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
- Discharge from Hospital to Long-Term Care: Issues in Ontario - Updated February 2014
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.
- “Home First” – Is It Right For You? - February 2014
- Memo to LHIN CEOs re: Home First Philosophy, Ministry of Health and Long-Term Care - January 2013
- Memo Re ALC patients who refuse an offer of admission to a prior-chosen LTC home bed, Ministry of Health and Long-Term Care - May 23, 2012
- Memo Re Crisis Designation and First Available Bed Policy, Ministry of Health and Long-Term Care - February 23, 2011