End-of-life care has become to be more accepted as North Americans have begun to understand that dying is a part of life, and life is a part of death. Much can be done to ease the transition from life to death.
Many of us want to die in our own homes, which can be facilitated by a health care team providing resources and support. There are many human resources and technology tools to assist you: home visits by palliative care teams, oxygen to ease breathing, hospital beds, devices such as walkers or commodes, special foods, appropriate nourishment, mouth care techniques. These are all designed to keep a care recipient and his/her family comfortable and more relaxed.
Not all are suited to being cared for in the home. This is another choice a spouse or adult child must make. And no one can make you feel guilty for doing so. Your family member's safety is at risk.
Once a family member passes over, the work of grieving begins.
Volunteer Hospice Visiting Services run regular groups for the bereaved. Check them out in your town or city. There is strength in sharing your grief.
Coping With the Holidays
You have choices. For those who are bereaved, changing a holiday tradition may be a good way to manage. For some the added stress at this time of year may cause too much pressure. For others, keeping up with the decorations, the holiday cards, music, food, and traditions, gives a framework and a foundation to the season.
Give yourself permission to do only what you feel most comfortable with, and doing only the things you have the energy to do. Give yourself permission to change it up.
Thinking of others may give you some joy. Finding a place to volunteer can help. Many who are grieving, or far from extended family, take in others who may be similarly alone and grieving. They call them ‘Orphan Turkey Dinners’, and invite anyone else who might be alone. Everyone brings a contribution to the meal as you break bread together.
Understand that grief and bereavement is a normal cycle of life. Give yourself permission to cry. Tears heal. On the other hand avoid situations where your grief may not be bearable at this time. We all grieve differently, at a different pace, in different ways. If you need to avoid the stores, with their Christmas music, do so. If you need to take a vacation, give yourself permission to leave town. Bring your grief out when you are able to manage.
If you choose to carry on with a family celebration, honour your loved one by sharing favourite memories. At a family gathering, place a box or a basket near the door. As people arrive, ask them to write a memory of your loved one on a piece of paper and leave it there. Find a moment to truly realize what it is that your loved one gave to the world. Hold these memories in your heart, and they will remain alive.
This is an excellent article. It puts it all into perspective. No more pre-cancer mastectomies. Be aware that there are many non-cancerous lumps. Screening tests do not screen well.
2. Why I support the new breast cancer screening guidelines DR. CORNELIA BAINESTo sum up, a number of reasons explain why some do not like the guidelines. Women are afraid of breast cancer and have faith in mammography. Doctors fear litigation if they fail to recommend screening for a woman who subsequently develops breast cancer. And even when doctors are informed about expert guidelines, many tend to ignore them. Politicians, especially in the U.S. are loathe to provoke the ladies with pink ribbons. Last but not least are very real but usually ignored conflicts of interest.
Dr. Cornelia Baines, professor emerita, Dalla Lana School of Public Health at the University of Toronto.
Employment Insurance Compassionate Care Benefits are available to people who have to be away from work temporarily to provide care or support to a family member who is gravely ill with a significant risk of death.
With a palliative diagnosis, a family member in Canada can qualify for a Compassionate Care Benefit (CCB), as long as the doctor is willing to make this diagnosis. Also, there are financial reasons in terms of an estate, to claim disability on a tax return. Unfortunately, doctors are not always willing to predict death within 26 weeks, a requirement of the CCB. This is a gross error on the part of government. This is the financial impact to the (mostly) women who care for palliative family members.
This leave has been in place for several years. Unfortunately, the barrier for me was not knowing how ill my mother was with cancer. No doctor could have predicted her death within 26 weeks. In fact, she died 6 weeks after I moved to be nearer to her. My late father's brain tumour was the same. Not knowing when end-of-life would occur, we bravely faced his increasing dementia week after week, as I continued to work as a teacher. He lasted 9 months when the tumour returned.
With Ontario's Family Medical Leave, you're eligible for up to eight weeks job-protected leave from work in the event of a loved one becoming gravely ill. You can stop work and care for them, knowing your job will be there when you get back.
