Thursday, May 21, 2009

Long-Term Care and flu - illegal closings

Residents in a Long-Term Care (LTC) home are often frail seniors with comorbidities: several chronic diseases that put them at risk. They require extra personal care. Their needs are different, in that they need nursing care unavailable in a regular setting such as their home, or a retirement home.

The Ministry of Health and LTC keep up a website of reports. You can search and find Hand Washing Poster (PDF) complaints about these (primarily) for-profit agencies. In Ontario something like 530/640 homes are for-profit, with government subsidies.

Homes can only be closed by the Health Department, by homes with reportable (and reported)  illnesses.

Read more here: LTC Bill of Rights - illness outbreaks

There are many 'visitors' to LTC. Loved ones try their best to visit their family members. There are many volunteers (Hospice, spiritual advisors, Therapy Dogs), or service workers like massage therapists, and professionals who provide dental or foot care), or other people that have been hired to see to residents. Some drive long distances to see them, especially in Central Ontario. Friends, knowing their buddies are in LTC, make every attempt to visit. This is not always possible, since a LTC home could be closed due to various reasons. Flu is an obvious one with the recent Swine Flu, H1N1. Giving LTC residents a flu shot might help, but with the new bugs around we cannot be sure it prevents new strains from infiltrating a home.

And scabies is an infestation that closes a floor or a wing. An unseen pest, the symptoms are itchy rashes that become infected if not treated or identified by those unable to communicate their symtoms. Another issue: the Superbugs that are floating around the health care system: MRSA, C. Difficile (CDAD), VRE, VAP. It is crucial that we are more vigilant in Washing your hands (- tips).

What is my concern, is that no one knows if a home is closed until you turn up at the door for a visit. I have a friend I visit regularly and have found this to be a problem. Many family members attempts to visit their loved one as much as possible and provide extra care that cannot be delivered by busy staff.

There should be a place where building, floor or wing closures can be listed. In fact, these incidents need to be tracked. It was in 1999 that Flu was blamed for 20 deaths at nursing home, (Last Updated: Friday, Nov. 10, 2000) CBC News). Until the Health Department becomes involved, no data seems to be kept. What about the homes where seniors are ill, family members cannot visit, and no deaths occur? Having flu is horrible when you are young and able, when you are incontinent and unable to take care of your bodily needs it must be frightening.

Those working in LTC, travelling from home to home, and resident to resident must be the most vigilant. at risk are LTC residents who require hospitalization a few days, only to return bringing risky bacteria and viruses. I would call on the Ministry to keep data on this information.Track incidents and require LTC homes to be more vigilant with hand washing.

Reportable Infections in Ontario

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