Government News

GOVERNMENT UPDATE: Failing home care system

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Our home care system is failing. The article written below perfectly expresses the significant ramifications of a poor quality home care system. Two new reports underline the need for senior care in the community.    

  • A woman goes without eating or drinking for two to three days, even though she was under the supervision of Ontario’s home care system.
  • Patients receiving palliative home care get cut off because they don’t die fast enough.
  • A patient with diabetes gets sent home after a heart attack. The expectation is that a friend will take care of her. She returns to hospital in a diabetic coma.

Those are just three tales from the trenches from personal support workers, patients, nurses, community service provider agencies and other groups involved with home care in this province.

Their testimony is contained in a two-year study, The Care We Need, released this week by the Ontario Health Coalition, an advocacy group that is rightly calling for a complete overhaul of the home care system.

If that message isn’t strong enough to be heard by the Ontario government, many of the group’s findings are reinforced by a second report on home care, made public on Thursday by a group of experts commissioned by the Ontario government.

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That report, Bringing Care Home, contains 16 recommendations to streamline and integrate services to make it easier for patients and caregivers to navigate a system that is now overly complex and unresponsive. As the experts say, the current home care system simply “fails to meet the needs of clients and families.”

The health coalition’s exhaustive study details what happens when:

  • People are forced out of hospitals to free up beds and cut costs without a coordinated, well-financed home care system in place to support them.
  • Patients end up back in expensive hospital emergency beds because they haven’t been given enough home care hours.
  • Elderly patients end up in expensive long-term nursing homes, because they can’t access the home care support they need.

What’s clear from both studies is this: the Ontario government cannot have it both ways. It can’t cut the extraordinary cost of keeping patients in hospital simply by pushing them out the door as quickly as possible without providing sufficient home care on the other end to ensure they don’t end up returning in worse shape, requiring more expensive care, than when they left.

And it can’t prevent elderly patients from accessing expensive long-term nursing home beds if it doesn’t provide the care they need at home.

The government has been warned for decades about the need to coordinate and support home care to accommodate:

The fast-growing number of Ontarians with Alzheimer’s and related dementia. There were 181,000 of them in 2011, and that number is expected to grow by 40 per cent before 2021.

The 13,042 people currently on wait lists for home care services. (This does not include those cut from the lists because Community Care Access Centres had to tighten eligibility because of a lack of funding.)

The increasing need for home care to help seniors retain their independence.

But instead of properly supporting and funding home care — to save money, never mind provide compassionate care — the current $2.4 billion budget for home care provides less per patient than in 2002/03, according to the health coalition’s calculations.

This year the Ontario government topped up the entire $4.9-billion budget for both home and community care (which includes community health centres) by $270 million and plans to increase that gradually to $750 million over the next couple of years.

Still, the Ontario Health Coalition is recommending:

  • Patient advocates or an ombudsman to help people access timely, sufficient home care.
  • Increased funding to ensure those in need are cared for.
  • More controversially, an end to the current mix of private and public health care services. (It argues the home care system should be a public, not-for-profit service)

Their report is a well-researched, well-thought-out eye-opener – backed up on many issues by the government-commissioned report. Health Minister Eric Hoskins should act on both immediately. The most vulnerable of patients – those waiting for help at home – depend on it.

March 15, 2015

(http://www.thestar.com/opinion/editorials/2015/03/12/ontarios-home-care-system-should-be-overhauled-now-editorial.html?referrer=https%3A%2F%2Fwww.google.com%2F)

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GOVERNMENT UPDATE: Care homes review the right path

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A government update by Murray Mandryk featured in the Leader-Post

“REGINA — Before we again charge into Saskatchewan’s home-care fray, maybe we need to acknowledge we’ve already come a long way towards tackling this problem.

Admittedly, it likely doesn’t feel that way – especially with the looming report from provincial Ombudsman Mary McFadyen into the 2013 death of Margaret Warholm.

In releasing a progress report to Health Minister Dustin Duncan this week, McFadyen noted she has received 35 formal complaints since Nov. 20, when she began an investigation into “region-run, non-profit and for-profit long-term care facilities.”

Add this week’s court appearance by 56-year-old Tessie Weigetz – a Santa Maria employee charged last December with assaulting a resident of the facility – and one shudders at the potential depth of this problem in Saskatchewan.