An employee can take Family Medical Leave up to eight weeks to provide care or support to certain family members and people who consider care recipients to be like a family member, qualify for this leave if a qualified medical practitioner has issued a certificate indicating that the care recipient has a serious medical condition with a significant risk of death occurring within a period of 26 weeks.
Ontario's Family Medical Leave is available to you whether you apply for federal Employment Insurance compassionate care benefits or not. If you are applying for Employment Insurance (EI) compassionate care benefits, a copy of the medical certificate submitted to Human Resources and Skills Development Canada may also be used for the purpose of family medical leave.
Care or support includes: providing psychological or emotional support, arranging for care by a third party provider or directly providing or participating in the care of the family member.
Six weeks of Employment Insurance benefits called Compassionate Care Benefits may be paid to EI eligible employees taking Ontario's Family Medical Leave.
For information about EI Compassionate Care Benefits, please call your nearest Human Resources and Skills Development Canada (HRSDC) office or call toll-free to 1-800-206-7218. Find out more about Ontario's Family Medical Leave.
After my radio interview, I've had several e-mail asking for help.
The issue with Canada is that each province handles healthcare differently.
In the US, each state has its own laws.
There are two areas in which Canada is vastly different from the US: education and healthcare.
In my post-career work as a healthcare advocate, I have seen how American pharmaceuticals have influenced healthcare policy in the US. I have witnessed how private health insurance in the US means that the poor suffer, while the rich can pay for insurance plans. How different it is in Canada, where, in theory, universal healthcare is a state-granted right.
Some of the healthcare policies, such as Alberta permitting concierge healthcare, is a concern. We move into dangerous territory where profits trump the philosophy of universal healthcare.
In Ontario, we outsource many services to for-profit agencies; Red Cross, VON, and smaller firms.
CCAC determines the Home Care a newly discharged ALC or hospital patient will receive.
They hire outside agencies, who compete for contracts through RFPs, to send personal support workers and nurses into people's homes. This seems to make sense, in that CCAC, and Ontario's provincial government hasn't the money to organize the 5,000 workers Bayshore hires across Canada. Their profits determine pay scales, and wages.
In certain situations, when nursing staff are depleted, or vacation season drains staff levels, many employers will call in other agencies. For example, a long-term care, which pays a salary, and often carries sick leave and provides PD to regular staff, may call in a nurse or personal support worker (PSW) on a short shift. Short shifts are the thorn in the side of healthcare. Residents and patients need continuity, and staff need to rely on sick leave. There simply aren't the number of nurses and PSWs available to meet needs. And if those with money can afford to pay more for private nursing, we drain the supply.
Bayshore Healthcare Ltd. is a private company categorized under Visiting Nurse Service and located in Mississauga, ON, Canada. Current estimates (2011) show this company has an annual revenue of $452,316,800.
Bayshore Home Health is Canadian owned and operated, since 1966. They are the country's largest provider of home and community health care services, with more than 50 home care offices, 20 community care clinics and 8,000 employees. They deliver care to more than 70,000 clients annually.
They offer nursing, personal care, home support and companionship services privately, as well as through government care programs (e.g., Ontario's CCAC Home Care), personal and group insurance plans and workplace safety insurance.
They provide nurse/caregiver staffing services, health education programs and treatments in community dialysis centres. Their subsidiary, Bayshore Specialty Rx, delivers a wide range of infusion pharmacy, infusion clinic and pharmaceutical support services to health care and pharmaceutical organizations.
The Credit, Up To $1,500 Each Year, Would Be Available To Senior Homeowners And Tenants, And People Who Share A Home With A Senior Relative.
The Credit Would Be Effective October 1, 2011.
Examples Of Eligible Improvements Would Include Stair Lifts, Walk-In Bathtubs And Ramps.
Unused assistive device
The notion is to keep seniors in their homes longer. It is an interesting notion, but one that fails to grab me, if you'll excuse the pun. If all it takes is a chair lift or a walk-in tub to keep a senior at home, then one is sadly mistaken.
