hospital. They give a level of support that can be offered by someone who has gone through a similar experience emotionally, physically, mentally. Also offer to speak to caregivers – an area of focus MODC is starting to offer.

5. Peers Fostering Hope Toronto & GTA
Highlights of last year – acknowledge and move on.

6. Transition from Hospital to home
Program Goals
Provide hope for improved recovery and quality of life
Decrease feelings of isolation
Facilitate a connection with someone who is successfully living with stroke in the community
After Hospital Transition
Out-patient Unit visiting – One-on-one scheduled appointments
Referrals - Purpose is to create a relationship with SS after visit(s) from volunteer with March of Dimes Canada to allow for check-in with stroke survivor or their caregiver
Check-ins occur at 3, 6 and 12-months after discharge
Help navigate life after stroke and refer to community programs
In-community visiting program piloted in 2017
Main recognized areas for stroke survivors are the need of hope things can get better, help them know they are not alone and connect with peers.
New developments once discharged is out-patient, the start of transition to life out of the hospital. This has been offered because of the change of information that can be sought after by survivors e.g. transportation, going back to work, socializing.
One area recognized to be developed is social integration. MODC offers peer support programs, can be hard to connect once left hospital. Adding in referral process to stay connected once discharged. Hospital volunteers offer this to SS they visit. Information transferred from hospital to MODC. Follow up occurs.
1) The volunteers have dedicated appointments with patients and patients can either come in specifically to see the volunteer only or they see the volunteer when they are visiting for another appointment.
2) Visits tend to be longer in out-patient - half an hour to even 1 hour in length.  
At one hospital staff first has a meet and greet between the volunteer and the patient so the patient can decide if they really want to participate.  
3) One volunteer communicate with people with very strong aphasia and according to her they find a way to communicate.  She has aphasia herself.  
4) Very positive feedback - with patients sometimes coming to the hospital only to see the volunteer and in some cases traveling a distance to do so because of the value and strong bond with the volunteer.

7. Transition from home to the community
Goal: To assist the stroke survivor to maximize their community participation
Referral Program
Currently in Waterloo-Wellington Hospital Visitation program
821 visits to new stroke patients and caregivers during past 2 fiscal years
April – December 2017 referred 48 new stroke survivors to local Stroke Recovery Chapters/Associations and have seen 32 re-engage into the community
What happens once back in the community? Resources can be hard to find or navigate for SS and CG because they don’t know where to start. Have someone they can connect with who has knowledge of the community.
Highlights of this successful initiative in WW.
Identified gap in PFH currently, so working with hospitals to see if we can integrate it into current offering if needed. In Mississauga Trillium Hosp have SN so this process isn’t needed. Implemented at OTMH and MD. Working with WP to implement
As per best practices: Percentage of stroke patients discharged to the community who receive a referral for ongoing rehabilitation before discharge from hospital (acute and/or inpatient rehabilitation) (core).
Median length of time between referral for outpatient rehabilitation to admission to a community rehabilitation program.
Frequency and duration of services provided by rehabilitation professionals in the community.
open discussions between primary care providers and patients regarding the resumption of pre stroke roles, responsibilities and leisure activities;
coordination between primary care provider and community agencies for referral to appropriate programs and services;
For patients with aphasia, all discussions should be conducted with proper support ensuring effective communication.

8. Transition from home to the community
In 2017 a Community Visiting Pilot Project was implemented in Toronto and Mississauga – 4 volunteers involved in Peel
Collaboration with VHA Home Healthcare
Why? High rates of depression identified in SS, needs are different at each stage of recovery, difficulty for some to navigate the system, another form of peer support
Community Visiting:
Trained on peer support and visiting. Tracked visits and topics of discussion. This was done as an additional level of peer support, once in community can be hard to navigate, so they can talk about their experiences at this stage of recovery. Refer back to professionals. Hope that this stage can get better.
Collaborated with VHA Home Healthcare, used their clients
1) young stroke survivors
2) family dynamics and home environment plays factor - often would be speaking with the family member to find out if the person would like a visit.  Sometimes the family member would say no on their behalf.  Some people may not be comfortable having someone in their home but also not have the mobility to meet with someone outside the home.
3) They are in a time of transition and "readiness" for peer support plays a role.  People may not be ready for support right out of hospital as they need to care for their immediate needs and have a lot of appointments with PSW's etc.
4) High rates of depression
5) The needs of individual are very different at each stage of recovery from hospital to home
6) Found that many were looking for help to find community supports for a variety of needs.  Some peers helped with connecting them to programs and staff involved in the pilot also played a role in this.  
7) Suggest using the Jane Parson's article - perhaps quote - or use the whole article as an insert in the handout

9. Example of peer support in the community
Jane a MODC volunteer with Deb who she has provided peer support to.
Deb says fondly. “She talks about what she’s gone through and what’s
worked for her—it helps me know what’s coming. It prepares me as I
go through the process and makes me feel like I’m not the only one who’s been through this.”
Jane. “Since my stroke, I can’t work and there are certain things I can’t do. I lost the use of my left [dominant] hand and sometimes I feel as if I’m not contributing to life. This program helps me feel better about what I’m doing or not doing. It helps me feel as if I’m working and giving back, and that means a lot.”
Quotes from VHA Homehealth care blog.

10. Thank you!
Questions? Please contact: Devon Evershed Community Coordinator, Hospital Visitation March of Dimes Canada