Lobby groups abound

CARP, as sister of AARP, continues to lobby the government for particular changes. Now, this is not a group that is subject to financial issues. It would appear that members have enough money to know what they want and how to get it.

The survey group does not represent minority groups, the poor, or those without the money to belong to CARP. In addition, AARP provides data that simply does not apply in Canada.
One of the recent survey that CARP published:

The survey in this issue is misleading.

#1 The assumption is that all of us are going to end up requiring 24-hour care. This is certainly not the case.
#2 There are insufficient nurses to provide 24-hour care.
#3 There are insufficient Personal Support Workers to provide 34-hour care. The costs to the taxpayer would be astronomical, even if possible.

I am shocked that CARP would even think of advocating for this. Again, it is the family caregiver and the adult children who will take up the slack, and be forced to meet the expectations of the failing senior. I've been there. Wrote the book.
Also read:

Canada’s treatment of war veterans 'a national embarrassment'

Confused about the changes in generic drugs in Ontario?

Here is an excellent article by Steven Lewis...

Ontario Generic Drug Wars, Part 2: 


Did Retail Pharmacy Need Rebates? 
By Steven Lewis

This is an excerpt to give you a taste of the argument...

Retail pharmacists in Ontario make around $50 an hour on average (Ontario Pharmacists’ Association 2007), and more if they are franchisers or otherwise share in the profits of the store. Compare this with what similarly educated nursing colleagues earn. The top hourly rate for a staff registered nurse in Ontario is about $42(O’Malley 2009), and the average is several dollars less. (Nursing managers get a pittance extra.) I think nurses have harder jobs than retail pharmacists.




What do I think?
What do you think?


BTW

Ontario Generic Drug Wars, Part 1: How It All Began

Steven Lewis

Power of Attorney

This is a warning: know your rights in your province or state...

Power of Attorney is supposed to be a legal document. 

Public Guardian steps in

Hospital physicians assessed Dolores Brent's deteriorating mental state, and an administrator from the health authority signed a form declaring her incapable of managing her affairs.
The certificate of incapability, as it is known, automatically put B.C.'s Public Guardian and Trustee in charge of her finances instead of her husband even though she had signed an enduring power of attorney appointing George Brent to look after her affairs if she became incapable of doing so herself.

To summarize the story the government, and health care officials stepped in and took over. The implication is that he P.O.d the care staff enough, as he was frustrated with her care, that they went to court. The province has staked a claim on the couple's home, and money withdrawn from their JOINT bank account to pay for her care.


Read more: http://www.cbc.ca/canada/british-columbia/story/2010/09/06/bc-rightsremoved.html#ixzz0yxQ52AmL

Family Councils in long-term care homes

One of the mandates of long-term care (LTC) homes is to allow, create or facilitate a Family Council. Similar to the parent/teacher councils, loved ones, and interested citizens, can sit on a council to advise a LTC home on its practices and procedures.

I was the president of the Family Council during and for a short time after my father was in residence in one. I found it an interesting experience.

I have been a volunteer in two LTC homes, as well as a close friend of a resident, Michele, whom I visited regularly.

I wrote a lot about it all in my book,

Living and Dying With Dignity: A daughter's journey through long-term care

Some are proactive enough to have websites:

Click the link below to view the Woodland Villa Family Council website.

     Woodland Villa Family Council-http://www.wvfamilycouncil.org/

Click the link below to view the Forest Heights Long-Term Care Centre Family Council website.

     Forest Heights Long-Term Care Centre Family Council-http://sites.google.com/site/fhltccfamilycouncil/

Click the link below to view the Medex Family Council website.

Extendicare Medex Family Council-http://medexcouncil.blogspot.com

Health Research

Good news for Canada...

Canada joins international network providing free access to health research

PubMed Central Canada puts latest Canadian health research at fingertips of researchers

OTTAWA, April 28 /CNW Telbec/ - The flow of information and ideas amongst researchers is a fundamental element in turning knowledge into discoveries that will address the health challenges of tomorrow. Thanks to the newly launched PubMed Central Canada (PMC Canada), Canadian researchers can now contribute to a growing, searchable digital archive of published Canadian health research.


Why is this important?


Because much policy is created using US or International data. It is important that all of us have access to Canadian information, statistics and reliable data that represents us in this world.

Finding a Family Health Team in Ontario

I have been pleased with my Family Health Team. Facing a move, I have had to figure out how to find another practice. The Nurse Practitioner I have been working with has been brilliant. I very much enjoyed working with her. But there is good news.

