Sunday, April 5, 2009

Self-neglect by seniors







Unfortunately, there is much in the news about abuse. Seniors are not only vulnerable to physical health issues, but mental health issues. Without colleagues to monitor one another, seniors trapped in their homes due mobility problems, they are at risk from family, care workers and friends. With closures of homes for those with ongoing mental health issues, residents are vulnerable to self-neglect.

Peel Police say that in 2006, there were 6 reported incidents of abuse. In 2007, there were 54 incidents; in 2008 there were 66. I wonder if the incidents are increasing, or that people are becoming more vigilant? I wonder if we are still underreporting? For example, in Domestic Assault cases, many are not reported, since for those dating they do not fit into the category of 'partner' and young women, like Bracebridge university student Natalia Novak. Many who live alone, and decline help, yet live in squalor and filth, due to ill-health, deserve intervention by all who come into contact with them: landlords, physicians, workers in public housing, social workers, postal workers, service providers (e.g., Meals on Wheels), community members such as store owners and operators. We all are responsible. Victims of self-neglect remain hidden.

I worry over the Privacy Acts in Ontario. FIPPA is an act cited by many health care workers when choosing not to divulge health care concerns. I have written about this before. The medical profession doesn't get it. PHIPA precludes FIPPA when it is a safety issue. You know, the first things they ask, when discharging someone, is do you have a caregiver, neighbours, family to care for you, yet you cannot have them there in hospital. We must allow single people, those without close family members, to be able to name a personal support advocate to help us through this maze. It is criminal what health care does to those alone and ignores those who profess to be 'fine'.

People, like Dirty George, have no advocates. Health workers are not trained, let alone landlords, to intervene and protect these people from self-neglect. Seniors are prone to dementia-related disorders or delirium when medications are not taken, or not taken as prescribed. Physicians must be vigilant in diagnosing such issues soon.

Self-neglect involves pets
My father, discharged from Emergency the day of my mother's funeral with delirium, due to an infection after radiation, was more than we could cope with. We are a family of educated, strong, functional people and yet we had no support. My father was sent home to fall, urinate on the floor, get up at 2:00 a.m. light a fire in the wood stove, and no one could help us until a phone call to his physician determined his condition. All it took were antibiotics to make him (somewhat) better. Then his brain tumour caused dementia, but that is another issue.

In the current climate, with crowded, understaffed LTC homes, Ontario LHINs (i.e., Champlain)are encouraging seniors in Aging at Home. The result of this, with underpaid, undereducated PSWs continuing to provide care to seniors with the benefit of travel hours and a regulatory body, incidents of abuse will increase. PSW Canada has been advocating for such legislation. I heartily concur and support for regulation of these workers who provide intimate, private, personal care to those who may not be able to advocate for themselves.

In addition, we need to train all members of society to monitor seniors, the frail, those at risk, and report it to an agency. They deserve our respect.

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