Wednesday, April 9, 2014

What is the purpose of long-term care?

Most of Ontario's LTC homes are for-profit institutions. When senior advocates call for changes and improvements to LTC, they fail to realize that most of these institutions are NOT government-run. In fact, the Ontario government has long been deconstructing the institutionalisation of both young and old, whether or not they have alternate care strategies in place.

CBC Ontario has done some research and has found that too many young people are being housed in LTC, since there is no other alternative. Group homes, again, are run by for-profits. I have had many students, wards of the court, who are in private, for-profit group homes.
Typical government, however, in that they develop no other strategies, leaving families to cope and struggle caring for developmentally disabled, adult children.

Nursing home life a struggle for young developmentally disabled people

'I don’t want to stay here forever' says 33-year-old Peter Farrah of Ottawa
The Ontario government has committed to a process of de-institutionalization for those adults, starting with the closure several years ago of facilities including the Rideau Regional Centre in Smiths Falls. However, many are still waiting for the government to provide the supports they need to live outside such institutions.

Monday, April 7, 2014

Tweed calls in RCMP for supervision; pot is seized

Just when we thought healthcare, and the feds, were moving into the new millennium...
Tweed has a licence to grow, and plans to help those who use pot. Unfortunately, the RCMP seized it. 
Tweed's budding business hits slight snag with B.C. pot delivery
Tweed Marijuana Inc. became the first publicly traded medical pot company in Canada on Friday, but behind the scenes the...

The case seems to highlight an ongoing confusion around the old legal regime, which allowed licensees to grow medical pot in their basements, and the new regime, which restricts production to commercial growers, such as Tweed. Before the April 1 switch to the new regulatory regime, individuals who previously had personal-production licenses were allowed to sell what “starting materials” they had, such as seeds and plants, to one of the new commercial producers.

Medical Marijuana in Canada: typical government bureaucracy

As mall owners and stock holders have allowed big box stores to dominate the market, small family businesses are going bankrupt. This is the same, growers warn, of the small growers upon whom many medical marijuana users depend. They cannot afford the premium stuff.

Friday, April 4, 2014

Canada has a crisis in nurse staffing

Excellent article...

Media keeps reporting that 'the system is broken'. It's not. We are short-staffed and the stress is killing the profession. Media-bashing of healthcare needs to stop.
Let us laud those who make a difference.

Canada's nursing crisis worse than ever

It's a damning, disastrous cycle: Not enough nurses to fill shifts. Rushed and harried staff who must scramble to provide proper care for patients. Young nurses scared off by poor working conditions, just when they are desperately needed to fill vacancies. Mid-career nurses who burn out and flee the profession, creating even more empty spaces.

More nursing seats have been funded across Canada in recent years, but nurses say the influx of new employees does little to repair the problem. Even though 8,000 nurses will graduate this year, the Canadian Nurses Association says there are 12,000 vacancies across the country; Winnipeg alone has 870 empty spots.  

Thursday, April 3, 2014

Is this elder abuse or plain fraud?

This senior hired a personal support worker. She took over the woman's life. She, and her family (husband, 2 kids) moved in with the victim, placing her in a small bedroom. Then they stole and sold her belongings.  She lost her life savings of $25,000.

Thankfully, the man who delivers her prescriptions from the pharmacy reported that something was wrong. This is why seniors need patient advocates, and well-trained caregivers, who are registered and monitored by a governing agency. This is the sort of situation where family and friends need to be wary, if seniors allow themselves to be exploited this way.

The police claim that this is an underreported crime, citing vague numbers of between 2 - 10% of all seniors facing abuse. There is little research to support these numbers.
For the most part, we have bank managers, caregiver agencies, and other support staff, who can and do monitor the lives of at-risk seniors.
I'm surprised that the bank would permit this to happen.

Tuesday, April 1, 2014

Medical Marijuana in Canada: typical government bureaucracy

As mall owners and stock holders have allowed big box stores to dominate the market, small
family businesses are going bankrupt. This is the same, growers warn, of the small growers upon whom many medical marijuana users depend.
Being a hospice and respite volunteer, I often come across people who would benefit from this drug. Doctors are often against it. That is changing. My friend, Michele, had access to it in British Columbia. She has been unable to access it here, in her long-term care home. In addition, the law forbids people from smoking on the property of LTC, hospitals and other government facilities. This is a huge barrier.
My friend, Michele.
I wrote about her in my book.

Many of my clients cannot afford to buy it from these new commercial producers. There have been Canadian Government changes to the distribution and growing of this product. Many fear that that will no longer be able to afford to buy from their regular growers. In fact, many who could use the drug are on disability (ODSP), unable to work, or unemployed due to their various illnesses. I had a client I took to the pain clinic, and she could not even afford it buying it on the street. 

