Almonte working to better address complex-care needs

Educational in-services, concerted efforts to address younger residents all part of plan

May 31, 2012 -- Deron Hamel 

An afternoon of music at PCCC

ALMONTE, Ont. - With long-term care increasingly seeing more residents with complex-care needs, Almonte Country Haven is working at finding solutions to meet the demands of these residents, who are often younger than the average person living in a home.

Ken Shepheard, 52, is one such resident. Shepheard has Huntington’s disease, a neurodegenerative genetic disorder affecting muscle co-ordination. He has been living at the Lanark County long-term care home about two months, and because of his young age it can be challenging to meet his needs. Both Shepheard and administrator Marilyn Colton acknowledge this fact.

For example, Shepheard is a big hockey fan, so the home has arranged for him to attend Ottawa Senators games. He and life enrichment aide Todd Cullen often go to a local Tim Hortons as well.

It’s these types of activities that are necessary for younger residents like Shepheard, and homes always need to be on the lookout for ways to meet their needs, says Colton.

CCAC sunshine list

OACCAC ‏@oaccac

@DavidRWilliams1 @jennjilks CCACs - neutral brokers who act on clients' behalf 2 ensure accountability. See pg 5: Policy analysts have done their homework. http://bit.ly/JhO81S #LHIN

Obviously PSWs, RPNs & HCAs have a vastly different definition of direct care than @oaccac. http://bit.ly/Jypgbt #LHIN

David R Williams ‏@DavidRWilliams1

Per 2011 Sunshine List, 135 people at #ORNGE earned $100k plus, yet there is not enough staff to fly helicopters? @deb_matthews?#onpoli

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16 MayDavid R Williams ‏@DavidRWilliams1

Average number of people earning $100k + per 2011 Sunshine List at each CCAC was 14. The @oaccac bureaucracy listed 36. #LHIN

National Physiotherapy Month May 14-18, 2012

LTA takes many to appointments through CCAC.
I took Princess Ducky with me one day!
I ride as a volunteer escort with clients
unable to navigate on their own.

Canadian healthcare is a different situation than our US neighbours. We all have tax money that goes towards paying for our systems. Each province and territory governs its own system, providing for smaller differences. The philosophy is that those with incomes can subsidize those with low income, living in poverty, to help ensure that their basic healthcare needs are met. We all pay a little, to help all of us a lot.

There are many for-profits that are paid to provide care for those who need it: Lanark Transportation Association picks up clients and takes them to city hospital, or rural appointments.
Bayshore Home Health, a company with many employees nationwide, sends PSWs and nurses into the homes of those who might otherwise be Alternate Level Care (ALC) patients in hospital.

God bless my physiotherapists!
Tenosynovitis!

 The US has many for-profits, including hospitals. The beauty of our system are non-profit healthcare delivery systems, transfer payment agencies that receive tax dollars to care for the frail, vulnerable and impoverished, as well as those who choose to hire healthcare professionals to make their lives easier.


Onother such agency is Saint Elizabeth

In conjunction with National Physiotherapy Month, Saint Elizabeth, a Canada-wide not-for-profit health care organization, celebrates Physiotherapists Week from May 14-18, 2012.

“Treating people of all ages, physiotherapists perform a variety of roles including helping clients rehabilitate after post-operative injuries and assisting those with neurological disorders,” says Nancy Lefebre, Chief Clinical Executive at Saint Elizabeth. “Saint Elizabeth physiotherapists work in homes and communities across Canada identifying the root cause of problems in order to reduce pain and increase health and wellness for clients.”

Saint Elizabeth has been a trusted name in Canadian health care for more than a century and is a leader in responding to client, family and system needs. As an award-winning not-for-profit and charitable organization, Saint Elizabeth is known for its track record of social innovation and breakthrough clinical practices. Our team of more than 6,500 nurses, rehab therapists, personal support workers and crisis intervention staff deliver nearly five million health care visits annually.

