Tuesday, August 23, 2016

Palliative Patients in Hospital made to co-pay

Our South East LHIN (Local Health Integration Network)  is demanding that vulnerable patients in hospitals, as well as the dying patients in palliative care rooms who are being told to take their loved ones home or pay a co-pay. This is criminal. They are forced to sign contracts to co-pay, on top of OHIP payments.

On top of this, many Ontarians have been told to take their palliative family members home, or to long-term care, WHILE THEY ARE IN A DESIGNATED PALLIATIVE CARE ROOM.

 Ontario hospital staff continues to pressure patients (This I wrote in May.)

Do these staff members not understand when patients are dying?
What pressure is administration putting on family members?
What is wrong with doing a Palliative Performance Scale (PPS) assessment, to determine the patient's situation?
What are the qualifications to be in a palliative bed in a hospital?

Staff tell the spouse the patient has to be removed and sent to long-term care. There isn't a place. They tell the spouse the patient is turning the corner, improving, and moves her to a room down the hall. The oxygen tube falls off the patient's face and it's up to the spouse to replace it.
'Here she is dyin' on you, and they move her to another room.'
There should be a PPS test done on a regular basis by staff. This doesn't seem to happen. She's at 30% when I visited her last at home, no better (20%) when I visited two weeks later in hospital.

dying patients deserve to be in hospital
their families have earned this right
There is a difference between Complex Continuing Care (CCC) requirements and palliative patients who need proper nursing, and pain and symptom management. Many have bedsores, catheters and infections. Family members are often unable to change soiled adult incontinence products, empty a catheter bag, or help a palliative patients navigate their way to the bathroom.

ACE Publications

In 2012, the Advocacy Centre for the Elderly (ACE) had over 250 requests for assistance relating to discharge from hospital. In the first six months of 2013, this number skyrocketed to 200 such requests! Patients requiring admission to other care settings or requiring additional care in the home are often told that they must comply with hospital or Community Care Access Centre (CCAC) policies. These policies may “require” the patient or substitute decision-maker (SDM) to select possible LTC homes from a “short list” where a bed is or will soon be available. If they do not comply with the policy, the hospital threatens to charge the uninsured daily rate which ranges anywhere from $500.00 to $1,500.00 or more per day. Hospitals may also require the patient/SDM to sign a “contract” indicating that they “agree” with this policy. In fact, no one is required to sign such a contract. More and more frequently, hospitals are blocking LTC home applications and CCAC workers are refusing to take applications from hospital patients, based on their interpretation of hospital policies or Home First/Wait at Home Program requirements. 

ACE dealt with this in Toronto in 2008:

Many people should be in hospital as they die, since family members are unable to change adult incontinence products, empty catheter bags, or have a CADD pump, which is only available in hospital, and provides morphine pain management on a regular basis. Families have a hard time keeping medications straight, let alone doing the nursing needed.



Jennifer A. Jilks said...

From Dying With Dignity Canada,
"Just looking at your blog post more carefully, and reading other resources on the file, if they're charging co-payments to patients who've been deemed palliative, it's straight-up illegal. "

Jennifer A. Jilks said...

Now, I wonder if this is the fault of the doctors who do not tell the family the truth.
They are not declaring the patient palliative, and, instead are happy to have them sent home to die.
The question is, how do they determine if a patient is terminal?
One patient, sent home with congenital heart failure, died shortly thereafter. Was she palliative?
The disease trajectory is clear. It is a chronic condition, "CCC".

Jennifer A. Jilks said...

From a PSW, a friend:

This family is lucky to have you in their corner it's too bad PSWs don't have the power to do anything else. The keep our hands tied by using privacy and confidentially to keep our mouths shut. Tell the family there are many of us thinking and praying for them.

After seeing my mom-in-law go through her ordeal, she quit her job to look after her mom and provide ALL personal care...we all need to speak up because all of us will have to care for someone at some point in our lives and most have NO CLUE WHAT BS they will be facing.