It'll cost the Ontario government 60 million dollars. Money better spent delivering services to those who need them, or assisting seniors in getting to appointments, finding respite care. I did a bit of research and one quote for a walk-in bathtub was $1899. A chair lift: $1349. Seriously. I don't know that that includes installation!
Mechanical lift in my late father's LTC
It is a laudable initiative, but there are many seniors who live in small apartments who need a broad range of services. How much farther would $60 million go if seniors, or their families, could hire paid caregivers, as in the initiative out west?In 2010, Saskatoon Health Region set up the Direct Client Funding Program - a pilot project that provides a way for unpaid caregivers to get paid.
Seniors, in Ontario, benefit from a number of tax credits. This works fine, if a senior has an income.
But for low-income seniors, especially the ones on a pension, it is a drop in the bucket. In the meantime, seniors who are high income earners can do renos to their heart's content, while the rest of help carry that tax burden.
Addictions, filth, despite CCAC delivery of services
There are many place to go for assistance with chair lifts and railings. Any local mobility and assist specialist can advise you on special programs that will financially help a senior with a debilitating or chronic care issue (e.g., MS, MD, March of Dimes, cancer societies; brain injury associations, arthritis, Parkinson, Easter Seals; see CCAC's PDF file), to install assistive devices. The walk-in bathtub, to my mind, is misleading. There are many seniors who should not be taking a bath alone. This is what Home Care, through the CCAC, should be paying for, and does pay for, should you require them. See the Assistive Devices Program.
Assistive Devices Program: Product Manuals and Approved Prices
The Ontario Energy and Property Tax Credit provides up to $1,044 to seniors, and the Ontario Sales Tax Credit provides up to $265 a year for each person in a low- to moderate-income family. Both were enhanced in 2010 to better reflect circumstances facing low-income seniors. Senior couples receiving the guaranteed minimum level of income from governments can receive the full benefit of these credits.
Ontario Senior Homeowners' Property Tax Grantis an annual benefit to help offset property taxes for seniors with low to moderate incomes who own their own homes. The maximum grant is $500.
Clean Energy Benefit. The benefit provides a10 per cent rebateto help manage rising electricity prices for the next five years.
With all the research I have done, screening tests are, at best, iffy. Far better to self-examine, know your own body, and if you in a high-risk category, talk to your doctor. If you have symptoms it is a different story. But in these cases you want a more expensive, diagnostic test that is beyond screening. We don't know how many people have had mastectomies that were contra-indicated, and truly did not have cancer. It is a very individual process. Mammograms on those <50 are not effective due to less breast density. This is true, too, for PSA tests.
Without symptoms, these tests do not prove their merit.
The screening tests, without symptoms, have not shown any better results in mortality. For every 1000 - 1500 mammograms, they find one case of breast cancer. Many women are having radical surgeries without actual cancer. How many needless surgeries are taking up operating rooms when a life can be saved with required surgery?
The American system, where-by huge lawsuits are awarded, has resulted in a physician culture where overtesting, with inaccurate screening tests, means that physicians protect themselves.
In my 20 plus years of practice I have never seen such bewildering recommendations released as Canadian guidelines for breast cancer screening. It’s a serious watershed. Curbing costs have trumped saving lives.
As your lifestyle changes, and you enter into a slower pace of life, it is important to pay attention to portion control.
I found this was a very slippery slope. Not only did I retire suddenly, but was suffering caregiver issues as I tried to look after my father's health.
As a teacher, I knew the importance of working out, and taking time to relax, refresh, spend time with family and friends. All that went by the wayside when first mom and then dad became ill.
Then we left our support structure of family and friends.
I had to quit work. I spend almost every day going in to feed dad dinner. Afterwards, dinner out, a couple of glasses of wine, and the weight piled on, especially with restaurant servings and the ubiquitous bread.
Instead of working out after work, I would do a workout in the morning. This helped with stress relief.
