How to improve healthcare

This woman made a one minute deposition to Toronto's City Council. The mayor's brother suggested they close libraries to reduce costs.
Perhaps, as she suggests, to reduce healthcare costs we should stop offering this very Canadian principle of equal access. This would save a bundle.
Like the US, we would rely on insurance companies who more often than not deny payments and determine that such things as rehabilitation are unnecessary.

Marketing to seniors

Heard an interesting story about the family running across N.A. on a marathon. They were interviewed on CBC by many hosts.

It bothers me to hear them disparage the healthcare system, saying: "...it's broken, 'we' don't do enough education, we don't exercise enough," etc., etc. 

Hubby, Joe, visited the FHT in Muskoka, had diet counselling, met with a dietician, lost 30 lbs. The women in his lecture/diet  group were shocked with the caloric content of peanuts, but won't give them up. He gave that up, plus peanut butter. We all have choices.

There is much info out there. I worked with CHAP -Cardio Health Awareness Program and there are many ways to track BP, weight, exercise, but many ignore it as well.

It is tragic that a family like this, with money to burn traveling around Canada/US, able to flog a book based on bashing our heathcare system.

They are fundraising, somehow, but it's not clear if they have a board to monitor this. He is selling a book, too.

I know I have a different viewpoint - but truly Search Engine Optimization (SEO) and marketing, fake Facebook people, pretending to be a real person, really bothers me.

I had one SEO marketing dude who wanted me to pretend to me Miss Muskoka, http://muskokagirl.ca/ with photos of a cute young thing, while I wrote the blog. Should be illegal! He ended up finding a young journalist student who once lived there to do it remotely, getting money for ads and such. She doesn't live there in Muskoka. Many ads, or Facebook pages, are run by youngsters, who do not understand what it is to be a senior. Especially senior health.

Seniors in long-term care are learning to use a computer, with a bit of tutoring by staff. I heard of several during a tour of PCCC the other day. I was in to volunteer.

They are starting to market things to seniors in the same vein. I keep getting offers for me to post ads on this blog, to post a link for a year for the grand total of $60. Things like Brain Gym, they say helps dementia. Just shifted brain games from kids to seniors. They don't do a darn thing.
Be a smart health shopper.

Quality care in hospitals

Transitional care patient 'coaches' cut hospital readmissions

Typically, 20 to 25 percent of patients age 65 and older are readmitted after 30 days, according to a press release. However, with intervention, a visiting coach can help cut the rate of readmissions.

Got a complaint that is bad enough you could sue? Patient Relations must inform Risk Management, which prepares the hospital for court. Whose interests are we protecting?

http://www.health.gov.on.ca/en/ms/ecfa/pro/updates/patientrelation/update_20110304.pdf

www.health.gov.on.ca

Further information on the Quality of Care Committee under QCIPA can be found in the

OHA’s Quality of Care Information Protection Act Toolkit (PDF-2004) and in From Law to 

Practice: Revisiting the Quality of Care Information Protection Act (2007)

Cancer cells and cancer terminology

Cancer is a disorder of the cells at the DNA level.

can·cer/ˈkansər/Noun

1. The disease caused by an uncontrolled division of abnormal cells in a part of the body.

2. A malignant growth or tumor resulting from such a division of cells. 

(Image from Understanding Cancer Series: Cancer.)

Defining Cancer

Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems.

Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start - for example, cancer that begins in the colon is called colon cancer; cancer that begins in basal cells of the skin is called basal cell carcinoma.

With Cancer, Let’s Face It: Words Are Inadequate

By DANA JENNINGS

'...after staggering through prostate cancer and its treatment — surgery, radiation and hormone therapy — the words “fight” and “battle” make me cringe and bristle.'

I agree. We speak of cancer as if it is an enemy. It is not. It is a medical situation, that must be spoken of and dealt with - as we are not victims of a warrior, a vicious fiend or beast. We have cells gone wrong. Cells that grow more quickly than normal and fight with normal cells for blood supply.

Seriously, the language of cancer is something we need to talk about ... The words we use to describe cancer make us feel bad about ourselves .

It isn't a mysterious soldier and why we use battle terminology defeats me. For those who die from cancer are not vanquished, they are not failures. They cannot 'lose a battle from cancer'. They have lived, and died from a disease. There is no assailant. No malice. No intent. For those who 'win' implies that they have some favour with the cancer gods, and are more worthy of having gotten rid of the disease than another.

