Saturday, 3 May 2008

Death in LTC

The most recent death while preventable, is not unexpected.
I predict an inquiry in which, as my husband said, will only result in two deaths: the already deceased frail senior and the truth.
A new long-term care act, part of Health Minister George Smitherman's "revolution" into nursing home care, promised after a 2003 Star investigation into nursing home neglect, will further tighten the rules around restraints. Homes must first show that there is no alternative before they can be used.
The truth is clear. Some seniors must be restrained. Seat belts must be tight. If a senior is determined to get out of a chair, they will worry it with all their might.

My heart goes out to families who must choose LTC and leaving family members in profit-oriented institutions. Long-Term Care has faced a great deal of criticism and the current crisis overwhelms a system unable to care for its seniors in dignity and respect. The barriers are immense: lack of funds for more staff, untrained staff, lack of staff to hire, and the inability of a system to maintain already high waiting lists of ailing seniors. We cannot meet their needs either at home or in the LTC sector. There are not enough nurses, physicians, or PSWs.
The food is bland and unappetizing.
Issues include:
• More palliative care rooms.
• More staff
• Better trained staff with a wide-range of expertise to manage chronic disease
• Family health teams that include PSWs, Nurse Practitioners, Physician Assistants, as well as Physicians, to address issues and deliver a full range of care
• More funding for staff
• Requirements for in-service training of PSWs, and medical staff, including nurses and physicians in geriatric issues: physical and mental health issues which require specific treatments
• More continuity of care, with staffing levels that permit this to occur

I recall my father desperately trying to release the seat belt mechanism on his wheelchair. In his advanced state of dementia he could not understand that he needed to stay in the chair. More often than not I would go into the LTC residence and find him worrying the seat belt, trying to take it off, instead removing his pants, and knocking things over in the process.

Restraints are important. Dad would continually get up out of bed in the night, fall, and then lie on the floor. First they raised the sides of the bed. This did not work. They put mattress pads on the floor around his bed and lowered it to the floor. Eventually, he was physically unable to roll out of he bed. It is heart-breaking to see.

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