Saturday, July 4, 2015

Driving... the Conversation with Older Ontarians (The Medical Process of Aging)

Published on 28 Apr 2015 Featuring Dr. Lindy Kilik, Ph.D. C. Psych.
Neuropsychologist,
Queens University and Providence Care-MHS

 As we age, we have to take responsibility for physical changes:
  •  Hearing: wear your hearing aids if you have them
  •  Flexibility and co-ordination - shoulder checks, minimize blind spots. 
  •  Mental functions: attentions, concentration, discriminate between focus of attention, mindful, purposeful driving. 
  • Dementia: Judgement of situations, juggling complex situations (i.e., 4-way stops)
  • Doctors must report individuals they feel are of concern for driving
  • If you are 80 or over, reassessment every two years, they provide strategies, a vision test and cognitive screening.
  • Age-related changes, and other cues, tell you or your loved ones, to stay off of the road.

Thursday, July 2, 2015

Assessing Healthcare in Canada

Assessing long-term care facilities: A look at the worst- and best-performing LTC homes in the GTA...
The Canadian Institute for Health Information recently assessed the performance of more than 1,000 long-term care homes across Canada.
Estimate the average cost of hospital services using Patient Cost Estimator. For example,

  • The estimated average hospital cost of a lung transplant is $107,037.
  • The average acute care length of stay for a lung transplant is 32 days.
  • Hospital services for newborns/neonates weighing less than 750 grams cost an average of $155,048 per patient. 
  • The estimated average hospital cost of a unilateral hip replacement is $9,263.
See more data on high-volume patient groups, average costs of hospital services, and lengths of stay using our web tool.

Take a look at the CIHI and Statistic Canada’s Health Indicators e-Publication— now with updated results for 27 CIHI indicators and 3 Statistics Canada indicators. Customize your search of these indicators in the following ways:

Monday, June 15, 2015

Critical Care Canada FORUM

October 25-28, 2015, Sheraton Centre Hotel Toronto, Toronto, ON.
The Critical Care Canada Forum is a 3-day conference focusing on topics that are relevant to the individuals involved with the care of critically ill patients, wherever the patients are located. Internationally recognized, the Critical Care Canada Forum focuses on leading-edge science through informative and interactive sessions, outstanding international faculty, poster presentations and exhibits with the latest products and services for the critical care professional.

Website 
Call for abstracts:
Information and online submission available .
Early Submissions deadline is July 1, 2015Late Breaking Submission deadline is September 14, 2015  
The CCCF is offering to cross promote your organization with link on the CCCF website, under Affiliates & Meetings. We can also add an upcoming meeting from your organization under the same page (as long as it does not conflict with the dates for the CCCF) in case you are interested. In this case, please send title of meeting, date(s), venue, and link for more information and/ or registration.

Thursday, June 11, 2015

Gender differences in personality and cancer-related pain among older cancer patients

Gender differences in personality and cancer-related pain among older cancer patients” 

by Jessica L. Krok-Schoen & Tamara A. Baker, Journal of Gender Studies, published by Routledge, Taylor & Francis.

One size doesn't fit all.

Gender and personality differences in cancer-related pain severity for geriatric patients.
With 75% of cancer patients in the UK over 60, and the costs of innovative drugs soaring, how to best identify and hopefully manage cancer-related pain in the elderly is a key issue. A new study published in the Journal of Gender Studies looks into this complex matter and, in claiming gender and personality significantly affect the experience of suffering, questions a 'one size fits it all' approach to pain management.


While there is a wealth of literature documenting how gender and temperament impact on our ability to cope with physical discomfort, the way 'gender moderates the association between pain and personality' needs to be investigated further, claim the authors of the study. Determined to shed light on this neglected matter, the researchers collected data from a sample of 150 adults (86 women and 64 men above 55 years of age) receiving cancer treatment in Florida (US) in 2011. Their principal objective was to identify gender and character differences – the latter scored against the Five Factor Model of personality – in the reported pain severity amongst participants, as well as establish if psychosocial factors could be predictors of cancer-related pain severity for the group.