Mr. Layton said of his prostate cancer, 'Like my dad, I'm a fighter, and I will beat it.'

Those who have had cancer, seem to feel the same way as I do. They do not want to be named victims, nor do they want their family members to be perceived as victims.


Jack Layton didn’t lose a fight: He died of cancer

It’s a common cliché, one many of us use when talking about a disease that is often feared and rarely understood. But to those touched directly by cancer, equating the illness with a war against the enemy, fighting an adversary, or suffering in order to survive can diminish understanding of the challenges and complexities faced by patients and their families. 

• THE LANGUAGE OF CANCER

By Leah: 'Seriously, the language of cancer is something we need to talk about'

• I prefer Starbucks

As you know, I think the language we use around cancer is powerful, and important. I talk about a dance, not a fight. I talk about having had a cancer, singular, not cancer, the big scary thing.

We cannot personify the cancer cell. This gives too much power to a symbol that destroys us with worry. How many of us fear cancer? Many. How many of us visit friends with cancer, and recognize the face of Jack Layton as it has so profoundly changed? Very few. Those of us who are hospice volunteers, and/or work in the field, recognize the gaunt face we see. Many friends steered clear of my parents in their ill-health.

We need to use words that are appropriate: radiation, chemotherapy, prognosis, treatment plans, rather than 'Cancer has struck charismatic...Jack Layton.' It hasn't struck him at all. His body has been found to contain cancerous cells. Nothing and nobody has lifted a hand to hurt him. There is something going wrong with his body chemistry. Whether a person is a famous 'charismatic' person or not, they all deserve some respect. It is not as if some unseen hand has tried to strike this man down.

This author (Stephanie Butland ) also cites references that use cancer as a metaphor.
So something that annoys me a great deal is the use and over-use of something described as being ‘like a cancer’. Debt, according to one well-known author, is ‘spreading like a cancer’. Corruption at FIFA is also like a cancer, apparently, and a footballer I’ve never heard of  - this is not surprising as I’ve only really heard of David Beckham and, of course, Ryan Giggs – has been called ‘a cancer on football‘. Other things spreading like cancer include wind farms, Iranian influence, illegal backpacker hostels , Starbucks and even deserts.

As Dana Jennings writes:

So, no, cancer isn’t a battle, a fight. It’s simply life — life raised to a higher power.

Jack Layton didn't lose a fight: He died of cancer - The Globe and Mail

22 Aug 2011 – Did Jack Layton die from cancer because he didn't fight the disease hard ...noted that Mr. Layton “gave his fight against cancer everything he had." 

Jack Layton has 2nd cancer

At today's news conference, 2011

Mr. Layton in 2008

While we must avoid the 'battling cancer' phrases, I am so sorry to hear the the Federal NDP Leader, Jack Layton, has been diagnosed with cancer again.

NDP Leader Jack Layton
speaks about his weight loss
due to prostate cancer during a news conference
 in Ottawa, Tuesday July 6, 2010

You can see from his photos that he is not a well man.

The speculation begins.

Twitter has been bleating madly: most with message of support and concern. But, as always, there will be those who speculate and spread rumours.

The bottom line is that dealing with a cancer diagnosis takes much energy, and stepping down is the right thing to do.

One cannot put a mere job, work or career ahead of health. His loved ones deserve more than the public and his party members.

I hope that he listens to his body. Fighting a Federal Election campaign must have taken its toll.

Certainly, those who live in poverty do not have many options. Many of our clients must work in hourly wages, while caring for failing family members. This is not the case for this well-loved, respected Member of Parliament. Who else would you want on your side than Olivia Chow, MP and a trooper, fighting for healthcare, and people. Her Town Hall on 'finding a physician.'
Ms. Chow fought hard for her mother:

For two weeks, while a surgical wound in her stomach grew raw and infected, Ontario's home-care system overlooked 83-year-old Ho Sze Chow.
That her daughter is Toronto MP Olivia Chow and her son-in-law is federal NDP Leader Jack Layton – both of whom understand how to manoeuvre through bureaucracies – made no difference.
Scheduled nursing visits were repeatedly skipped. Phone calls and complaints went nowhere.
It was, Chow concluded, a cautionary tale for the 770,000 Ontarians – hospital patients sent home early, the disabled and seniors trying to remain in their homes – expected to use home-care services this year.


"Advocates, nurses and health-care academics agree the province's home-care system is stressed. Health Ministry figures show the number of clients has jumped 75 per cent over the past four years, while funding has risen 30 per cent."

