Friday, June 17, 2016

Educational Online Event: Medical Assistance in Dying (MAID) in Canada from CHPCA

Educational Online Event: Medical Assistance in Dying (MAID) in Canada from CHPCA on Vimeo.
The federal legislation is currently before Parliament and the Senate and the plan is to have it passed prior to the June 6th, 2016 deadline. That process is currently in process but we need to start the conversation around what comes next. Come learn about the federal legislation Medical Assistance in Dying (previously referred to as Physician Assisted/Hastened Death (PAD) process and content. How does it impact the hospice palliative care community? What comes next as it plays out in the provinces and territories?

Participants will:
- Learn about the status of Bill C-14 and how potential legislative outcomes will impact the practical application of MAID.
- Learn about the impact of MAID legislation on hospice palliative care in Canada, and how to approach policy-makers in the context of Health Accord negotiations between the Federal/Provincial/Territorials governments.
- Discuss potential stumbling blocks for the hospice palliative care community when deciding facility or individual practitioner approaches.

Presented by Dr. Susan MacDonald, Dr. Christina Vadeboncoeur, MD FRCPC, Pediatrician, Palliative Care Program, Children’s Hospital of Eastern Ontario, and Sharon Baxter, Executive Director, Canadian Hospice Palliative Care Association

Wednesday, June 15, 2016

Assisted Dying news in Canada

Assisted Dying in Canada by Udo Schuklenk

HealthcarePapers, 14(1) April 2014: 38-43.doi:10.12927/hcpap.2014.23969


This paper makes an affirmative ethical case in favour of the decriminalization of assisted dying in Canada. It then proceeds to defending the affirmative case against various slippery-slope arguments that are typically deployed by opponents of assisted dying. Finally, a recent case of questionable professional conduct by anti-euthanasia campaigners cum academics is flagged as a warning to all of us not to permit the quality of the professional debate to deteriorate unacceptably, despite the personal emotional investments involved on all sides of the debate. 

Assorted articles

Sunday, June 12, 2016

Caregiving demonstration videos by Canadian Virtual Hospice

Check out Caregiving Demonstrations (short video clips) where you can see:
  • How to give medications – by mouth, under the tongue, by patch, etc.
  • How to safely assist someone moving from a bed or chair
  • How to give someone a bed bath, wash their hair, or clean their mouth

Caregiving Demonstrations

Saturday, June 11, 2016

So, where do Canadians die?

Yes, this is a start. More funding has been announced in Ontario for residential hospices.

Province Strengthens End-Of-Life Care With $75 Million ... 

This investment would improve community-based hospice and palliative care services including:
  • Supporting up to 20 new hospices across Ontario and increasing the funding for existing facilities
  • Increasing supports for caregivers that will help families and loved ones support palliative patients at home and in the community
  • Promoting advance care planning so that families and health care providers understand patients' wishes for end-of-life care
  • Establishing the Ontario Palliative Care Network, a new body to advance patient-centred care and develop provincial standards to strengthen services.
Sadly, most of us do not want to die in hospital, and hospices are few and far between. Too many die in acute care, or the ER, despite a predictable disease trajectory, and research-based information that would clarify and support the deaths of a loved one in dignity and peace and quiet.

My husband, who volunteers with Meals on Wheels, gets mileage when he delivers meals. I, as a hospice volunteer providing respite, do not. There isn't enough money for this, despite the need for caregivers to get respite, and volunteers whose  mileage costs could be $65,000. I am rarely aknowledged, nor do clients offer to donate to my hospice group. We are never mentioned in obituaries as good places to donate in memory of a loved one.

It depends on where you die! Settings of care in Canada

Jun 18, 2012 - Currently, only 16-30% of Canadians have access to hospice palliative care.[ii]
 It is essential to understand the places in which Canadians are dying before we can improve the access to and quality of hospice palliative care.
  1. Acute Care. Most Canadians are dying in acute care hospital settings[iii].  Too many people who are dying end up in emergency departments during the last months and weeks of life, an indicator of poor quality end-of-life care.[iv] 
  2. Long Term Care (LTC). Some LTC have hospice palliative care training for staff, but many LTC residents also end up visiting the emergency room in the last weeks of life. Having a formalized palliative care program is not mandatory under the LTC act. Almost 50% of residents in LTC Homes are dying in the facility each year.
  3. At home. Home care costs in the last six months of life are roughly double what are required for all other home care recipients, and not all of these costs are covered by Medicare or private insurance plans.[v] A recent Ontario study showed that people with life-limiting illnesses who receive care at home early and receive more hours of care at home, are less likely to visit emergency rooms in the last weeks of life.[vi]
  4. Residential Hospice. Only 16 - 30% of us have access.
  5. In shelters/on the street. There is a marginalized homeless population who die in shelters or on the streets, with little care. There are now a small number of hospice programs for the homeless in Canada. 

