Thursday, August 20, 2009

Seniors and Canadian Health Care - part 2

This is a follow-up to my post on our Canadian system. Seniors, and people on welfare have extra services. In addition to free medical services, my parents, for example, would only be required to pay $2.00 for new prescriptions filled.

If you are disabled, frail or ill in Ontario, you phone up the Community Care Access Centre (check the sidebar), and they will appoint a Case Manager. The Case Manager, a nurse, will asses your needs, and determine the type and amount of help you can be given.

As an example, my mother was discharged after her first cancer surgery in 2002. She had the surgery a few months after diagnosis. She had not told her physician, nor me, and put off surgery until after my August 22, 2002, wedding. She had timely surgery and good care. She had a second surgery in early 2003. I met her at the hospital. She was discharged, with a Case Manager ensuring she had a nurse to attend her for a brief visit on a daily basis. She was sent a nurse on a daily, then weekly basis, who would change her dressings, check for infection, and reassess her needs until she recovered. I was living 400 km away, and thought all was well.

Dad drove Mom home from the first two surgeries. Driving home from her 2nd one, he had a petite-mal seizure, which they only realized later. He had a massive seizure later at home. They did an MRI a month after this and found he had developed a brain tumour. Dad had surgery and the brain tumour was removed another month later. All paid for through the Ontario Health Plan. Mom could not drive, since she was quite ill recovering from her cancer surgery, and I was working full-time a five-hour drive away. Dad had had his brain tumour removed, but was not allowed to drive.

She ended up getting an infection. Later, since she had had her lymph nodes removed during surgery #3 (or 4?), her leg swelled to massive proportions. Her Case Manager sent a tensor bandage to limit the swelling.

The Canadian Cancer Society provided a volunteer driver to take Mom to radiation appointments, an hour's drive away. They had this benefit, since I lived so far away, to drive them to these government provided treatments.

Dad had MRIs every 6 months after his surgery, on the government's tab, while the Cancer Society volunteers (bless them) drove him to appointments, Mom stayed at home fretting.

After she had radiation, (2005-ish?) Mom was rather ill. She could have had a Red Cross health care aide to provide some housekeeping, and some meal preparation, but she refused it. (She was a determined, independent woman! Only old, sick people had such support!) Born in 1925, her house was her castle, and women cared for others.

Eventually, when her cancer made her bed-ridden, she accepted a Red Cross worker (4 hours per day) while I drove 62 km to work to teach. By then I had moved, found a new job close to her, and we were preparing to provide more care. She saw the nurse regularly, who made house calls. And her doctor kept in close contact. Mom died at home, on her couch, as she wished in 2006, six weeks after I moved to care for her.

When Dad's brain tumour came back, we phoned CCAC who arranged to have his name put on the list for a bed in a long-term care (LTC) home. The government pays for these home, as well as nursing care, PSW care (health care aides) and physician care within both private and publicly-funded homes. These differ from retirement homes, where the senior is a resident, not a patient as such, with the opportunity of receiving nursing support.

Another benefit in Ontario are Transfer Payment Agencies (TPAs). This is how services for children, seniors, and the disabled are managed by transferring tax dollars to such agencies. Unfortunately, many agencies, such as Hospice Muskoka, for whom I am a volunteer, also rely on fundraising. This is something that needs to be corrected. Hospices provide volunteers who will help a family when someone is in palliative care.

I worked for The Friends, a TPA that provides supportive living facilities in the Parry Sound-Muskoka area. They also provide respite services for caregivers, support groups for caregivers, as well as those with chronic health issues such as MS, cardiovascular issues, such as stroke, and they are invaluable. They have:

Accessible Housing-with 24-hour support
Outreach Programs
Adult Day Away Programs
Respite Care
Volunteer Program
Attendant Services

I sit on the Board of Directors for our local Family Youth and Child Services board. We arrive at a budget, and are given tax dollars to provide services to our young people. This is true for all the TPAs. A board controls tax dollars and hired staff provide services. Services are available in our province for the young and old, pregnant, frail, and those with varying health care issues.

We have Meals on Wheels clients (subsidized by the province; client pays a modest amount) to have a volunteer deliver meals a few times a week.

Another benefit of our tax dollars: agencies, such as Muskoka Victim Services, will provide social and emotional support and counselling.
Ontarians can access services through a government-run 211 phone number, or visit, for on-line information. The services are free. If you are ill, you are able to access any number of agencies to provide support. There is a broad range. Services are not parcelled out. There are wait times, which are improving, but no one is denied care - despite American anti-universal health care lobbyist claims. Some do hire private nurses and caregivers through private agencies, but much is available for those who cannot afford health care.

Community Care Access Centres
Arrange in-home or school health and social services, and place people who can no longer remain in their own homes in long-term care facilities.
Community health centres
Low cost, culturally sensitive health care and education for individuals, families and communities.
Developmental disabilities
Services for people with developmental disabilities.
Environmental, occupational and public health
Services that promote and build healthy and safe working and living environments, including public health departments.
Finding a medical professional
Services that help you find a doctor, dentist, or other medical professional.
Hospitals including hospital emergency departments.
Long-term care facilities
Long term accommodation for individuals who require more nursing or personal care than can be provided through home support agencies. Includes facilities formerly known as homes for the aged and nursing homes.
Mental health
Services for people with serious or chronic psychological, emotional or psychiatric problems.
Physical disabilities
Services for people with physical disabilities.
Prenatal and postnatal services
Services for parents before and after childbirth including breastfeeding programs.
I hope this helps my American friends, as well as others. Let me know if you have any questions!

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