Long walks, lots of reading, and hobbies: gardening, choral singing, and photography.
As you decrease physical activities, you must also decrease your portion sizes. I was on my feet, teaching, all day, five days a week. It took me a long time to get back into the swing of things. Eventually, I got back into a new routine of volunteering, but life has surely changed.
Now that I am middle-aged, I have to be firm with myself and this is one of my goals. Now that I have a new routine to my day, morning exercise, walks with the cats in the forest, and volunteer work.
There is a light at the end of the tunnel. I only did what I could manage for my dad. When I needed a day off, I took it. They say you have to put the oxygen mask on yourself first. This is so true.
Caregiver stress has a huge impact on caregiver health.
Here is a May Clinic that may help you with your own portion control.
The beauty of the healthcare system in Ontario, is the ability of each LHIN Board of Directors to create policy, advocate and create initiatives for a particular region. Unfortunately, individual cases of inequities are only coming to light when the media becomes involved.
The ugliness of this system in each LHIN's regionally-driven program, as an example, means that the Sunshine List (employees making more than $100,000 in salary) has increased while real wages for lower level staff have not seen such increases. This isn't sitting well with most. This is why the Occupy movement has impacted us all.
If we want everyone to have accountability, PSWs as much as doctors, nurses and hospitals, if we want to draw the best PSWs, as well as the best nurses, with the most upgrading, education and training, we're going to have to shorten the chasm between hospital CEOs and PSW wages. I firmly believe we draw the best leaders with good salaries. I also believe we must pay a fair wage to those seeking to earn a living in the homes, institutions, and facilities where our frail, vulnerable seniors live.
My local S.E. LHIN Red Cross-employed union of support workers has resulted in fixed wages for 3 years for these PSWs. This means, in real terms, $15.03/ per hour to go into people's homes, change adult incontinence products, change bedding, and provide intimate care for loved ones unable to care for themselves. And no salary increase for three years.
Local citizens find it hard to stay on top of their local LHINs, and those who do are blocked (specifically in cyberspace–for that is how taxpayers can keep up an awareness and generate buzz) in a politically driven healthcare system. The famously, highly-touted Aging at Home Project is one of the tax-payer driven systems to help seniors stay in their homes longer, with some support. A Win-Win for politicians, it is an elderhood issue, driven by those who need a bit of help. In my region, SE LHIN, it is estimated that by 2016 1/6 citizens will be seniors. Again, there is a need for locally-driven responses to specific populations. It is an important part of the LHIN. But the provincial government cannot stand back and stand by, washing their hands to avoid particular issues.
Gag orders, it has been written, are the norm in Guelph, says the Guelph Mercury. The matter was most recently advanced by Mercury letter writer David Williams.
In our area, according to the Waterloo Wellington Community Care Access Centre’s own statistics, between the 2008-09 and 2009-10 fiscal years, funding increased from $87 million to $100 million. Despite this increase, in the same period, again according to their published numbers, total nursing visits went down, total therapy visits went down, information calls went down, and the total number of clients serviced went down. The only service provision increase was in personal support worker hours, which was marginal.
There are many for-profit Transfer Payment Agencies (TPA) who operate on tax dollars, through the LHINs, having bid in an above-board RFP process to deliver services to our frail children and seniors in their homes. Agencies include for-profits and non-profits. There appears to be no distinction to me. What is risky, to me, is that there is much opportunity for abuse of the system and of individuals, and it is a slap in the face to all those who fight for transparency in the healthcare system.
What is the impact of a gag order on individuals?
It is specific, harsh, and turns into issues such as Elder Abuse. An issue toward which huge sums of money have been devoted provincially and federally.
Our government transfers tax dollars to for-profits, and non-profits alike: hospitals, senior's supportive living facilities, long-term care and retirement homes. The CCACs, Community Care Access Centres, also contract out services, such as nursing and PSWs, to local for-profits, to ensure that seniors in their homes have the care they need for their ADLs (activities of daily living): toileting, meals, light housekeeping, grocery shopping, bedding changes, on the part of PSWs; and IV lines and wound care, for example, on the part of nurses.