The street value of pot is about $2 per gram, but these sophisticated plants cost money. Health Canada sells it for $5/ gram. They anticipate selling it for about $8/gram in the large-scale production plants. Former legal growers are upset, in that they are able to have a couple of clients, and have spent 40 years, some of them, learning how to grow this plant. All of their expertise will be lost for customers who live in rural or remote locations, as well as those in the city who depend on the small growers.
  • The federal government gave permission for two patients to smoke pot in 1999.
  • In 2000, the courts rules that Canadians have a constitutional right to use cannabis as a medicine.
  • In 2001 they granted legal access to cannabis for those with HIV/AIDS and other illnesses.
  • In 2001 they permitted some 100 authorized users. 
  • In 2014 there are 37,800 legal users. 
  • There are 25,000 authorized to grow pot for themselves.
  • Authorized designated growers: 3900.
  • Currently, there are 12 commercial producers licenced under the new rules (See the list below).
Some say they can grow at home for pennies a gram, while official suppliers licensed by Health Canada charge anywhere from a discounted price of $3 a gram to as much as $13.50.

Medical marijuana users take fight to grow pot to Parliament Hill

Protest comes after Ottawa said it would challenge injunction letting medical users keep growing pot

  1. Medical marijuana growers warned to destroy pot or face police ...

    Mar 17, 2014 - Health Canada is warning users and growers licensed under an outgoing law they must destroy and dispose of their pot by April 1. offers compassionate pricing
The  Marihuana for Medical Purposes Regulations (MMPR) are in effect and the Marihuana Medical Access Regulations(MMAR) will be repealed on March 31, 2014. The MMPR deal exclusively with the medical use of marijuana and do not address the issue of legalizing marijuana for general use.
If you already have a valid Authorization to Possess (ATP) under the Marihuana Medical Access Regulations, you can use your Authorization to Possess (ATP) to register with a licensed producer until the validity date shown on the ATP. For more information, please refer to the Frequently Asked Questions.

If you do not have an Authorization to Possess (ATP) under the Marihuana Medical Access Regulations, you need to follow the following steps:
Authorised Licensed Producers
Name of licensed producerPhone numberEmail (if applicable)Website (if applicable)
Bedrocan Canada Inc.1-855-420-7887info@bedrocan.caNext link will take you to another Web site Bedrocan
Canna Farms Ltd.1-855-882-0988info@cannafarms.caNext link will take you to another Web site Canna Farms
CanniMed Ltd.1-855-787-1577info@cannimed.comNext link will take you to another Web site CanniMed
Delta 9 Bio-Tech Inc.1-855-245-1259info@delta9.caNext link will take you to another Web site Delta 9 Bio-Tech Inc.
GreenLeaf Medicinals Ltd.1-855-488-3668info@greenleafmedicinals.caNext link will take you to another Web site GreenLeaf Medicinals Ltd.
In The Zone Produce Ltd.1-800-420-1707info@inthezoneproduce.comNext link will take you to another Web site In The Zone Produce Ltd.
Mettrum Ltd.1-844-638-8786 (METTRUM)info@mettrum.comNext link will take you to another Web site Mettrum Ltd.
MedReleaf Corp.1-855-4-Releaf (73-5323)askus@medreleaf.comNext link will take you to another Web site MedReleaf Corp.
The Peace Naturals Project Inc1-888-64-PEACE (73223)info@peacenaturals.comNext link will take you to another Web site The Peace Naturals
ThunderBird Biomedical Inc.1-778-588-9528info@thunderbirdmedical.caNext link will take you to another Web site ThunderBird Biomedical
Tweed Inc.1-855-55-TWEED (89333)hi@tweed.comNext link will take you to another Web site Tweed
Whistler Medical Marijuana Corp.1-604-962-3440info@whistlermedicalmarijuana.comNext link will take you to another Web site Whistler Medical Marijuana Corp.

Medical Marijuana Factory YouTube Tour

Tweed is a new producer of medical marijuana.
They have taken over a Smiths Falls Factory, what was the Hershey Factory, since it's been abandoned and production has moved to Mexico.

Monday, March 24, 2014

Is the incidence of Alzheimer disease decreasing?

New Insights into the Dementia Epidemic
Described in the early 1980s as "The Silent Epidemic," dementia in the elderly will soon become a clarion call for public health experts worldwide. The epidemic is largely explained by the prevalence of dementia in persons 80 years of age or older. In most countries around the world, especially…
Although demographics will drive an increase in the number of dementia cases, recent reports — generally based on population-based community studies or survey data — point to declining age-specific prevalence or incidence rates among people born later in the first half of the 20th century (see table). 