After a thorough analysis of the figures collected, significant differences emerged in regards to personality. Females presented significantly higher neuroticism compared to men, and gender was a key ‘predictor of pain severity’, as well as a moderator in the association between the personality trait of neuroticism and average pain severity. Interestingly, while higher anxiety in women was associated with lower reported pain severity, differences in neuroticism between genders could be imputable to social stereotypes too, explain the academics. It’s not a secret that, traditionally, anxious traits are considered more socially acceptable in women than in men. Low extraversion also appeared to be a significant predictor of greater pain severity in women, but not in men, suggesting social roles – women as dependent and less apt to autonomously cope – may weigh on how pain is managed by women. In addition to gender and character traits, psychosocial factors, such as age for women, and education for men, were also identified as strong predictors of pain severity amongst participants, with social status and power balance being crucial components.

In claiming pain severity may be gender-specific, as well as dependent on personality and social-psychological factors, this study warns of the dangers of a ‘one size fits all’ approach and calls for a diversification of clinical procedures to cancer-related pain management in the elderly. In doing so, it greatly contributes to our understanding of the pain experience amongst the elderly.

* Read the full article online:

Tuesday, June 9, 2015

PART XXXVI: Biopsy #2

Biopsy #1 was done after the initial PSA tests. Hubby had moderately high scores, but the enlargement was the issue. We went to the urologist in Smiths Falls, who referred us to the Urologist at Ottawa Hospital. The robotic surgery (Jan, 2014)  only got some of the cancer cells. The cells have metastasized. This over a year. We've been tracking the cells through scans and other tests, more PSA tests, as well. Once the cells metastasize, they change, which makes tracking them more difficult.

Two MRIs, two bone scans, three CT Scans,  PSA tests every 3 months, 3-month check-ins with the urologist, one colonoscopy (negative), two cystoscopies. It's all a waiting game.

BIOPSY PREP

  • Take enema 3 hours prior.
  • Eat before, you want something on your stomach.
  • Arrive 30 min. prior.
  • Takes 2 hours.

The day


12:24 left house, checked the rain gauge before we left: 53mm rain over last night/this morning. scenic route! Gillian said we would get there for 1:37 = lots of time
1:45 JB took antibiotics in the car
2:01 arrived in the parking lot Back on 7th floor Cancer Assessment wing
we wait
2:35 taken into the room. Guy pacing, driving me nuts! I'm doing my embroidery. I realized someone took my wingnut off of the frame.

we wait more
Dr. Oz in on the TV, talking about stupid things. I changed the channel to CTV News.

3:25 back out, off we go home Bladder perforated, 3 samples taken. He felt pain, despite a local anesthetic.
5:19 Home, picked up dinner at O'Reilly's and brought it home to a weary hubby.

Yes, our family has cancer: managing your diagnosis

Yes, our family has cancer. It *IS* a family issue. My most important job is taking notes at doctor's appointments. That is the best piece of advice I could give. It focuses me, and it means I need clarity and figure out questions as we go.

No, we are not 'fighting', we are managing it. If you have had such a diagnosis, you will understand. The appointments will begin, you gear your lives around dates on the calendar. We live each day to the fullest, living in the present moment.

We are not being brave or strong. We just deal each day as best we can. Some days are better than others. Prior to another test, we gear up. Afterwards, while we wait for the reports to get to our Urologist, and then await the follow-up appointment when he interprets the results, we keep busy.

Cognitive Behaviour Therapy

This is a great technique. When dark thoughts enter my mind, when I get sad, I acknowledge them, and then dismiss them. When I am tired, I rest. We treat each other with kindness. We spoil each other. We enjoy EVERY DAY, and do not dwell on the possibilities, such as 5 weeks of radiation treatments. You cannot spoil today with worries of tomorrow. When it enters your mind, let it go.
We give one another permission to have a bad day, provide total support, and get through it.

Our journey so far

Two MRIs, two bone scans, three CT Scans,  PSA tests every 3 months since 2013, 3-month check-ins with the urologist, one colonoscopy (negative), two cystoscopies. It's all a management and a waiting game.

Yes, you can read about the survivor's groups. You can read all about the battle terminology, and fighting, and if you make your way through getting rid of the cancer cells, you can claim you've won. This isn't the case for many. People die from cancer. You take each day one day at a time.

You have to remember that this is YOUR body making these rogue cells. Cancer cells happen due to invasive trauma, like smoking, or poisons, toxins, but most of the time (60%) they don't know why we produce cancerous cells. Cells which grow out of control, sapping the 'normal' cells of nutrients, morphing into new adaptations, and changing their DNA.