Ontario is giving more money to publicly-funded hospices, adding $4.9 million to the $26 million a year it already gives them, a big increase to a budget that's still much smaller than ... Ontario is giving more money to publicly-funded hospices, adding $4.9 million to the $26 million a year it already gives them, a big increase to a budget that’s still much smaller than it ought to be. So the government is increasing funding to adult hospices by $15,000 a bed and to children’s hospices by $22,400 a bed. A decade ago, the government didn’t fund hospices at all. Now it’s promising to help build 20 more besides the 39 hospices Ontario already has, in addition to Friday’s by-the-bed funding increase.
4. The category "Place of death, non-hospital" includes deaths that occurred in private homes, in health care institutions such as nursing homes and other long-term care facilities, nursing stations and other short-term care facilities and other health care facilities not licensed to operate as hospitals by provincial, territorial or federal governments and at other specified sites.

Health Council of Canada. Seniors in need, caregivers in distress. April 2012

The impact of dementia: disinhibitions and violence

Here is an interesting dilemma. In Canada, our biggest problem is taking the car keys from our parents who are facing issues like dementia.
Here is an interesting Times article, based on research from PEW.

Another Delicate Topic With Aging: When Is It Time to Give Up Guns?

  • Last month,  Rolfe Pilati (87), killed his wife before shooting himself at their Virginia home. A son told investigators that Mr. Pilati had dementia. 
  • In Minnesota a man with Alzheimer’s, Kenneth Bowser , 90, fatally shot his son, telling investigators that he feared the son would kill him.
  • In other recent cases, people with dementia have killed or injured friends and relatives in Oregon, Missouri, Texas, Oklahoma and Tennessee.
  • In the US,  40 %; of the country’s older population has a firearm in the home, according to the Pew Research Center, and about 11% of people 65 and older have Alzheimer’s.
  • In 2014, more than 5,000 people 65 and older committed suicide using a firearm. The same year, at least 200  people in that age group killed someone else, according to the F.B.I. 

Why do you own a gun?

guns in the US

Wednesday, June 8, 2016

More sex assault charges against worker fired from Richmond Hill hospital

This is why we need better training, as well as a supervisory agency for PSWs.

  More sex assault charges against worker fired from Richmond Hill hospital
GTA hospital didn't notify police about allegations seniors had been ... system for health care facilities to share disciplinary action against PSWs. About two thirds of PSWs work in hospitals and long-term care facilities, and one third ...
York Regional Police are alleging that a personal support worker who was fired from a Richmond Hill hospital after elderly female patients complained he sexually assaulted them went on to get a job at another healthcare facility where he assaulted two more women.

Sunday, June 5, 2016

Medical Assistance in Dying

Medical Assistance in Dying: What Hospitals and Boards Need to Know Ontario Hospital Association (OHA) and Governance Centre of Excellence (GCE) are pleased to offer programs  which will provide an in-depth look at the role of the hospitals and the role of the board members.

Medical Assistance in Dying: What Hospitals Need to Know
Complimentary Webcast Event: June 6, 2016 12:00pm-1:00pm
This webcast will cover:
• The applicable legislative and regulatory framework
• The provincial approach to medical assistance in dying
• Practical considerations from two hospitals

Family Caregivers in Ontario

New Report Takes a Closer Look at Family Caregivers in Ontario
The Change Foundation released an in-depth review of Ontario-specific data from Statistics Canada’s 2012 General Social Survey on caregivers and caregiving. The report helps to paint a more complete picture of the province's family caregivers in a number of key demographic categories. Read more
The report's key findings include:
  • An estimated 3.3 million Ontarians, 29% of the provincial population, are family caregivers.
  • 53% (1.8 million) of caregivers are women and 47% (1.5 million) are men.
  • Nearly three in 10 caregivers perform medical treatments such as tube feedings, wound care and injections.
  • 2.5 million Ontario caregivers are balancing caregiving duties with paid employment and of these caregivers:
    • 30% (741,000 people) were late for work or had to leave early;
    • 29% (735,000 people) missed an average of six days of work because of caregiving duties; and
    • 1% (33,000 caregivers) left their employment voluntarily or involuntarily.
  • One million caregivers said they felt they had no choice in taking on their caregiving responsibilities.

Wednesday, May 25, 2016


The G. Raymond Chang School of Continuing Education announces exciting lineup for annual 50+ Festival, June 1 to 4
Toronto, May 25, 2016 – Presented by Programs for 50+ at The G. Raymond Chang School of Continuing Education at Ryerson University, the 50+ Festival, now in its ninth year, offers an impressive lineup of sessions—mostly free of charge— that encourage the discovery of new possibilities for those 50 years and older. Running from Wednesday, June 1 through Saturday, June 4, the annual festival engages older adults interested in personal growth and continued learning.

Featuring collaborations with the Toronto International Film Festival and the Royal Conservatory of Music, the 50+ Festival will engage, uplift, and inspire attendees with candid discussions about the challenges faced by the sandwich generation, as well as a host of stimulating lectures and workshops.
Highlights include:
At Programs for 50+, those 50 years and older can access academic tools and opportunities for personal enrichment, self-actualization, and engagement in society with their peers and as part of an intergenerational campus dynamic through The Chang School. For more Festival information and schedule, visit Most sessions are free of charge, but participants must register in advance.