National Advance Care Planning Day

Advance Care Planning Day:  Launching a National Awareness Campaign to Improve End-of-Life Care for Canadians Still want to learn how you can help with the National Advance Care Planning Campaign? Want to learn more about Advance Care Planning and communications? Join us at the Canadian Hospice Palliative Care Learning Institute in Banff, Alberta, June 1-3, 2012. The Awareness, Information, Social Media and Advance Care Planning stream will teach participants how to create a successful communications and social media plan using the Speak Up: Start the Conversation about end-of-life care tools. This stream will also focus on Advance Care Planning through case studies and group exercises. Visit the Learning Institute website for details and to register.    Still need to make a plan? Want to help family members or friends? Visitwww.advancecareplanning.ca for some great tools and resources, including: a downloadable wallet card for information about your Substitute Decision Maker workbooks to help you and others make a plan videos to watch with family and friends conversation starters to help you get started Join the ACCEPT Study Collaborative! The ACCEPT Study is a multi-year, multi-centre, prospective audit of current practice related to advance care planning (ACP) in patients who are at high-risk for dying, as well as their families. Join the ACCEPT collaborative include and enhance end-of-life communication and decision making for patients and their family members. You will receive a benchmarked report of ACP activities in your institution, enabling you to see your strengths and opportunities for improvement. Click here for more information

PSWs May 16 was Personal Support Worker Day

I believe they must be regulated, and have better training. Too much harm is done, in my experience, by those who treat all clients the same. My dear friend was denied her food supplement, as requested, as the PSW thought that the rule was she couldn't have her Boost when she wanted it. Kay had lost 30 lbs. with health issues.
Kay is 100% functioning cognitively; she cannot eat solid food.

 PSWs are increasingly providing the majority of direct care services to elderly or ill patients who live in long-term care institutions or who receive home care. Unlike most other health care workers in Ontario, PSWs are not a regulated health care profession, meaning there is no governing body which sets standards for the skills and knowledge needed to practice as a PSW, and the services they can provide. Rather, PSWs have a role standard which says “personal support workers do for a person the things that the person would do for themselves, if they were physically or cognitively able”.

An estimated 57,000 PSWs in Ontario work in the long-term care sector, 26,000 work for agencies that provide community and home care, and about 7,000 provide care in hospitals.
From

Diabetic Special Diet Allowance

From Income Security Advocacy Centre (ISAC)

Are you on OW or ODSP?
Do you have “pre-diabetes”?

You may now be eligible for the Special Diet Allowance.

Download a printable version of this fact sheet here
If you are on OW or ODSP and have been diagnosed with pre-diabetes by your health care provider, you should apply for the Special Diet Allowance. You can get a Special Diet Allowance application form from your OW or ODSP caseworker. Instructions on filling out the form are available here.

If you lost your pre-diabetes Special Diet Allowance after the government changed the list of eligible conditions, you should re-apply.

You can also contact your local Community Legal Clinic if you need help with this issue. To find your local clinic, go here .


ISAC
ISAC was established in 2001 by Legal Aid Ontario to serve low income Ontarians by conducting test case and Charter litigation relating to provincial and federal income security programs. These programs include Ontario Works (OW), the Ontario Disability Support Program (ODSP), (un)Employment Insurance, and the Canada Pension Plan (CPP).

Canadian Patient Safety Week

Mark your calendars!

The Canadian Patient Safety Institute is excited to announce the dates for two of Canada’s patient safety events!  Don’t miss out on Canadian Patient Safety Week and Canada’s Virtual Forum on Patient Safety and Quality Improvement happening October 29 to November 2, 2012.

Canadian Patient Safety Week is celebrating its seventh year of raising awareness on the importance of patient safety and quality improvement.  Join us, along with thousands of other healthcare providers and patients, and receive a free package of promotional materials to highlight patient safety in your organization and across the country.

Due to the overwhelmingly positive response, CPSI is pleased to bring back Canada's Virtual Forum on Patient Safety and Quality Improvement to the frontlines, allowing you to log on from your office and join the conversation.

Register now for free! 

The norovirus can stay in your stool for 2 weeks or more even after you feel better. Hand washing is crucial. This is a horrible virus, that causes diarrhea and vomiting. Most of us live to tell the 
tell. The very fragile person is at risk of dehydration.


There are five steps to keeping your hands bacteria-free :

1. Wet your hands with warm running water.
2. Add soap, and then rub your hands together, making a soapy lather. Do this away from the running water for at least 15 seconds, being careful not to wash the lather away. Wash the front and back of your hands, as well as between your fingers and under your nails.
3. Rinse your hands well under warm running water.
4. Pat hands dry with a paper towel.
5. Turn off water using same paper towel and dispose in a proper receptacle.