With the vast numbers of seniors, and developmentally disabled children, in their homes or institutions, the government does not have enough resources to take care of these needs themselves. They must outsource to these agencies and institutions. HOWEVER, and this is a big one, the for-profit long-term care (LTC) homes consist of about 5/6 of the 600 LTC homes in Ontario. The evidence is clear: there is abuse. I volunteer, or have had access to, several retirement homes and many LTC homes (for-profit and non-profit), and have never seen an incident of abuse. I have seen many incidences of neglect. It has been quite frequent that I have seen far below standard services delivered to those in dire economic straights. Poverty is a huge predictor of ill-health. It is also, in my experience being caregiver to mom sine 2006, and volunteering in healthcare since then after her passing.
In these situations, a TPA sends in support, but with no standard education, no regulation, training, monitoring or accountability for these PSWs, with an inability to speak truth to power, i.e., gag orders, this is the reason why we will continue to face horror stories in the media. This is why we may come to believe that the millions we spend in creating Elder Abuse prevention initiatives are the political panacea for elder abuse. This is why and how politicians can smugly purport to have studied, and created a solution for these issues. This, also, is the reason why we need an OMBUDSMAN for the MUSH sector; Municipalities, Universities, Schools, Hospitals. There must be an avenue for whistle-blowers.
Abuser is usually a staff member or other residentnt
A private nursing home chain enforced such strict rations on diapers that staff wrapped residents in towels and plastic garbage bags to keep their beds dry.
Public Sector Salary Disclosure 'Sunshine List' The Public Sector Salary Disclosure Act, 1996 (the act) makes Ontario's public sector more open and accountable to taxpayers. The act requires organizations that receive public funding from the Province of Ontario to disclose annually the names, positions, salaries and total taxable benefits of employees paid $100,000 or more in a calendar year
TEDxToronto - Dr. Brian Goldman - Redefining the Practice of Medicine
He admits his mistakes, speaks truth to power. A respected medical journalist for CBC Radio, and Emergency Room (ER) Physician in Toronto's Mount Sinai.
This physician is an amazing person. If anyone can improve the healthcare system in this province, in this country, it is Toronto, Ontario, Canada's Dr. Brian.
His premise?
We need an environment that supports the admission of error, the correction of those errors, and a redefined medical culture, starting with one physician at a time.
*Dr. Brian admitted to several mistakes he made in his ER. And he tells us that they were not made in his first five years of practice, but spread out over his many years as an ER physician and a medical journalist.
Have you ever been in an ER?
The kids singing at the top of his lungs, the people coughing into face masks, the contractors holding a bleeding arm/hand up in the arm, while blood drips down to the ground. In inner city situations, I cannot fathom how patients can sit there watching the walking wounded file in.
I feel that an ER physician is a very different specialty than others. They must juggle the sublime, to the severe. From stitch that needs removal, to undiagnosed congestive heart failure, epiglotitis, appendicitis, many are faced in this same ER. All this faced with patients sitting watching their watches, pain, blood, children crying. Then comes the follow-up treatment plan, the medications, and a home care plan. Difficult to do when there is a 4-hour wait. This, too, is something best done by a GP, family physician, over time.
There are three ways, Dr. Brian says, in which ER physicians can show their measure as an ER doctor:
those who who make mistakes and those who cannot
those who can handle sleep deprivation and those who cannot
those who can handle failure and those who cannot.
Alone, ashamed and unsupported, a physician toils in the ER and may use addictions, and cover-ups to deal with the pain of failure, sleep deprivation and making mistakes.
In his 20 years of medical broadcasting, he has learned that errors are absolutely ubiquitous.
Errors in prescriptions of 1/10, hospital-acquired infections abound.
In Canada, this medical journalist tells us, something like 24,000 die of medical errors every day.
If you weed out error-prone healthcare professionals, there won't be any left, especially in the busy ER. We must improve patient safety by addressing the mistakes, working as a medical team where each member feels free to call up one another before a mistake is made, at the time. This, according to The Emergency Room Nurse, is something physicians have a hard time accepting.