Monday, June 1, 2015

Lyme disease symptoms

Canada.ca/health
See your health care provider right away if you:
  • find an attached tick on you
  • experience symptoms of Lyme disease
  • feel unwell after outdoor activities where ticks could be present

Recent notices


CTV News

Changing climate brings ticks, Lyme disease into Canada
Changing climate brings ticks, Lyme disease into Canada ... the tick population will grow exponentially in the coming years in many parts of Ontario.

Tick trouble: Expect to see more ticks, says York University expert
Darlison doesn't think it's a deer tick associated with Lyme disease and ... ofOntario, Windsor-Essex is in a red zone which means the blacklegged tick ...

Friday, May 29, 2015

PART XXXV: Prostate Cancer diagnostic MRI #2

1:45 Left house, took back route, past The Swan, through North Gower. Easy drive, although some traffic.

2:30 arrived at the MRI office - between modules M and O, another form to fill in.

Then we sat and waited. 
Another couple: The man came out, wearing his lovely hospital gown. His wife giggled!

"C'est beau." I tell him, they were francophone.

"On y va." Al says.

 "Sexy." said Al. The wife mentioned his droopy drawers. A tall, thin man, his boxers were hanging off his frame.
Selfie!

Hubby read. I fooled around with the iPad.
I took our usual selfie. The francophone woman laughed. Hubby said not to worry about me, I'm harmless!
Another couple arrived.

 4:10 JB was taken into the other room. Lovely outfit. Another man's name is called. "Already?" he asked.
     "Well, you can sit and wait some more," said Al. He is droll!

Off hubby went, into the mysterious other room, with the noisy machines.

5:14 still waiting...  Did some cross stitch. Thumbs hurt.
5:17  I can hear the machines. Stopping, starting. Weird noises. Floors were mopped as the evening staff comes in.

5:30 out he came. He was to sit for 5 minutes to ensure he wasn't dizzy. He thinks he had a nap.
Some rush-hour traffic. Sigh.
6:30 Dinner at The Swan.
8:39 Home


Droll Al.



He banters with another person
All his stuff into the locker
people came and went

Monday, May 18, 2015

Pilot project for self-directed home care –a dismal mistake

That is my belief.   Currently there is a cap of at-home nursing care visits per month: 120 visits. They are raising this to 150 visits per month. The Minister added $5 million in new funding for home care. The biggest barrier to getting home care is the lack of experienced, competent workers: from personal support workers (PSWs), to nurses, and physicians who will make house calls. The next barrier are the budgets that limit the number of visits. Next, the biggest barrier is the lack of regulation and training for PSWs. Poorly trained PSWs make the news. Unregulated PSWs who slip under the radar can go from employer to employer.

In the Ontario system, there is a packet of money for various home care supports: primarily PSWs who provide assistance with daily living (ADL: cleaning, housekeeping tasks, meal prep, bathing clients, keeping them dry and clean). There are also nurses who provide wound care, manage the case, and keep on top of medications. When a change is needed in medications, for those who are palliative or unable to go to the physician, they will phone the doctor and request different medications.

Families tell me that they have difficulty in coordinating care: juggling support from various
agencies, keeping on top of medications, doing errands. The agency employee (e.g., PSW or nurse) with the home care contract (e.g., Bayshore Home Health, Red Cross, VON) will phone the family and let them know when they will be over, which day and time. There is no choice, as they are swamped with work, the transportation issue, going between clients home, is complex, especially in rural Ontario. Imagine forcing client's and caregiver to phone these for-profit agencies themselves. This is what the CCAC Charge Nurse is paid for: to coordinate care.

Clients who qualify for home care are now going to have to search out an agency, and create a contract themselves. For those who qualify for nursing visits, or support with ADLs, they are still going to have a hard time finding someone to come. As it is, some families qualify for a PSW to come weekly to bathe a loved one, and hire someone to do house cleaning. This is what people with money do for themselves.

~~~~~~~
A Canadian pilot project that would give patients or their caregivers money to spend on the home health services of their choosing. Details were scant on the government’s plans for experimenting with “self-directed care,” an approach that Health Minister Eric Hoskins said is already working well for some parents of autistic children who have been given the flexibility to spend public funds on the programs they believe are best for their children. 


Pilot project to give cash to Ontario patients for 'self-directed' home ...

The Globe and Mail-May 13, 2015
In a bid to respond to a blistering report on home care in Ontario, the ... give patients or their caregivers money to spend on the home health ...