New family health teams increasing access to care

More than 900,000 Ontarians have been attached to a family doctor, since 2003. It is expected that once all 200 teams are operational, they will provide access to primary care for more than three million Ontarians. As of 2009, there were 2,886 more doctors providing services to Ontario patients than in 2003.

Ontarians without a family health care provider can register with Health Care Connect, a program that helps people find a family doctor or nurse practitioner in their community. 


To register with the program, simply call 1-800-445-1822. You will need a pen, some paper and your OHIP card when you call Health Care Connect. You can also register for Health Care Connect online by entering your information a.

Ontario has also announced 25 Nurse Practitioner-Led Clinics which are expected to care for more than 40,000 people. Find out more about Family Health Teams 

Ethics in the Emergency Room

It is important to have advanced directives. You family needs to understand what you want after you cannot self-advocate, when you can no longer speak for yourself.

Preparing for the Unexpected—Teaching ER Ethics

Kelly A. Edwards, PhD, and Thomas Robey, MD, PhD

This is a good article on creating a framework for dealing with ethical issues in the ER. 


Speed doesn't negate need for ethics, and for one to take one's time.

Strategy 1: Anticipating and Practicing

Strategy 2: Using Ethical Frameworks for the ED Setting

Strategy 3: Building Scaffolding for ED Ethical Decision Making

LETTING GO

What should medicine do when it can’t save your life?

How about make us comfortable? How about listen to us? How about offering us information about local hospice care, and those volunteers who can help?

See also:

Resource Allocation Shake-Up, June 2010

Make It OK That This Life Is Ending, June 2010

Taking No for an Answer: Refusal of Life-Sustaining Treatment, June 2010

Mental Health Issues & the Silver Tsunami

As our aging population balloons, we will be facing more mental health issues in those aging and frail at home, in long-term care, and in retirement homes. Those with mental health issues can be confused with dementia. It is a wise caregiver, whether spouse or adult children, to determine causes of behavioural issues. Many hide their dementia, and can be deemed quirky rather than physically or mentally ill; a diagnosis is key.

Ontario’s mental-health system needs to be fixed now

Last Thursday, a committee of the Ontario Legislature released a hard-hitting report on the need to fundamentally transform the province’s mental-health and addictions system.

“Out of Control”: Violence against Personal Support Workers in ...

Long-term care workers link violence with working conditions. .... Violence in long-term care is not just a workers' issue. It is a women's issue.

Beaten Down: Nursing homes: Fear and violence

CBC.ca... says that long-term care facilities can be dangerous places where residents attack residents, residents attack staff, and staff abuse residents.

Between 2003 and 2006, the number of violent incidents among residents reported in the province more than tripled. (446 ⏎  1,416 cases - Ontario government documents)

More than 150,000 Canadian seniors were living in residential care facilities across the country in 2004/05, according to figures released by Statistics Canada in the spring of 2007. One out of every 30 people aged 65 or older. One in 5 of those over age 85.

Fast Facts: Mental Health/Mental Illness (CMHA)

Who's affected?
* Mental illness indirectly affects all Canadians at some time through a family member, friend or colleague.
* 20% of Canadians will personally experience a mental illness in their lifetime.
* Mental illness affects people of all ages, educational & income levels, & cultures.
* ~8% of adults will experience major depression at some time in their lives.
* ~1% of Canadians will experience bipolar disorder.

How common is it? 
* Schizophrenia affects 1% of the Canadian population.
* Anxiety disorders affect 5% of the household population.
* Suicide accounts for 24% of all deaths among 15-24 year olds & 16% among 25-44 year olds.
* Suicide is one of the leading causes of death in both men & women from adolescence to middle age.
* The mortality rate due to suicide among men is 4x the rate among women. 

What causes it?
 * A complex interplay of genetic, biological, personality & environmental factors causes mental illnesses.
* Almost one half (49%) of those who feel they have suffered from depression or anxiety have never gone to see a doctor about this problem.
* Stigma or discrimination attached to mental illnesses presents a serious barrier, not only to diagnosis & treatment but also to acceptance in the community.
* Mental illnesses can be treated effectively.

What is the economic cost? 
* The economic cost of mental illnesses in Canada for the health care system was estimated to be at least $7.9 B in 1998 - $4.7 B in care, & $3.2B in disability & early death.
* An additional $6.3B was spent on uninsured mental health services & time off work for depression & distress that was not treated by the health care system.
* In 1999, 3.8% of all admissions in general hospitals (1.5M hospital days) were due to anxiety disorders, bipolar disorders, schizophrenia, major depression, personality disorders, eating disorders, & suicidal behaviour.


Sources: The Report on Mental Illness in Canada, October 2002.
 EBIC 1998 (Health Canada 2002), Stephens et al., 2001