Read 'When Nurses Write About Physician Bullies, Don't Shoot the Messenger'
These are the bullies, we've all faced them in the workplace. The people who have such a need for power that can can discount a wise nurse who speaks out in truth.
Now, my point is, that while some conditions present themselves, in an emergency situation, many issues can be prevented, and diagnosed before they become serious. If you wait until you are in such pain that you are in agony, the ER is a difficult place in which to sit. If we all had access to a physician, which isn't the scope of this post, we would have less-crowded rooms.
Dr. Brian feels that physicians who make mistakes sit alone, ashamed and unsupported.
The difference in Dr. Brian's practice, and other's, seems to be his statement, "I asked my colleague to reassess this patient." In these cases, mistakes were prevented by collaboration and consultation.
THIS is what will improve healthcare.
He talks about his mistakes, finds the still small voice that makes learning happen, and creates a climate where all those on the healthcare team can and must participate in patient care.
Healthcare practices in Canada Influenced by the USA's for-profit system
The system that we have completely denies mistakes. I have written previously that I believe I know where this culture of denial comes from. It is the US-based system of medical practice in which insurance companies cannot accept mistakes, where pre-existing conditions are denied medical reimbursement, and the terribly litigious world of US healthcare. Where US hospitals are rewarded financially, "Hospitals with best patient satisfaction to draw in reimbursements."
US healthcare where,
The US healthcare system is a for-profit system, although revamped, in which patients must sue in order to gain compensation, and reimbursement of the vast sums of money required to seek redress, therapy, and beds in long-term care, support from rehabilitation centres. In Canada, a sense of closure seems to arise when patients sue a doctor for malpractice, for incompetence. (CTV News - Brain-damaged boy's family sues health officials)
Mistakes or Incompetence
Fortunately, there is a difference between mistakes and incompetence. When we know better we do better. Truly, the College of Physicians and Surgeons must determine this difference and create learning opportunities for those who make mistakes, and curtail the practices of incompetent physicians. I reported my father's doctor to the College. I tried for nearly a week to get adequate pain management for my late father. This GP, attached to the LTC, was unreachable, and the Charge Nurse, whose job it was to make a call to him for morphine, told me to contact the doctor myself as he wasn't responding to them. The follow-up by the College was fabulous. I felt closure, and that lessons were learned.
System Errors
Not ferreting out the problems as we should.
Admitting the difference between a mistake or error, and incompetence. (Such as the incompetent pathologist, Charles Smith.)
In a hospital system where medical knowledge doubles every two years, it is impossible to know everything.
Failing to create a culture of collaboration for ALL STAKEHOLDERS, as well as inclusion of those who directly serve the patient (patient, doctor, nurse, family, hospital, caregivers).
Human Errors
Sleep deprivation is a given, you must be able to cope.
Inability to deal with stress.
Cognitive biases during diagnosis in the ER; alcohol on the patient's breath, gender and socioeconomic biases, all serve to confound an accurate ER diagnosis.
Yet I have to say, in my experience, the attitude that MDs must micromanage every element of patient care is slowly disappearing among physicians. Occasionally you get one who appears to have slept through the lectures on collaborative practice and the critical role of nursing on the health care team, but this is increasingly rare.
These are the Charge Nurses who fight with, for or against a doctor or colleague for better treatment of those who are weak, vulnerable and at-risk.
These are the PSWs who work to provide care, who can speak of their residents issues without fear of censure by the nurses who may deride them for their ignorance.
It is the wise professional, nay, cancel that, it is the wise person who can admit a mistake, make reparation for it, and promise to do better, get retraining, therapy, help, and support.
Medical malpractice is based on crime, punishment, prevention and deterrence. The theory is that without patients suing doctors, they won't be inclined to improve their practice. According to opinion surveys of physicians, the system creates incentives to undertake cost-ineffective treatments based on fear of legal liability—to practice “defensive medicine” (Harris Interactive, 2002).
