Every JIA kid should have a YARD

Turning 18 is an exciting and challenging time for young people. High school grad, post-secondary education, and travel await a new chapter in life called adulthood. But what happens to those who have had JIA throughout childhood? In addition to all the excitement and anxiety of this giant step forward in life, they also face the looming concern about managing arthritis in the adult world of Rheumatology.

Many with JIA have been supported in an environment where all physical, spiritual, emotional and psychosocial needs have been addressed by a caring team of healthcare professionals in paediatric settings. Launching into the adult community for continuing care can be scary and intimidating to both the family and the patient. Fortunately, in some centres, there are clinics specifically designed to facilitate the move into the adult environment. Such is a transition program at the University of Calgary/Alberta Health Services called the YARD (Young Adults with Rheumatic Disease) clinic.

Established 3 ½ years ago the clinic is designed to ensure that the transfer of care from paediatric to adult care is as seamless and stress-free as possible. Past medical information is forwarded to the clinic and initial appointments are booked with the paediatric Rheumatologist in the adult setting. This way the patient and family need only worry about finding parking and locating the clinic on the first visit; they are assured there will be a familiar face looking after them in the new environment. Other team members including nursing, physiotherapy, and social work are introduced and involved with new patients at this initial visit, and appropriate referrals and contacts with other disciplines are initiated. Subsequently, the patient has an appointment on a day that the receiving adult rheumatologist is in clinic so that the paediatric specialist can have a face-to-face exchange of information, ensuring that information regarding past history and course of disease and treatment regimes are passed on. Patients are comfortable in this setting and over time accept responsibility for managing their disease. They remain until they have completed post-secondary education, or are settled in the workforce (usually age 23-25), when they leave the transition clinic and see the adult Rheumatologist in their adult practice.

This stair-step transition program is praised by patients and parents. It provides a framework of support and information that allows JIA kids to understand and deal successfully with their disease, treatment and personal needs as they grow, develop and 'graduate' into productive and successful adulthood. Every JIA kid should have a YARD like this!