Click on the poster for a larger image. Click here for a PDF file. It is crucial for caregivers, and visitors to wash their hands, and clean surfaces with antibacterial agents, as well. Caregivers need to remind visitors, especially professionals who go from client to client, or patient to patient, to simply wash their hands and dry them on a paper towel.


If you are ill
Stay home. Prevent transmission. Stay away from high-risk folks, do not touch them or their personal effects.
If you are ill, sneeze into the crook of your elbow, or your sleeve, not your hand, to keep viruses out of the air. This is how Swine Flu (H1N1) spreads. Do not touch your face, mouth, or eyes. Use antibacterial pumped soap and water, not antibacterial sprays or gels, they do not kill Superbugs. The water rinses the bacteria and viruses away.

When do you wash?

• Before, during, and after food preparation
• Before and after touching a patient or client
• In the bathroom
• Before eating
• After gardening
• After handling any waste - animal or vegetable, e.g., litter boxes, diapers!
• Often, if someone at home is sick
• After sneezing or coughing (watch this video, embedded below - The Sneeze: How Germs are Spread! It is a hoot.)

Once area that needs examination, are the reusable grocery bags we all carry
They require cleaning on a regular basis. As with all of the superbugs, many can live on inanimate objects. This girls' team of 17 thirteen/fourteen year-olds, travelled to a soccer tournament. One girl carried the infection, eight caught it from handling the cloth grocery bags or eating the food within.

Read about this study: The study appears here in the Journal of Infectious Diseases. 

Scientists Say Reusable Grocery Bags Help Spread Norovirus

They were exposed by handling a bag of snacks that unfortunately had been stored in the hotel bathroom. Virus aerosolized within the bathroom likely settled onto the reusable grocery bag and its contents. Matching viruses were found on the reusable shopping bag two weeks later. 


The 97% of people that never clean their dirty reusable grocery bags are certainly not thoroughly disinfecting their bags. The CDC says one of the ways the norovirus can be transmitted is by "touching surfaces or objects contaminated with norovirus then putting your fingers in your mouth." 

Home Care and Volunteers in Rural Ontario

Many benefit from home care services. This allows people to go home, rather than be an Alternate Level of Care (ALC) resident in hospital.

Meals on Wheels delivery

Fortunately, Ontario has a range of services to allow the ill or frail to stay in their homes. Of course, this is not always the best placement for all. The risk of falls is severe for many. Home care nurses and personal support workers (PSW) are not always available and doctors do not make house calls. Adult children are often called upon to give the extra care needed, and this can be a drain for us as we try to juggle jobs and family.

I volunteer for Community Home Support - Lanark County. Currently, I have two clients. One I accompany to doctor's visits. This takes 5 hours from my leaving my home to returning, by the time I get my client into her wheelchair and onto the wheeltrans bus. Another client I visit for a couple of hours a week. Both have physical and mental health issues. Both are at risk for falls, and have family members who are not able to provide home care. If a client falls at home, it could take hours or days for someone to find them.


VOLUNTEERS
Compassion - Action - Impact

respite care

Over the 2010/2011 fiscal year, 825 volunteers have served 2322 clients. We are very fortunate to have these caring individuals on our team. Their commitment to our community is tremendous. Thank you to all for your time and effort!

Community Home Support -Lanark County STATISTICS
We are constantly amazed by the number of hours (48,065) our devoted volunteers donate to improve the lives of our clients.

Meals on Wheels 
In the fiscal year (April 1, 2010, to March 31, 2011), 23,798 meals have been delivered.

Transportation
Rural client services differ from urban, in the distance volunteers travel each year (843,316 km; more than 21 times the distance around the equator) to care for our residents. In all, 9153.5 trips have been made.

Many groups offer subsidized transportation, such as Lanark Transportation Association. It can be cheaper to take LTA, than to drive and park in the city. Many elderly spouses have a hard time getting spousal wheelchairs in and out of cars.

Diner’s Clubs 
There have been 4111 days of participation in our congregate dining programs.

Foot care
A total of 676 individuals have received foot care in our office clinics.

Friendly Visiting, respite care
Friendly visits have been made 1379 times to individuals by phone; to homes, long-term care and retirement homes.

