Behind the diagnosis: How Unity Health Toronto supports patients living with dementia

For people living with dementia or other memory-related conditions, care can look different depending on where they are in their journey. Whether in a hospital setting or long-term care, care teams from across Unity Health Toronto stress the importance of seeing the person behind the diagnosis. They recognize that each patient or resident has life experiences and relationships built outside of their care setting, as well as routines that help them feel safe and comfortable. 

Specialized memory care services are available in hospital, in the community and in long-term care. At Providence Healthcare, for example, the Adult Day Program (ADP) supports people living in the community with moderate to severe dementia through social programming designed around their individual needs. The program also provides support for families and caregivers. 

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As needs change over time, patients can move between care settings. Someone who first received care at St. Michael’s Hospital may later access rehabilitation, community programs or long-term care at Providence Healthcare. This connected approach helps ensure patients and families can access the right care at the time they need it.  

Supporting memory care in acute care 

At St. Michael’s Hospital, occupational therapists Lisa Vandewater and Paula Isenberg work as part of the geriatrics team on the Acute Care of the Elderly (ACE) Unit. The team works with patients over 65 years old who often have complex geriatric syndromes, a term used to describe common age-related health challenges such as falls, dementia, delirium and difficulties managing daily life independently.  

Vandewater and Isenberg assess patients’ cognitive function and safety, helping determine whether they can safely return home or if they require additional care. During a patient’s stay, they work to help them with confusion and dementia by doing simple things like reminding them where they are and regularly working to talk through the date and mark the passing of days on the calendar. This helps patients to stay oriented as long stays in hospital can affect a person’s sense of routine. 

Vandewater says hospitalization can be especially difficult for someone living with dementia. Loved ones may not always be present, and an unfamiliar environment can increase confusion and anxiety. Programs such as the ACE volunteer program help to support reorientation and cognitive stimulation. In hospital, patients often have many daily tasks done for them, but for people living with dementia, opportunities to stay engaged and mentally active are important to maintaining function and independence. 

The ACE volunteers also help patients complete “My Story,” a person-centred information sheet posted above a patient’s bed, that captures details about their life. A patient’s profile might include information about what they like to be called, who matters to them, what they enjoy and what helps them feel calm. “My Story” allows staff and volunteers to have a basic overview of who the patient is outside of the hospital and encourages patients to reminisce and stay mentally active.  

The unit is also piloting “Music Connections”, a program which gives patients access to personalized playlists of familiar music.  

“What’s interesting for individuals with dementia, particularly Alzheimer’s disease, is that the part of their brain that houses musical memories is fairly well preserved,” Vandewater says. “I was recently working with someone who loved the Bee Gees, and when one of their songs came on, they lit up and said, ‘Oh, look, I can still groove,’ and she started dancing away.” 

For Isenberg, moments like these reflect the importance of looking beyond a patient’s immediate medical needs. Person-centred care recognizes that a person is more than a blood test or an X-ray. There’s a whole life and story behind who they are. 

Creating connection in long-term care 

At the Houses of Providence, Unity Health’s long-term care home at Providence Healthcare in Toronto’s east end, memory care takes place in a different setting: one where residents live, build relationships and settle into daily routines. 

On the secured unit, staff support residents, often with memory-related conditions, who may become disoriented or wander. The unit gives residents the freedom to move about safely while reducing the risk of getting hurt or lost. 

On the floor of the unit, Activation Assistants Sheri-Lynn Barton and Trexie Yntig shape days around movement, music, spiritual care, cultural celebrations and activities that reflect residents’ interests. Programs may include balloon tennis, mini bowling, karaoke, outdoor concerts and creative seasonal games. 

Barton says flexibility is key. Some days residents are eager to join activities, while on others they need something quieter. The goal is to meet people where they are and create opportunities for joy and connection. 

“This is what I am here to do. I work to bring the joy and fun into their daily lives,” Barton says. “Most of our residents can’t express it anymore, but you can see it in their faces, they’ll smile at you and clap along.” 

Registered nurse Priyatharisini Gnanasekaran says building trust with residents and families is central to the work. Families often share important details about routines and cultural preferences that help residents feel at home. 

“We care for the person, not just the diagnosis,” Gnanasekaran says. People living with dementia continue to experience emotion and connection even as memory and communication change.” 

“The smallest moments of connection can make the biggest difference for people with dementia,” she adds. 

For many residents, long-term care represents one stage in a broader care journey. Some may have previously accessed community-based supports, received care elsewhere or within Unity Health before arriving at the Houses of Providence. Across Unity Health Toronto, our commitment to person-centred care continues wherever the care journey leads.  

By Hannah Nickle

Photos by Kevin Van Paassen