November 27, 2013
 Larson E.B.Yaffe K.Langa K.M. 10.1056/NEJMp1311405 Is the incidence of Alzheimer disease decreasing? | Lon S. Schneider MD's Blog


Thursday, March 20, 2014

Polysporin shortage in Canada

  1. Eye drop shortage leaves patients scrambling, pharmacists ...
    Dec 2, 2013 - Polysporin eye drops are commonly used to treat pink eye, but many pharmacies in the ... Polysporin has a shortage of eye drops in Canada.

Sunday, March 16, 2014

Should I have chemotherapy?

Leave it to the journalists to create this obtuse title.
They should write: Palliative patient's receiving chemo end-of-life wished overlooked
The other mistake they make is to cite a US-study, with their vastly different procedures and billing methods, right to care protocols, leave some without care.

Some patients, declared palliative, receive palliative chemotherapy to "ease symptoms and prolong survival." Personally, my late mother was killed by chemotherapy, in her weak condition she could not tolerate it, nor could my late ex-husband, who had a heart attack and died. People with terminal illnesses need to have good information, counselling, and a supportive healthcare team who will tell them the truth and be honest about quality of life.

Patients declared palliative are entitled to know their disease trajectory, understand what their end-of-life might look like, and make the best decisions for themselves and their families.
For example, patients with ALS often receive excellent support from the ALS Society, and understand about their trajectory, and often complete DNR orders.

All patients need to understand about therapies, treatment outcomes, the impact of tube feeding, and other treatments that can reduce their quality of life.

What this study concluded is that:
  • 47% of the palliative chemotherapy group died at home
  • 68% of patients treated with palliative chemotherapy died where they wanted to die.
  • 80% of all patients without palliative chemotherapy died in a location of their choice (Home, hospice, hospital).

  • Terminal patients receiving chemotherapy less likely to die at home
    A team of researchers from Harvard Medical School, the Weill Cornell Medical College and the Dana-Farber Cancer Institute.  The study, published in BMJ (formerly the British Medical Journal), followed 386 adult patients of varying ages from eight oncology clinics across the U.S. for a period of six years, from 2002 to 2008.
    “Until now, there hasn’t been evidence of harmful effects of palliative chemotherapy in the last few months of life,” said the study’s senior author Dr. Holly Prigerson. “This study is a first step in providing evidence that specifically demonstrates what negative outcomes may result.”

    How much does your hospital stay cost?

    The Canadian Institute for Health Information has a fabulous website where you can compare costs by province, or individual city hospitals. How well Canadian hospitals are performing is important, as we should know how much we should spend, vs. how much individual treatments cost the system, and how much the government is willing to spend.

    Here is their data per province:

    They estimate that 72% of costs are for salaries, which is a good thing. We pay the best to deliver the best, specialists earn more. According to the Ontario Sunshine list (reporting earnings over $100,000 per year) pathologists earn around $350,000 or more, but OHIP pays other physicians directly, not through government tax dollars. The big issue here, are the salaries paid to CEOs compared to front line workers, such as the lowly paid (and educated) personal support workers (gr. 12 education) and nurses (College degrees, B.Sc., or more educated Nurse Practitioners). [See: What is the difference between a PSW, RPN, RN, and NP?]

    I'm not sure the purpose of this data, since specialty and teaching hospitals have different costs. We should know what healthcare costs us, as this helps taxpayers make good decisions, politicians should not be trusted to cut taxes, when costs are only rising.

    Big hospitals surely have lower per patient costs than smaller ones in small hospitals. That's what I would have thought, but comparing Ottawa Hospital (with big teaching hospitals; CHEO, uOttawa Heart Institute, etc.) is higher than my regional Perth and Smiths Falls District Hospital
    Here I have compared, from top to bottom, Ottawa Hospital, B.C., Ontario, and Perth and Smiths Falls Hospitals.
    Here is more information:
    Media Release
    Nov 7, 2013

    Mixed results across the system

    The website shows that Canada’s health system is performing well in some areas, but improvements are still needed in others. Divided into five themes, the site gives visitors results such as these:
    Access: While most Canadians are getting cancer radiation treatment in a timely fashion, waits are increasing for joint replacements.
    Quality: A significant drop in hospital deaths suggests that the quality of hospital care is improving overall in Canada; however, 1 in 12 Canadians is readmitted to hospital within 30 days of discharge.
    Spending: Spending on health care varies greatly across the country, even after considering age differences in the population.
    Health promotion and disease prevention: While smoking rates are declining in Canada, obesity rates continue to rise.
    Health outcomes: Canadians are living longer than ever, but they are not benefiting equally from improvements in health.
    Related Content: For more information, see CIHI’s report on hospital financial performance measures.