The best professional strives, by promising to remember, to learn one thing from what happened that s/he can teach to someone else, in a loving, supportive way.
Defensive medicine can take two forms: positive and negative. Positive defensive medicine involves supplying care that is unproductive, not cost effective, or even harmful. Negative defensive medicine involves declining to supply care that could be beneficial; it also includes physicians deciding to exit the profession altogether.
Positive defensive medicine is driven by moral hazard from health insurance, which means that neither patients nor physicians bear most of the costs of care in any particular case. Negative defensive medicine is driven by two facts: that patients reap substantial surplus from medical care for which they cannot adequately compensate providers, and providers bear malpractice risk for which they cannot fully charge patients.
We need to receive care in a culture of medicine that accepts that individuals make mistakes. For victims to be awarded millions of taxpayer dollars costs the Canadian system much. Prevention is much less expensive.
We need back-ups to catch mistakes, and must fosters places where all participants can call up and prevent mistakes, and honour those who speak truth to power.
Strive to learn one thing to pass on to other people.
I do remember...
Dr. Brian's video runs 19:37, but it is well-worth the viewing.
*Dr. Brian, and while we've broken bread together, and he interviewed me in my home, I use this designation with the dignity and respect he deserves, not that which he demands.
Health officials and the Ontario College of Physicians and Surgeons found that Farazli had lax procedures for disinfecting gastroscopy and colonoscopy equipment over a nine-year period from April 2002 to June 2011.
The family of a 12-year-old Manitoba boy who suffered severe brain damage, allegedly the result of a routine tonsillectomy, has filed a lawsuit against doctors, nurses and the Winnipeg Regional Health Authority.
I am woman, hear me roar. When the men went off to war in 1945, the women worked in the factories: it was the War Effort. Some women did their part in their homes; some women provided childcare for their sister's children. Other women took their place in the work world. The men returned from the war, and the women were sent home. Women built war ammunition, and flew planes from factories to airfields, yet they were denied work in the industry after the war. They were sent back to their homes, competent people they proved themselves to be, still, gender bias prevailed. But they found a toe-hold.
I come into contact with many of these women in my hospice work. They are amazing. Michele, paraplegic in LTC, a nurse on BCs west coast for 41 years. Kay, nurse for 40 years. They paved the road.
My daughter, M. Sc., is a hard-working woman and the result of the encouragement my generation gave, as we fought the glass ceiling, the rights of women to remain in the workforce, despite the power-that-be believing we ought to remain barefoot and pregnant, or streaming us into teaching and/or nursing.
Being a physician isn't for all of us. Many women, parents, wives, contributing members of society, thanks to feminist principles, have entered the work force. Women are police officers, volunteer and full-time firefighters, contractors, veterinarians.
Some of us were meant to be teachers (as I was) or nurses, traditionally accepted work, but my generation learned that you must do what you love, not what society thought you should do.
I remember midwives (mostly women) as they fought 30 years ago with OB/GYN physicians for the right to serve health non-risky pregnant women. They won. My daughter gave birth, at home, to our second grandchild in dignity, calm, and the peace of her own bedroom, in her own bed. Attended by two midwives, who immediately taught her how to care for her wee newborn, what to remember, gave her a refresher on how to breastfeed, and visited her, at home, every day for a week.
I can see how nurses have fought physicians for the right to a better education, respect, and to serve patients, especially those without a GP. Nurse Practitioners have won recognition, independence and serve remote rural populations where doctors won't go. Still... some physicians bully nurses, and treat them disrespectfully. Doctors have invented Physician Assistants, a higher rate of pay than nurses, with less education. This saddens me. (Read more about Respect.)
Now, nurse managers in power (and the government) are trying to control the work and the practice of PSWs, as they strive to improve their practice, learning and working conditions, as they serve their clients. Agencies are treating their PSW staff the way they have been treated, domineering attitudes, negativity and disrespect. This must change.
