As the population ages, a greater number of elderly persons will need assistance to remain independent, especially in times of crises. In November 2007, as a member of the Board of Canadian Pensioners Concerned (CPC), I was asked to participate in a pilot pandemic exercise directed toward the frail and vulnerable. Volunteers were trained to phone those who might need help (also volunteers) and to address specific needs.

The exercise was created as an IDEAL Health Canada Project under the direction of Rory Fisher, MD, a geriatrician, and jointly developed by Laurie Mazurik, MD, a specialist in emergency medicine, Alan Dick, a social worker, and Barb Johnathan, an advanced practice nurse in geriatrics. Clinidata, which provides Telehealth Ontario advice in many areas of Canada, developed additional questions designed to identify what services could be provided at home.

The pandemic exercise, called Telebuddy, is a simple concept using a telemonitoring system which will identify the needs of the elderly population during a pandemic and help keep them independent and safe in the community thus avoiding unnecessary and potentially dangerous visits to hospital. The concept also can be read on an ongoing basis to assist at-risk persons to maintain themselves at home. Family, friends, senior volunteers, university and college students would be trained to identify support needs for those in the community who require them. Each night at an agreed time, a phone call would be made to see how the day went and to visit by talking on the phone. If a specific need were identified, then that would be addressed as well.

Clinidata developed a variety of appropriate scripts for identifying any health, social or environmental problems that the call recipients might be experiencing. The scripts were sent to participating organizations for their input. These included the Public Health Agency of Canada, CPC and the Toronto Community Care Access Centre. Clinidata then put together a training module for the phone centre and sent two instructors to train the student volunteers who came from various health sciences. There were eight students who received approximately one hour's training on the morning of the exercise. After their introduction to the module, they made trial calls to each other. Following this they each made live calls to the volunteers in the community. CPC provided eight volunteers to participate in the role playing from the provided scenarios. We were phoned on the morning of the event to review the process and to answer any questions.

The students noted the outcome of their calls on a client caller tracking sheet which listed indications for various resources. Health-related issues were transferred and managed through well-established Telehealth protocol. At a follow-up meeting, the data collected showed most issues were related to medications, transportation and home support. The students were asked to bring forward the problems and solutions were discussed with input from two representatives from the Toronto Community Care Access Centre, a social worker, an advanced practice nurse in geriatrics from Sunnybrook, a geriatrician and two nurses from Clinidata. Follow-up calls were made to the community volunteers and the consensus was that the Telebuddy concept was valuable.

This pilot project showed that students and others can be trained to carry out a service call with a short period of training. Senior volunteers were supportive of the system, but identified areas needing improvement and development. It was stressed that the students should speak more slowly and distinctly.

Telebuddy is adaptable to different areas such as family practice units, Community Care Access Centres, specialized geriatric services and Lifeline which could phone their vulnerable clients during times of crises. It might be expanded to include a registry of the at-risk groups to share with the appropriate service providers. Since the true picture of the frail elderly is quite often not known by a phone call, a follow-up visit would be the next part of the project which could be developed as a volunteer program. Because of Toronto's diverse population, translation for phone calls also should be considered. All in all, the concept would be an excellent addition to the existing services provided for the at-risk population.