From hospital to home: Taydon and his mother Denise

Taydon and his mother Denise

We were fortunate to have a lot of angels in our corner surrounding us with what I wanted to see for my son and setting him up for success. Not the norm, but it is his norm.”

– Denise, Taydon’s mother

Who is Taydon?

Taydon is a very outgoing young man in his early thirties who enjoys spending time with his family and friends. Taydon’s life is full of simple pleasures, such as the joy of shopping, watching movies and going for walks. His favourite movie is “Madagascar” and the iconic tune “I Like To Move It” is his ultimate favourite song that gets people dancing while Taydon claps his hands with joy! 

Taydon's favourite day of the week is Sunday when his mother, Denise, and younger brother, Anderson, often come to visit.Taydon has a developmental disability and is a man of few words. Despite this, he can communicate by pointing to symbols and pictures. Prior to being in the hospital, Taydon lived with Denise and Anderson, supported by caregivers who would visit his home.


Taydon, his mother, Denise and brother Anderson going on leisurely drives in the neighborhood

Unfortunately, in 2016 medication changes led to heightened aggression and seizures that became unsafe for Taydon and his family. This ultimately led to a 12-month stay in a large urban hospital.


What led to Taydon’s hospitalization?

In 2016, Taydon experienced seizures that sent him to the emergency room for three weekends in a row. The medical team tried changing his medications to stop the seizures, but Taydon's condition kept worsening. He was experiencing toxicity to his medication, which caused additional seizures and made him unable to control his movements. When he returned home, Denise became increasingly worried. Nobody in the family could manage his seizures, which were happening more frequently, and his behaviors were posing a danger to himself and Anderson. These incidents were traumatic for Taydon and his family. At some point, Taydon became so lethargic that Denise called an ambulance for him. Ultimately, Taydon was admitted to the hospital.


What were the challenges hindering Taydon’s return to the community?

It took a long time for the medical team to diagnose Taydon’s condition and stabilize him with a new medication regimen. The repeated seizures and medications had left him so weak that he started using a wheelchair and wearing a helmet to keep him safe. 

Taydon smiling in a wheelchair and pointing to his helmet to keep him safe in the hospital.

During this period, his individualized funding (Passport funding) was used to bring support workers into the hospital. However, the funding wasn’t enough to meetfell short of meeting Taydon’s needs, and Denise ended up paying out of pocket to ensure Taydon had the support he needed.

Following a six-month stay in hospital, Taydon was stabilized. However, given her son's fragile state, Denise knew that Taydon returning home was not an option. The hospital tried to secure different placement options for him, but due to lack of funding none of them could provide the types of support that he needed. As a result, he remained in hospital for another six months.


“More essential services & and funding is needed. Not Less! It’s never enough!”

– Denise, Taydon’s mother


How did things change for the better for Taydon?

After some strong collaborative advocacy, a team was assembled that included the hospital and different agencies from the developmental sector. This team took the time to get to know Taydon and understand his community support needs in order to develop a transition plan. Taydon and his mother were always included in the meetings. Meanwhile, a worker from a developmental services agency helped Taydon join a day program so he could receive stimulation and begin re-engaging with the community while he was in hospital.In January 2017, the team secured a temporary placement for Taydon. Denise organized and painted her son’s room to prepare for his move and Taydon had an opportunity to visit and become familiar with his new home before moving in.This transitional home allowed Taydon to experience living in a community setting while his team and family continued to search for a permanent placement. The hospital staff as well as workers from the developmental services agency went to see him regularly to ensure that he was adapting well to his new home. In summer 2022, Taydon finally was able to move to his forever home, a 2-bedroom unit in a large urban centre not far from his family.

“Lines of communication are number one – you have to be able to communicate with every partner – agencies, community – with the patient at the top of it. Don’t leave him out because this is his life. Everything branches out from him.”

– Denise, Taydon’s mother


How is Taydon doing post-transition?

Taydon is extremely happy with his current living situation, and Denise is equally thrilled and happy for him. Taydon is healthy and thriving. He gets along well with his roommate, who is only a few years older than he is and they share many of the same interests. He has access to two support staff at all times who have worked with him to build back his physical strength. He continues to attend his day program and his individualized funding (Passport funding) allows him to be out in the community with one-on-one support. In addition, he has a fantastic team of providers supporting his physical and mental health. Taydon continues to have regular appointments with the hospital neurologist and receives excellent support from his longtime family health team (a primary care model where a family physician works together with a multidisciplinary team).


What key components helped with Taydon’s hospital-to-community transition?

Taydon's successful transition from hospital to community was facilitated by several crucial elements. These elements align with some of the 10 core components identified in the practice guidance document.
Component 3 - Patient and family involvement in transition planning - All transition planning meetings included Taydon and his mother Denise. Denise played a key role in ensuring her son received the care and supports he needed. She strongly advocated for her son to attend a day program while he was hospitalized, which he still attends today.
Component 5 - Transition and Community Support Plan - A multidisciplinary team including hospital and community representatives worked together to develop a comprehensive transition plan and secure a housing situation that matched Taydon's medical and community support needs.
Component 6 - Graduated, overlapping and coordinated transition - Taydon’s transition was supported by a strong collaborative team including partners from the hospital and different agencies from the developmental sector. This team facilitated a graduated and overlapping transition, including opportunities for Taydon to visit his new home before moving in and ongoing support from the hospital team afterTaydon moved to ensure he was adjusting well to his new home.  
Component 8 - Coordinated follow-up medical and clinical care - Even after Taydon transitioned out of hospital, his medical team stayed the same. He continues to see the hospital's neurologist and his longtime family doctor, who works within a family health team. Family health teams include interdisciplinary providers (e.g. nurses, dietitians, social workers) that work together with family doctors to provide comprehensive primary care.
Component 9 - Appropriate and timely housing and community support - Although it took some time to get there, Taydon ultimately ended up in a home that is right for him. Taydon's permanent placement allows him to have access to continuous support from staff and day programs. He has a roommate he gets along with and he is only a 20-minute drive away from his family, allowing for weekly visits with his mom and leisurely drives through the neighborhood.
Component 10 - Sufficient and flexible funding - Funding was essential in finding Taydon a transition placement and then a permanent home. Passport funding was also important to cover some of the cost of the additional staff supports Taydon required while hospitalized, though it fell short of covering the full cost.

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