Monday, April 4, 2011

How things work, when they don't work

World War II ended September 1945 when Pacific surrender documents were signed. Precisely nine months later I was born in Vancouver and my future one and only wife arrived in Powell River. That puts us in the front ranks of post war baby-boomers, people that a few posh folks believe will make Canada's healthcare system unsustainable. (That's code for more expensive.)

I don't intend to join the bleedin' choir invisible for some time yet but I have been examining the issues of eldercare in British Columbia. I fear the province treats domestic violence and eldercare more with public relations puffery than effective action. After a friend was victim of serious spousal assault, I paid attention to responses of police and courts. The service received by this mother and her children fell far short of that due under guidelines of the Ministry of Public Safety and Solicitor General. I tried to communicate with the RCMP to inquire about the gap between actual services provided to victims and that which is theoretically available. The RCMP media office refused to take questions. In an off the record  interview, a former senior Ministry official in Victoria admitted that police are intractable and many officers on the front lines actively resist changes to policies involving family violence.

The PSSG Ministry has much carefully composed bumf online resulting from lengthy and expensive consultations with experts. To a person untouched by real world experiences, the policies give comfort but, in reality, they are nothing more than goals of bureaucrats. Police and provincial court judges do things their own way and the gap between real and theoretical responses is immense.

In reviewing these broad issues, I stumbled across a shocking story about a sad situation in British Columbia. Oddly, I didn't read the story in any publication here; I found it online at CTWatchdog.com, an American site founded by George Gombossy, an award winning investigative journalist with long experience. Granny Snatching: Narcotic Poisoning – A Bitter Prescription was written by Ron Winter, a decorated Vet who has written extensively on elder abuse.

The story is about 88-year old Kathleen Palamarek, rescued recently by ambulance paramedics after suffering narcotic poisoning from morphine administered at a large residential care home in Victoria. Mrs. Palamarek's daughter had called 911 after finding her mother comatose at the care home. The patient was removed by paramedics for emergency hospital treatment, apparently over the objections of the institution charged with caring for her.

After acute treatment, the patient was returned to the Lodge at Broadmead over objections of her daughter, who with her husband offers a home where Palamarek could live, which independent healthcare professionals have testified Mrs. Palamarek is capable of doing. The case is complex but my initial examination indicates that people with major financial conflicts want her kept at Broadmead and have used a dangerously broad section of the BC Mental Health Act to eradicate her civil rights.

Even worse, the Act is so broad that it could be used to imprison anyone if it is alleged that, without care, the person could suffer "physical deterioration." Frankly, as a 64-year old with arthritis, I could be removed from home by that clause. It is hard to imagine that relatively recent section could survive a court challenge but it is operative and is being abused.

The trouble is, as Mrs. Palamarek and her daughter discovered, courts take a leisurely pace to resolve any issue before them. Judges prefer to leave things as they are until all arguments have been heard and long periods of review ended. For this patient, the delays in regaining her freedom are appalling and the people she is fighting against have an interest in keeping her in care, by which they gain financially.

Read through the Granny Snatching article written by Ron Winter and circulate this story as widely as possible. I will continue making inquiries, trying to learn more about this case. Unfortunately, the courts are immune from transparency. Supporters of Mrs. Palamarek don't know if they will wait another month or another year. In the meantime, one pioneer citizen may be denied freedom against her will and against her best interests. I wish could suggest a course of action but I think that authorities involved want it to stay out of public view and have placed barriers to settlement that are unreasonable, unfair and aimed at protecting private interests. You might help by emailing your MLA, asking for an urgent review of the Palamarek case and of the BC Mental Health Act.
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15 comments:

  1. This is disgusting! I too am getting up there and having been involved previously with the "health authorities" and "their doctors" I will start preparing myself for when the time comes, and my time will not end in one of these "facilities". They practice euthanasia. I personally don't have a problem with euthanisia, but that is "MY" choice and my time, not some doctor in a private home being paid for by a private contractor AND the heatlh authority. People, if you have someone in elder care, PAY ATTENTION! I cannot say this loud enough. Watch for drowsiness, incoherency, non-eating, bruising, cuts, broken hip, and the list goes on. Ask and DEMAND to see the records for your loved one and pay attention to the meds that are being administered to a loved one, and ask WHY. Don't let them BS you, it is your right. If they had MORE staff, more "trained properly staff" around the lock, I believe things would be better. Right now there are not enough and their answer is DRUGS for control.
    Yes, I am ANGRY at anyone who treats another human being this way!! Disgusted !!!!!!!!!!
    My apology Norm for going on. Having watched this before and to think these authorities are still doing it? The court better rule properly! This woman should be home with her "family".

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  2. Absolutely disgraceful - it is worth noting that this has occured smack bang in the middle of Gordon Campbell's time in office !. It sure makes you think that something more sinister was / is afoot. The ruling BC Liberal government and their business partners seem to stop at nothing, to relieve a person of what wealth they might have - and that includes the illegal use of medications and narcotics.

