Sunday, May 25, 2008

Family Members and Ailing Seniors

It is clear that family members face severe and potentially profound issues when caring or advocating for family members. Unfortunately, many health care providers do not understand the various Health Care acts that apply to both their clients and their families. Some of these include: Mental Health Act, Public Hospitals Act, Health Protection and Promotion Act, Long-Term Care Act, Occupational Health and Safety Act, Child and Family Services Act. Workers in health care continue to cite Freedom of Information and Protection of Privacy Act (FIPPA) Legislation when refusing to communicate serious and crucial safety information regarding those in their care. The Personal Health Information Protection Act governs (PHIPA) such workers. Yet, workers fail to communicate with adult children to inform them of the status of frail seniors health. Health Care providers and professionals have an obligation to inform family when they feel that seniors may be facing dementia, for example, which might put seniors at risk in their homes. This risk has a impact on the seniors, their neighbours, and the community in that those who fall end up in hospital. Those who accidentally leave pots on the boil cause fires that tie up emergency services. Those who leave a tap on in an apartment cause flood damage to other resident’s ceilings.

Dr. Ann Cavoukian, Information and Privacy Commissioner for Ontario, is on a personal mission to inform health care providers and professionals about their responsibility to inform family members of those who are privy to the mental and physical health conditions of patients and clients. Health information custodians who collect, use and disclose personal health information, or non-health information tells them to exercise judgment. In a conflict PHIPA prevail over other acts. This includes FIPPA. Health information custodians include professionals, licensed and non-licensed practitioners: social workers, those working in LTC, or operate health facilities, pharmacies, laboratories, ambulance services, centers, programs or services for community or mental health purposes.

Disclosure can be made for the purpose of contacting a relative, friends or substitute decision maker of an individual who is incapacitated, injured, or ill, and unable to consent(s. 38(1)(c), p. 38), if it is necessary to eliminate or reduce a significant risk of serious bodily harm to a person or group (s.40, p. 40).

Frail seniors living on their own may be incapable of taking their medications at the right time. This is a serious risk to a senior. It is up to a health care provider to make the decision to inform family. Many family members may not understand that their ailing relatives are incapable of ADLs or IADLs when friends and neighbours cover off these duties. The risk of such enabling actions is great to both the senior and his or her family. Disclosure must be forthcoming to protect on and all.

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