Thursday, June 5, 2008

Primary Health Care

There are 400,000 Ontarians who do not have access to a physician (Primary Care). They are called orphan patients. The complications of old age: nutritional issues, comorbidities (other health issues that could lead to further deterioration of health), access to physiotherapy, pharacological support, dementia and many other factors contribute to inadequate delivery of Primary Care for our seniors.

What is even more difficult for seniors is that they often have many complications that compound their access to Primary Care: transportation, for example. Frail seniors are not always given enough time by their health care team. They need patient advocates or navigators to help them through an already stressed system. For those who face polypharmacy they may be weakened by a complicated cocktail of chemicals designed by those not on a health care team.

My parents' physician was an age peer and did not have up to date facilities and access to technology that would have given them some benefit in their access to Primary Care.
The ravages of radiation and chemotherapy took their toll on their already frail psychological and physical bodies. Wait times in already crowded emergency room exacorbated their issues. The lack of nursing staff in Long-Term Care (LTC) homes meant that my father's care was less than ideal. An already burdened staff does not have time to reviews medications and check on residents of LTC. We are incredibly short-staffed in Central Ontario and it does not seem to be getting better.

Aging At Home projects have not seen fulfillment. We drive an 88 year old to the library, grocery store, and Post Office. In her winter home she had access to volunteers/Red Cross personnel who took her three times a week to the store and out to take care of her IADLs. She is a brilliant, well-educated, retired teacher whose physical frailties belie her mental acuities. She cannot drive, nor stand for long periods of time. With a home care worker she could manage. She is not a candidate for a retirement home, nor does she need one, but she does need more help than the system can afford to provide for her.

*Primary care – basic or general health care from the medical system

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