After all, we’ve been hearing from the NDP Opposition since the spring 2013 session about elderly residents left to soil themselves because no care-home attendant was available to help get them to the bathroom.

So compelling was the Opposition’s case that it inspired Duncan to send out health region CEOs to tour every facility in the province in the summer of 2013. They brought back an honest assessment of inadequate meals, under-staffing and rundown facilities – stories Duncan described as “heart-breaking”but so far, Duncan has been more about words than action.

After committing $10 million for “emergency” improvements – barely half what health regions requested – there has been no additional budget funding.

Seemingly more focused on its lean agenda, delivered by a U.S. consultant specializing in privatefor-profit hospitals with little understanding of integrated long-term care in our public health system, the government is struggling to see the forest for the trees.

Seriously? Regina and Saskatoon health regions can find money to hire more six-figure lean bureaucrats or for trips to Seattle (during a supposed travel freeze, no less), but we can’t find any more money for seniors’ care? We need to invest more in our seniors and less in consultants and bureaucrats. That said, where was the NDP’s interest/investments in long-term care during its 16 years in office?
But as easy as it is to bemoan all the problems in our system or the cynical opposition/government lip service, maybe we also need to step back and look at where we are really at.

We have 155 stand-alone special care homes (plus 13 long-term care facilities that are part of hospitals or health centres) and some 8,872 beds in the province. It’s a ratio of beds-to-seniors-in-need-of-them that is enviable most everywhere else in the country and the world, where care for the aging is a faster-growing and even bigger problem. And while the focus of government and opposition has rightly been on the critical incidents that need to be eliminated, the vast majority of these 168 homes provide good food, dry beds and loving care to their residents almost all of the time. Our past eagerness to honour our pioneers has given our nursing home system a solid foundation that much of the country and world can only envy.

Around the world, there are now more people over 65 – 523 million – than have ever existed on the planet. By 2050, there will be 1.5 billion people over 65 (16 per cent) which will be 2.5 times as many as those under five years. Chalk this all up to the post-Second-World-War relative prosperity of the developed world (the source of the baby boom now producing all these seniors).

The global aging challenge is one Canada is already experiencing. With 14.77 per cent of the population over 65 (according to the 2011 census), Canada ranks 28th in the world, behind first-place Japan (at 25 per cent) and most European nations.

Of course, it’s an even bigger problem in Saskatchewan … although, not as big as it once was. This province has gone from having 15.42 per cent of its population over 65 (highest in Canada, according to the 2006 census) to 14.87 per cent over 65 in 2011 (still higher than the national average, but now seventh).

And let us understand that the vast majority of the current 154,000 Saskatchewan people over 65 will never require acute nursing home care – especially with our increasing emphasis on in-home care. Clearly, one good thing emerging out of this debate is a rethinking of future seniors’ needs.

However, the best thing of all is that we are even having this debate.
That the tragic death of one elderly woman – something that might be roundly ignored elsewhere – would incite an Ombudsman’s investigation into the entire nursing home system has clearly demonstrated a high level of caring and commitment by the opposition, government and entire province. We have far to go, but at least we seem to be on the right path.” 

January 30, 2015

(http://www.leaderpost.com/touch/story.html?id=10772702)

 

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Government Protects Private Sector Pension Plans

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Cabinet has extended a moratorium on solvency for a group of private sector pension plans, protecting the benefits of 158,000 plan members which will Senior Living in Calgary

In their December 18 meeting, Cabinet approved two changes to the Employment Pension Plans Regulation, which applies to private sector pension plans. One of the changes allows defined benefit collectively-bargained, multi-employer pension plans to continue a moratorium on solvency funding until permanent legislation addressing their funding concerns is in place. Without this change, 158,000 plan members could have seen their benefits reduced.

“The extension of the solvency moratorium is an indication that the government understands the importance of pension security to Albertans, and is working to ensure a legislative framework that supports well-funded sustainable and secure pensions. Union sponsors of multi-employer pension plans are working with government to address the needs of updated regulations.”

Bruce Moffatt, Chair of the Collectively Bargained Multi-Employer Advisory Committee and Business Manager and CEO of the International Union of Operating Engineers Local Union No. 995

The second change deals with pension splitting rules in cases of marriage breakdown for supplemental plans registered under the Employment Pension Plans Regulation. Going forward, one set of rules will apply when splitting regular and supplemental pension plans, simplifying the administrative process and making it clearer for all parties involved.