Home-care system stretched to limit - thestar.com

www.thestar.com/News/GTA/article/269098 - Cached

22 Oct 2007 – That her daughter is Toronto MP Olivia Chow and her son-in-law is Jack Layton.... Toronto MP Olivia Chow's mother, Ho Sze Chow, 83, had to go to the ER .

For the rest of us, I hope we ask physicians the right questions.

Oncologists, especially, must be accountable to their patients to identify a treatment plan.
Patients, or their caregivers, must ask the hard questions to determine whether the treatment plan will potentially successful, and/or interfere with quality of life.

Essentially, with seniors there are

• statistics that can predict the quality of the treatment,
• its impact on the patient and caregivers,
• and the probability of its success.

A patient and family must ask:

• about treatment options - you need NOT have the treatment if you choose not to.
• how far the disease has progressed (i.e., is it in the lymph nodes?)
• what is the prognosis?
• about the impact on the quality of life during treatment
• about the impact on the quality of life after treatment
• How can I avoid or relieve my symptoms?
• How can I relieve pain? (Agitation or pain? Get a pain management kit if you are at that stage of the cancer.)

• If removal of lymph nodes is suggested: what is the impact of lymphedema?
• How much time you will gain and at what cost?

The impact of radiation can vary widely with patients, but one result of this treatment is the destruction of infection-fighting antibodies. My father fought a urinary tract infection undiagnosed in the emergency ward, and he was sent home incontinent and unable to function with the side effect of delirium.

The need to determine the outside resources available if, for example, the patient is incapacitated by radiation treatment or chemotherapy. In Ontario CCAC will help with this.

Case studies #38 - 47

#38. Just admitted to the Smiths Falls Hospital for tests and management of confusion.  This lovely 92 year old female client is suffering from recurrent TIAs.  She is much brighter since her IV treatments.  She may have been dehydrated.  She is expected to be in the hospital for a few days.  She needs a visitor on Monday and Tuesday to visit her over lunch.  She feeds herself.  A volunteer would be providing companionship, help/encouragement with her meal. 


39. A 74-year-old female client who was re-diagnosed with metastatic colon cancer, 3 days after the recent sudden death of her husband. She wants a friendly visitor, as she is undergoing chemo treatments biweekly in the city and stays with her daughter there for a few days after the treatment. Chemo is planned to continue through to November.


40. A 61 year old female client who has cancer that has spread throughout her body.  She has a growth on her kidneys, in her bowel, lungs and thyroid.  She is in need of emotional support and her husband is in need of respite.  He had triple bypass surgery in the spring.  The client mobilizes on her own and really needs someone to just sit and listen.  


41. A 61 year old female client, suffering from advanced COPD.  She lives alone in her own home and is very weak, having very low energy.  She recently spent 3 weeks in the hospital and is really starting to have a hard time looking after herself.  She is being encouraged to apply for long-term care.  I am wondering if a volunteer can visit her once per week and accompany her and assist her with her grocery shopping.  She still wants to go, however, she moves very slowly and cannot manage the items at the cash.  Please let me know if you are interested in this placement.



42. An 83 year old female client is in need of a volunteer visitor.  She lives alone and is very frail, forgetful (getting her days and nights mixed up), has narcolepsy and back problems.  She uses a cane/walker and gets up to her apartment in a chair lift.  The client is very isolated. 


43. A male caregiver is in need of respite and support.  He is caring for his 78 year old wife who is suffering from a form of Parkinson’s Disease.  The client’s mobility is very impaired and she is very hunched over.  This is a difficult placement as the disease is very advanced and debilitating.  A volunteer is needed to visit once per week for 3 hours to give the client’s husband a break and some support.  

Seniors: falls, wait times, safety

Falls in long-term care
Many of us can report about falls in our roles as caregivers. The government is just realizing that understanding the patterns, and preventing falls, is an excellent way to keep seniors healthier longer.
Preventing falls, which account for 65% of injuries in seniors, are said to cost Canada's healthcare system an estimated $2.8 billion, according to Credit Valley Hospital.

According to the Alberta government, falls caused more than 95% of hip fractures among seniors.
Did you know that 20% of seniors will die within the first year following a hip fracture and 50% never recover full mobility. Take their quiz for more information: QUIZ.