Physicians bullying nurses still exists. (Framing the Discussion Around What’s Best for the Patient) Now, nurse managers are perpetuating this attitude and supervisory practice.
We know what works in healthcare: communication, collaborative practices, advocacy, respect, a flattened hierarchy that recognizes experiential learning, and the wisdom of years of experience on the front lines. Great male doctors are not be threatened by female nurses. The good ones recognize nurses' important contributions to healthcare in an integrated, collaborative team where Patient Outcomes are the priority.
I can see how PSWs are being treated as members of the healthcare team. WCBA Season Debut: Personal Support Workers and Seniors. In long-term care, and other institutional settings, PSWs recognize the intent of Ministry of Health and LTC standards. They recognize that while the law states that a resident must not be roused out of bed before 6:00 a.m., and yet will respond, in their busy morning routine, when an insomniac senior asks for help getting dressed. The nurse manage will reprimand them, with the dire warning that they violate the law. Managers, in their fear in this litigious society, fail to realize that there is a difference between a LTC and a prison, and that a resident must have their requests met if possible with time and energy constrictions. They understand that the intent of the law is to prevent for-profit LTC from acting like a prison, and denying a senior a simple request.
Change is slow. Organised groups, like OPSWA (with whom I volunteer), are fighting for internal accountability, independence and respect. The Ontario government, as it responds to the call for greater accountability, is still treating PSWs (primarily women) as a group they must take care of. This is no longer true. PSWs are learning, faster than some in the nursing profession, to become good managers. They intervene and respond to PSW/patient conflict as the mediators that our poor union brothers and sisters cease to be.
I will fight for you, with you, and the principles you stand for: better education, better training, respect, accountability, as you work with the most frail, needly, at-risk, vulnerable patients: our loved ones.
My dear friend, Kay Devlin (1916 - 2012)
Celebration of a life worth living!
It was my honour to sing Amazing Grace at Kaye's funeral. She was an amazing woman and she was well-loved. Lanark County was blessed by her energy and spirit.
Your visits mean so much. Volunteer, if you can. Consider doing a Life Review for family or friends who wonder about what to say or do during visits.
"Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around."
-Leo Buscaglia, author (1924-1998)
Volunteer
~it's good for you. Click on the image to read about things you can do.
Pouring rain, magnolia, lilacs droop; frost tonight?
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Poor Mr. Phoebe happy with all the bugs! Yes. The forecast if for
temperatures near freezing in the night. I could have covered my potted
plants, but I was...
Groundbreaking Ceremony May 9th, 2013
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*[image: Habitat NCR Nantes St Groundbreaking Version3] *
*Celebration Time: *More than 110 people gathered for the Nantes Street
Ground-breaking...
Biography
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Jennifer Jilks, retired teacher and educational writer, moved to Muskoka to
care for her failing parents. Her intent: to write a book about teaching.
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1 year ago
Jenn Jilks: Senior's Advocate
This site is for information only, and should be used to help you navigate healthcare and finding more health information. The best source of medical information is your family physician or pharmacist.
An educator, leader and lifelong learner, Jennifer is an avid reader, writer
and blogger. She has developed expertise in working with a wide range of professionals
in education and health care. This has helped her negotiate with medical staff
while advocating for her parents. She have served on several Boards of Directors. She holds
a degree in Early Childhood Education, also, a B.Ed. and an M.Ed. in Curriculum
and Technology, with experience teaching students from Junior Kindergarten to
grade 8, and a Special Education Specialist, she worked with many special needs
students. She has delivered workshops to peers, and lectured on a part time
basis at the University of Ottawa to student teachers.
Blog posts must not be copied, distributed, or reproduced in any manner, without the express permission of the copyright owner. All content is the intellectual property of the author.
Many of us want to die in our own homes, which can be facilitated by a health care team providing resources and support. There are many human resources and technology tools to assist you: home visits by palliative care teams, oxygen to ease breathing, hospital beds, devices such as walkers or commodes, special foods, appropriate nourishment, mouth care techniques. These are all designed to keep a care recipient and his/her family comfortable and more relaxed.
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