The changes do not apply to public sector pension plans.

This fall, the Employment Pension (Private Sector) Plans Amendment Act, 2014 ended when Legislature was prorogued. The Government of Alberta is working collaboratively with groups such as private sector unions and the Collectively Bargained Multi-Employer Advisory Committee to draft new legislation to address the long-term sustainability of private pension plans.

Our senior citizens deserve security. Senior housing is not included in Alberta Health Services so it is important that our seniors have the funds needed to cover the cost of Senior Living. Elderly Care Services are expensive and require the long-term sustainability of private pension plans in order for our seniors to be able to afford the care they may require. 

December 19, 2014 (http://alberta.ca/release.cfm?xID=37534E9DBF94B-FBF7-01E6-15421511296CE739)

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GOVERNMENT: The Upside to Canada’s Aging Population

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The fact that a third of all Canadians will be over the age of 60 by 2050 does not have to mean doomsday. The following is an excerpt from Adriana Barton’s article for The Globe and Mail

“An international team of researchers looked at Germany as a case study. Germany’s fertility rate of 1.4 and median age of 44.3 years make it the greyest nation after Japan. Nevertheless, the land of sausage and sauerkraut may not do too badly in its golden years, the researchers found. They identified five areas in which countries such as Germany could age like fine wine:

• Better health: As people live longer, they stay healthier longer. Projections suggest the average German man in 2050 will spend 80 per cent of his lifetime in good health, compared to 63 per cent today.

• Increased productivity: Aging populations tend to have higher education levels, which could help offset the decline in labour force.

• Sharing the wealth: As life expectancy increases, people will inherit at older ages and be better equipped fund their own retirement, or help adult children financially. And as families have fewer children, inheritance will be split into larger chunks.

• Good for the environment: Changes in age structure and a shrinking population size are associated with reduced consumption of energy-intensive goods and lower carbon dioxide emissions.

• Quality of life: The ratio of leisure, work and housework is expected to change in the future, with leisure time increasing on average.

The picture may sound rosy, but the new study isn’t the first to giving aging populations an A-plus. Back in 2003, the Government of Canada released a document entitled Population Aging: From Problem to Opportunity. The report outlined how policies supporting greater life-course flexibility might address the labour shortages associated with retiring baby boomers, and at the same time, provide people with more choices as to how they approach activities such as work, learning, caregiving and leisure over their lifetimes. As well, it cited Health Canada research showing that longevity is not a key driver of health-care costs.” BY: Adriana Barton’s article for The Globe and Mail

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SUPPORT: Hackathon tackles Dementia

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In a period of high tech and innovative ideas it is welcoming to see what transpired at an event hosted by Ryerson’s Digital Media Zone. Students, computer programmers, healthcare professionals and technology enthusiasts all came together and tackled the challenges facing individuals with dementia. The following, written by Calvin Dao and Andrea Vacillate outline a couple of the best entries.

“The software building competition — dubbed DementiaHack — was organized by the nonprofit programming organization HackerNest and the British Consulate-General in Toronto. The hackathon brought skilled people with an interest in developing technologies to make the lives of those living with dementia and caregivers easier.

The grand prize was awarded to the team behind an app called CareUmbrella.

Powered by Near Field Communication (NFC) connectivity, it allows patients of dementia and Alzheimer’s disease to call up specific information on their phone by tapping it on an NFC-enabled sticker. This technology comes at the cost of just cents per sticker, according to Hayman Buwan, a physician who came up with the idea three years ago.

They demonstrated CareUmbrella by tapping their phone onto a sticker coded to bring up an instructional video on how to use a microwave.

One factor that he and his team kept in mind was the importance of letting patients be independent, regardless of their disease’s limitations.

Nitin Malik, an iOS developer who has a family member with dementia, won a runner-up prize with his team for a hardware innovation they called All the Pi.

It uses a single-board computer to play audio reminders to remind patients to complete tasks and sends push notifications to caregivers if a task was not complete at the usual time. For example, when a light switch with this system is turned on, a programmable recording is played reminding them to turn off the light.” -By Calvin Dao and Andrea Vacl

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