Visit the Injury Prevention section of the Division of Aging and Seniors Web site for useful information on preventing falls, including:

•  You CAN prevent falls, Go for it! A guide to choosing and using assistive devices; and
•  The Safe Living Guide: A guide to home safety for seniors.

You can reduce your chances of falling by following these tips:

1. Begin a regular exercise program.
2. Make your home safer.
3. Have your health care provider review your medicines.
4. Have your vision checked.

Ontario Health Quality Improvement: Individual Home Results by Indicator
Percentage of residents who had a recent fall
A fall — from a minor slip off a chair to a major fall onto the floor — can cause injury, disability or even death. It is impossible to prevent all falls, but many falls can be avoided by removing safety hazards (e.g., poor lighting, slippery floors, clutter or the wrong bed height), using assistive devices like walkers and correcting vision problems. Some medications also put people at risk for falls and should be avoided. Muscle-strengthening exercises can also help.

Reducing the number of falls is an important goal, as long as this goal is not reached through the regular use of restraints or because residents are not as mobile as they should be.

This information is misleading in that we have no idea of the residents' health issues in the long-term care. Physical restraints may be necessary for particular health issues. My late father kept falling out of his wheelchair and a restraint provided us some safety. He had a brain tumour and dementia.
Also, infection rates: flu, or infestations, e.g. scabies, need to be reported.

What you should know before you choose a LTC home
Violence and abuse should be reported: resident to staff, resident to resident.
Staff training initiatives.
Activities in the home. Most have a monthly schedule, with regular and special activities. LTC must report on resident's activities. Retirement homes do not.
Know whether it is for-profit or non-profit, Canadian-owned, or US conglomerate.
Staff turnover is a good indicator, but is not reported.

Public Reporting Indicators for LTC

The public reporting indicators for long-term care LTC used  were selected following a rigorous and evidence-based process that included:

• an environmental scan of long-term care indicators in use in Ontario and other jurisdictions, and public reporting mechanisms;
• consultations with academic experts (a Scientific Expert Panel); and
• consultations with representatives from the People Caring for People Implementation Team, led by Shirlee Sharkey, President and CEO of Saint Elizabeth Health Care and author of “People Caring for People: A Report of the Independent Review of Staffing and Care Standards for Long-Term Care Homes in Ontario.”

These groups chose indicators that can be accurately measured and influenced by homes.Click here to read the scientific panel’s report, “Long-Term Care in Ontario: A Report on Quality.”

Other Public Reporting Efforts

Wait Times in Hospitals As part of a provincial strategy to improve wait times for surgical procedures in Ontario hospitals, the Ontario government, through the Ministry of Health and Long-Term Care, reports to the public on wait times for individual procedures and at a facility level, through the Ministry’s website.

Patient Safety in Hospitals In September 2008, the Ontario government, through the Ministry of Health and Long-Term Care, started reporting to the public on infection rates and other indicators of patient safety in Ontario hospitals through a new website.

Nursing shortage

There is currently a shortage of 11,000 nurses, and by CNA estimates, it could increase to 60,000 by 2020 if the situation is not remedied.
Hill Times

Video cameras in long-term care and retirement homes

'Granny cams' might ease long-term care concerns 

In 2009 we learned about the story of Janet Brumell, who had placed a hidden camera in her mother's room at the Longworth Retirement Residence in London, Ont.

It caught her mother, 88-year-old Jean Holden, falling to the ground, an event the family would not have known about without the camera.

Hidden camera reveals nursing home neglect, lawsuit filed

13 Jul 2011 – Jacqueline Rioux, girlfriend of this dementia resident, is suing the long-term care facility for negligence. The public nursing home [long-term care] in Quebec where her 68-year boyfriend is a resident, walked unsteadily across the room, while an employee in the doorway encourages him to fall.

In French, she says, “Fall, fall, hurt yourself. Then you’ll go to the hospital, I’m fed up with you.”

This kind of attitude must be monitored by staff, and personal support workers (PSW) can be the best advocates for residents. Most PSWs have only the utmost concern for our loved ones. This is why a registry and the regulation of PSWs must be enacted.

While falls are a normal part of some disorders, there are strategies to prevent them. Ask what the protocol is in a facility. My late father had to be belted into his wheelchair. With dementia, mobility issues, and a brain tumour that caused balance issues, we knew he was falling.

But there is a difference between the verbal abuse in this video.

Meals on Wheels and Long-Term Care in Lanark County

Meals on Wheels

Lanark Lodge is the site where meals are prepared for Perth's Meals on Wheels program. Lanark Lodge has earned a high satisfaction rate by its residents.