Security/Reassurance
Clients have been comforted by a visit or a phone call a total of 2040 times.

Home Help/Maintenance
To help seniors remain in their homes longer, we have contracted 11,498 hours of assistance.

Income Tax 

A typical Meals on Wheels meal

Assistance has been provided to 288 clients.

Hospice

Friendly visiting in LTC

We’ve made 5450 visits this past year. That equals nearly a visit a day for 14 years to retirement homes, long-term care or hospital settings!



MEALS ON WHEELS
This past month, 30 - 40 meals have been delivered each day, five days a week, in the Perth Area alone. Coordinated and delivered by thirty-five or more dedicated volunteers, this service is
offerred in many areas. Call 211, or visit 211Ontario.ca to find a Meals on Wheels in your area.


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

Dr. Brian Goldman, interviewing me for his

White Coat, Black Art Unpaid Caregivers Radio show.

What a thrill! For more information about my book.

Measuring and reporting on health system performance in Canada: Opportunities for improvement

Today the Health Council of Canada released Measuring and reporting on health system performance in Canada: Opportunities for improvement. The paper calls on governments to set clear policy goals with both measurable health outcomes and supporting health indicators in order to hold health system leaders accountable for performance. The paper asserts that to support performance improvement efforts across our health system in Canada, there must be alignment of provincial and territorial reporting on health system performance within a national framework. The paper provides recommendations to governments, at the same time highlighting innovative practices across Canada and in the United Kingdom and Australia that can provide a way forward. Download the paper to learn about the many complexities of performance reporting in each of Canada’s provinces and territories. healthcouncilcanada.ca

Lyme Disease in Canada

The Ontario government published information, e.g.,

How do ticks transmit Lyme disease?

Blacklegged ticks are the only type of tick in Ontario that can consistently transmit Lyme disease. Even with a bite from an infected blacklegged tick, there is only a small chance of getting Lyme disease. Ticks feed on blood by inserting their mouthparts (not their whole bodies) into the skin of a person, or an animal. Ticks feed slowly and their body gradually enlarges as it feeds, making it more visible. It usually takes from 3 to 7 days for a blacklegged tick to take a complete blood meal.

Ticks are most likely to transmit infection after being attached for more than 24 hours of feeding because the bacteria requires time to migrate from the tick’s gut to its salivary glands. Because of this delay, prompt detection and removal of ticks is one of the key methods of preventing Lyme disease.

Lyme Disease Fact Sheet

• What is Lyme disease?
• How do people get Lyme disease?
• What are ticks?
• What are the symptoms of Lyme disease?
• How is Lyme disease diagnosed?
• What is the treatment for Lyme disease?
• What precautions should you take to avoid Lyme disease?
• How prevalent is human Lyme disease in Canada?
• What is the Government of Canada doing to address Lyme disease?

Mental Health Strategy for Canada

From Mental Health Commission of Canada 
Changing Directions, Changing Lives


The Mental Health Commission of Canada is a catalyst for improving the mental health system and changing the attitudes and behaviours of Canadians around mental health issues. Through its unique mandate from Health Canada, the MHCC brings together leaders and organizations from across the country to accelerate these changes. Each of its initiatives and projects is led by experts from across the country who bring a variety of perspectives and experience to the table. The MHCC’s staff, Board and Advisory Committee members all share the same goal – creating a better system for all Canadians. The MHCC is funded by Health Canada and has a 10-year mandate (2007-2017).

MENTAL HEALTH AFFECTS US ALL

Mother, father, neighbour, friend – mental health affects over one in five Canadians and costs our economy over $50 billion every year. We need a national strategy to help combat mental health problems and illness.

 The Mental Health Strategy for Canada is the first of its kind and is a culmination of the hard work and advocacy of thousands of people all across the country. The Strategy offers recommendations to improve mental health and well-being throughout Canada.

How you can make a difference today in the lives of the one in five Canadians who live with mental health problems and illnesses.

 1. Promote mental health across the lifespan in homes, schools, and workplaces, and prevent mental illness and suicide wherever possible. Reducing the impact of mental health problems and illnesses and improving the mental health of the population require promotion and prevention efforts in everyday settings where the potential impact is greatest.

