Wednesday, June 23, 2010

Accountability and Responsibility Case Study #11

I adore reading this blog, Emergency Room Nurse. Now promoted to 'Clinical Care Leader', the author is an advocate for all stakeholders in the system, from patient to professional. Her latest piece,

When the Physician is an Idiot, You Have To Be an Advocate

is fabulous.

We in the health care system must advocate for our loved ones, family and friends (they are not mutually exclusive or inclusive!) In this case, her nurse over rode the intern, who misinterpreted a DNR order as a Do Not Treat order, and denied appropriate, simple, medical intervention. Such a shame, but bless those in uniform who do so.

Those delivering services to seniors, as volunteers, must be aware of the responsibility that they accept. By visiting a home, it is their role (in my humble opinion - IMHO) to advocate for the men and women they serve. Often, they have no one else, or family does not know the situation. I was speaking to another adult caregiver for a failing parent. Before dementia was diagnosed, often neighbours and friends would phone and suggest to the caregiver that they were responsible for letting said parent engage in dangerous activities. Unfortunately, as with my case, I had no idea my mother was driving unsafely. No idea a neighbour would help her turn her minivan around as she could not manage her vehicle..

But, back to volunteers. In a home they should be checking a refrigerator. For those delivering Meals on Wheels, for example, they need to be noting how much food is actually in the refrigerator and whether it has been eaten. Phoning their contact person is crucial if there is either no food, or too much. Chains of command are interesting, in that anyone in Ontario can report elder issues to either the police, or to the  Community Care Access Centre(CCAC). This is the agency that works through the regional Local Health Integration Networks, the Transfer Payment Agencies for Ontario Health Care.

If a senior is not eating, if their home is dirty, it is up to someone to take control. If moldy food is left in a refrige, and it is eaten, there could be dire consequences. My concern is if there are no standards of care for a Personal Support Worker, and they are not checking the food situation for a senior, someone has to be accountable.

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