My husband delivers and dispatches Meals a couple of day a week. We gave a tour of the facilities to Dr. Brian Goldman, of White Coat Black Art.

They have an easier time finding those who will deliver meals, than those who will dispatch. Dispatching takes a great deal of time and organization. Hubby, Joe, arrives around 10 a.m., and doesn't leave until the last meal goes out, about 11:30.

Hubby and volunteers for MOW

Dispatching means that they talk to the retirement home staff, chef on duty, dietician, kitchen staff. Then they determine which meals will be served. Next, the dispatcher stamps each lid with the date, writes on the recipient of the meal tray. One staff member helps volunteer delivery drivers put the meat, veggies, into the trays. They check their dispatch lists, ensure diabetics have the right food, those with food preferences don't have, for example, chicken if they don't like it. Then those delivering take the cooler bags and off they go!


Lanark Lodge, 1967, Municipal Home for the Aged. Lanark Lodge Handbook, 2008.



Many LTC have posted FAQs.
What if I cannot afford semi-private or private rates – will you switch me to a basic room?

Lanark Lodge - where Meals on Wheels, Perth, is prepared.

Any newly admitted resident is not eligible for a change of accommodation level for the first year of residency. The reason for this is that for Lanark Lodge there are shorter waiting periods for private and semi-private rooms. Therefore, to allow early movement could result in the potential for manipulating an earlier admission. However, after one year, application in writing can be made asking for a lower accommodation level, and the resident is placed on a waiting list.

LL is next door to Perth Community Care Centre (PCCC) where I volunteer. PCCC site is 100 years old.

PCCC
It has changed ownership over the years...

PCCC - I volunteer, friendly visits every Thursday!

Lanark County's House of Industry - 1903
Wiseman's Chronic Hospital - 1948
Tayview Nursing Home -1967
PCCC - 1985

Long-term care litigation

Dad needed a mechanical lift

Falls occur for many reasons. Many seniors refuse to use walkers, or other aides. (Adult children complain about this a lot.) My father, with dementia, was desperate to get out of his bed, wheelchair, and staff put pads around his bed, which they lowered to the floor. He was unable to walk, yet kept trying to get out of bed to go to the bathroom. Sometimes they are self-inflicted wounds due to stubbornness, ignorance, or psychosocial issues.

This PSW litigation (below) is poignant, since many people are 'two-person' lifts. It must be a lesson learned. PSWs must be aware of policies, protocols, individual treatment plans, Scope of Practice. It takes time and energy to read a client's file, which is why continuity in caregiving in a setting is important.

I fought hard with staff to treat dad using palliative protocols.
My husband injured his back after lifting my dad. Dad would beg us to get him in and out of bed.

Mission Creep is bad news.

Caregivers must be vigilant NOT to do things that would be dangerous. I cannot tell you how many PSWs and volunteers report back issues. I know of a volunteer, working with a friend, who was asked to take her down to the toilet. She hadn't been out of bed for days.
While I was volunteering a PSW new to the case was asked to do the same for the client. She, too, hadn't been mobile for days and was at great risk for a fall.

Caregiver not only need information, but must be aware of each case, the treatment plan, status of mobility, and risks cannot be taken on the part of the caregiver or care recipient.

Check out this comment on a previous post:
"I too am a caregiver, working alone in the Client's home. While I am not concerned for my life, I am concerned about injury due to inappropriate tasks being assigned.
In another position I had a few years ago I worked with a man who had a history of sexual inappropriatness.
Both of these positions were funded by the local office of the B.C. Ministry of Health under a programme in which the client administers the funds themselves.
My question relates to ultimate responsibility. In cases where a caregiver is injured, or killed, what responsibility is carried by the agency that oversees and funds the care?"

Nursing home worker charged in senior's death in Pickering

The Canadian Press

Date: Friday May. 27, 2011 7:28 AM ET

PICKERING, Ont. — An employee of a Pickering, Ont., nursing home has been charged after an elderly resident died from injuries suffered in a fall.
The worker allegedly moved a 91-year-old female resident by herself on March 20, in violation of the resident's personal care plan and the home's policy.

The resident hurt her leg during the move, no fall reported, taken to hospital with a fractured femur on March 23 and died on April 4 due to complications.

Diane Peck of Pickering is charged with criminal negligence causing death and failure to provide the necessities of life.