2. Foster recovery and well-being for people of all ages living with mental health problems and illnesses, and uphold their rights. The key to recovery is helping people to find the right combination of services, treatments and supports and eliminating discrimination by removing barriers to full participation in work, education and community life.

3. Provide access to the right combination of services, treatments and supports, when and where people need them. A full range of services, treatments and supports includes primary health care, community-based and specialized mental health services, peer support, and supported housing, education and employment.

4. Reduce disparities in risk factors and access to mental health services, and strengthen the response to the needs of diverse communities and Northerners. Mental health should be taken into account when acting to improve overall living conditions and addressing the specific needs of groups such as new Canadians and people in northern and remote communities.

5. Work with First Nations, Inuit, and Métis to address their mental health needs, acknowledging their distinct circumstances, rights and cultures. By calling for access to a full continuum of culturally safe mental health services, the Mental Health Strategy for Canada can contribute to truth, reconciliation, and healing from intergenerational trauma.

6. Mobilize leadership, improve knowledge, and foster collaboration at all levels. Change will not be possible without a whole-of-government approach to mental health policy, without fostering the leadership roles of people living with mental health problems and illnesses, and their families, and without building strong infrastructure to support data collection, research, and human resource development.

National Nursing Week May 7 - 11, 2012

In conjunction with National Nursing Week, Saint Elizabeth, a Canada-wide not-for-profit health care organization, celebrates Nursing Week from May 7-11, 2012.

 “With over 1,800 Saint Elizabeth nurses delivering care in client homes and communities across the country, our nurses touch the lives of so many people – from newborns to teens to seniors,” says Nancy Lefebre, Chief Clinical Executive at Saint Elizabeth.

 “The impact that nurses have on our collective health and wellness is enormous.” Saint Elizabeth employs Registered Nurses (RN), Registered Practical Nurses (RPN), and Licensed Practical Nurses (LPN) who provide a variety of specialized nursing services, including:
 • Pre- and post-natal care
• Breastfeeding consultation
• Mental health and crisis intervention
• Home chemotherapy
• Respiratory care
• Psychogenic care
• Wound and ostomy care
• Diabetes management
• Palliative care

 Saint Elizabeth has been a trusted name in Canadian health care for more than a century and is a leader in responding to client, family and system needs. As an award-winning not-for-profit and charitable organization, Saint Elizabeth is known for its track record of social innovation and breakthrough clinical practices. Our team of more than 6,000 nurses, rehab therapists, personal support workers and crisis intervention staff deliver nearly five million health care visits annually.

A Generational Comparison of Social Networking Site Use: The Influence of Age and Social Identity

I came across a study of social networking (see below).
Somebody tell me why they did not study people above age 64?

Lots of residents play Wii in LTC

Skypeing with daughter and granddaughter!

I have friends in LTC who play video games, Skype with family, and unwind with Wii.

The pharmaceuticals do not do drug tests on people above age 65, either. Nor do they study people with comorbidities. This is shameful. Drug interactions are important.

Imagine my shock when this trivial study didn't include people 65+. Where I volunteer, PCCC, they are teaching 95-year-olds how to use computers.

80+ playing solitaire on computer.
For those with arthritis in their hands,
this is ideal!

When talking about 'the influence of age', surely they could have examined people above age 64. Many of us retirees keep in touch with family and friends on-line. We learned to use these tools for work - no reason why we wouldn't use them for play.

This study doesn't choose a valid population. An 'on-line survey', doesn't tell us who they found.

The International Journal of Aging and Human Development
	Issue:	Volume 74, Number 2 / 2012
	Pages:	163 - 187

A Generational Comparison of Social Networking Site Use: The Influence of Age and Social Identity Valerie Barker A1 A1  San Diego State University Abstract: An online survey (N = 256) compared social networking site (SNS) use among younger (millennial: 18-29) and older (baby-boomer: 41-64) subscribers focusing on the influence of collective self-esteem and group identity on motives for SNS use. Younger participants reported higher positive collective self-esteem, social networking site use for peer communication, and social compensation. Regardless of age, participants reporting high collective self-esteem and group identity were more likely to use social networking sites for peer communication and social identity gratifications, while those reporting negative collective self-esteem were more likely to use social networking sites for social compensation. The theoretical implications of the strong relationship between social identity gratifications and social compensation are discussed.