Advance Care Planning

A new tool to support patients and caregivers at the end of life offers customized reports that are designed to facilitate and improve communications between patients, caregivers and health care professionals. This video explains why it's important to talk about end of life care preferences - for more information about the CANHELP tool, visit: www.thecarenet.ca



US video A documentary on `Having the Conversation`:

An intimate story about the American struggle with communication and preparation at the end-of-life

Tired of being blamed for health care costs?

Which generation are you? Heaven help you if you are a Boomer. Many of us are active volunteers.

Myself and Mary - Hospice Muskoka volunteers

The Characteristics of Boomer Volunteers
   • Clear leaders -- in terms of average hours of volunteering compared to other groups
   • Impressive overall participation rates – consistently among the highest
   • Meaningful engagement – boomers look for purpose in their volunteer activities
   • Available time and flexibility – boomers have more time and relatively flexible schedules compared to other groups
   • Expectation of organization – boomers want organizations to be efficient and effective in their management of volunteers and staff
   • Loyalty – Boomers indicated they are willing to stay at an organization for many years as long as they are treated well


You've heard of the 'Silver Tsunami', the aging of the baby boom generation, but many of us are living longer, healthier lives. The myths, and the negative language, and the general attitudes to those of us who have helped shape this country.

ccmd1 Chris Carruthers MD 

Ont long term wait dramatically increasing. Blocked hospital beds. Future not good as wait times will worsen http://bit.ly/mQnFK3

A 'blocked bed'? We don't call ALCs that pejorative term, bed blockers. Alternative level of care (ALC) patients need to be somewhere, until a suitable placement is found. I am shocked at attitudes.

The women who did not have maternity leave when caring for children.
The citizens who have contributed to Canada, and our healthcare system.

In fact, numerous studies indicate that the aging of the population is too gradual to rank as a major cost driver in health care, and that it’s more of a glacier than a tsunami. 

Debunking the 'Grey Tsunami' Meme

by Alan CasselsDrug-policy researcher, University of Victoria; expert adviser, EvidenceNetwork.ca.
While the aging population is contributing to increases in health-care spending, increased utilization (more drugs, doctor visits, surgeries, and diagnostic/screening tests) is contributing about four times as much. Maybe the grey tsunami should be rewritten as the “tsunami of over-medicalization.” A British Columbia study found that, over the past 30 years, population growth accounted for seven per cent of growth in health-care spending, while aging accounted for 14 per cent, inflation 19 per cent, and increased utilization 59 per cent.

And another: They cite a study, finally!

Canada's elderly not likely to swamp health system

The Canadian Press

Date: Monday Aug. 29, 2011 4:27 PM ET

VANCOUVER — Fears that Canada's aging population could lead to soaring health-care costs may be greatly exaggerated, say researchers, who suggest that the predicted "grey tsunami" may turn out to be more like a "grey glacier."

Two studies by health economists at the University of British Columbia say other factors are driving up health-care costs -- primarily the growing use of specialists, increasing diagnostic tests for the elderly and higher consumption of ever more costly drugs.

Caregivers need information

It took 5 RCMP officers, and pepper spray, to capture this man know to prey on females.

Terrence Saddleback, targeted women, had mental health issues.

Declared by the courts not fit to stand trial. He weighs about 250 lbs. had attacked a woman before, in a LTC facility. 

Caregivers in Camrose should have been warned. The man needed a better placement than LTC. He needed a lockdown facility, yet people are so frightened of trampling on care recipient's rights.

risk assessment 

A PSW registry needs to go both ways. We are so concerned with Elder Abuse, that staff in LTC go unprotected.

Report warned of patient's violent behaviour  Man was charged with killing caregiver 18 months after risk assessment 

By Karen Kleiss, Edmonton Journal

June 29, 2011  

Olmstead filed his report Aug. 25, 2009, 18 months before a colleague found Canadian Mental Health Association worker Valerie Wolski dead in
Saddleback's Camrose home on Feb. 13, 2011. Wolski, 41, had been
strangled. 

A risk assessment completed more than a year before Saddleback allegedly strangled his caregiver to death says the 26-year-old was “unpredictable” and that staff should have access to a “locked panic room” where they can take refuge when he became violent.

Caregiver not warned of danger on MSN Video
	video.ca.msn.com/watch/.../caregiver-not-warned-of-danger/16adfxd834 days ago A 2008 report warned that a mentally disabled Alberta man, later accused of killing his mental health worker, posed a threat to anyone who cared for him.