    Wow, how low this government has sunk. I have passed this story around so it will hopefully get the attention it deserves.


    Thanks

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  3. It has been my own very sad expereince while caring for my mom, that once someone enters long term care in this province, they no longer have the rights of a citizen of this country. As it says in your article, the gap between real and theoretical is immense. The front line staff generaly try hard to do the job but there are not enough of them. Ever. trainign is getting worse and worse and sometimes barely exists at all. Night time is ridiculous, as far as the dangerously low numbers of staff go. Given the fact that everyone in long term care is there because they cannot be alone, the amount of time they actually spend totally untended to, is, in my view criminal (Canadian Criminal Code definition of criminal neglect).
    The over drugging of seniors is the way this system deals with not enough staff. The facilities still blatantly advertise as being a 'home' for the person where they can make choices and do what they wish. It is such a crock of garbage. People ( seniors and much younger people, who are in Long term care) are drugged to be in bed and sleeping by 7, usually earlier. Many, if not most, are drugged to stay quiet through the day as well.
    Licensing knows this. The government knows this. The health Authorities know this. Yet still it continues. Now families are having their rights to care for the people they love and who have loved them, arbitrarily taken away, by a system that has long forgotten how to care. A system that makes up it's own rules, it's own laws and it's own Canadian constituiton, as it goes along. The Geneva Convention affords more rights to prisoners of war than are given to the seniors who built this country. It is a disgrace.

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  4. Okay...I just tried to post a comment on here but managed to delete it I think. I am sending this one as a test before I try to resend the other one, so that I don't duplicate stuff. Excellent article by the way.

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  5. J.C. you state the case clearly and truly, in my opinion. You stimulated me to drag out an article published over a year ago because it demonstrates the accuracy of your comment here.

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  6. Any kind of drug or narcotic administered at a care home has to be authorized by a doctor. Same with using the mental health act.
    I have had experience with elders in care homes and they vary greatly from one to the other. The administration at the top sets the tone. Please do not blame front line staff workers unless you have witnessed something personally by one of them.
    It sounds like the problem in Ms. Palamarek's case is her families. My experience is that the care homes take it very seriously if a patients 'rights' are being trampled.
    Only a NDP government will assess the state of elderly care in BC today. The trouble is, people keep electing Liberals, who don't care about people.

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  7. Anon 5:13 PM: the police are investigating this care facility and the doctor who administered this narcotic poisoning. The doctor's prescription permitted the care facility to administer the morphine at their discretion, in ever-increasing doses, presumably without end.

    The family played no role in causing this woman to almost die.

    This practice is standard for (many, but not all) people who have a terminal illness and are suffering pain that cannot be otherwise managed. It is called palliative pain management.

    That’s not what this case is about though. If you read the article at the link provided here, you will know that this BC woman was NOT terminal and had no pain requiring lethal doses of morphine.

    These types of prescriptions by doctors, where they permit facility staff to make the decisions about how often and how much medication to give residents, are far more common than most people would realize.

    When a doctor prescribes any medication in this manner (referred to as a “prn” or “give as needed” prescription) it means staff (often LPNs) are the ones who actually decide how much of a drug a person in a care facility will actually get, not a doctor or even a registered nurse.

    Advice I would give to people who have loved ones in these places, is to ask for a copy of the resident's Medication Administration record (often just referred to as a “MAR”), if you're concerned about or interested in your family member's actual drug consumption in care facilities for the elderly.

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  8. To all Liberals out there, why did the Gordon Campbell government eliminate the position of the BC Mental Health Advocate in 2001 just after the Liberals were elected? What was your goal, who was behind the decision to deny the people of BC a Mental Health Advocate and why?How much money did Pharmaceutical companies provide the Campbell regime with?

    Kathleen Palamarek needs to be afforded her Canadian Charter Rights to be free to live where she choses! Who are these people?!

    Just so you all know some BC police provide only subjective verbal reports to medical staff when police detain/apprehend/arrest and take citizens to them under B.C's Infamous Mental Health Act Section 28(1) and provide nothing in writing!

    Who's Watching The Watchers?

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  9. Doreen, we were advised by a "nurse" to get our relative out of the home because of what was going on. Drugs. They, according to the nurse, were being used to control the residents. Part of the reason was short staffing, they didn't have enough, and choose not to. Don't think we didn't try and stop this, but then the threats started in moving our family member far, "far" away from us. I have never been so disgusted in some of my fellow "human beings" as I was then. I feel for the people working in these facilities, believe me, but what is going on is despicable. Everyone is too afraid to speak out, which should never be the case, but it is, the companies and managers involved have made sure of that, and it's even more threatening when you live in rural BC where jobs aren't available. And you know, the current government doesn't give a damn in my opinion.

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  10. As long as you use, answer to and, or, agree to be surety for THEIR NAME you are their property and they can do anything they want with their property, that is the reality in which we have placed ourselves. Use your Given Name that your parents gave you and break the presumption that you are one of theirs and then they can not kidnap you without facing Criminal Charges. Do not agree to be surety for THEIR NAME, break the chains of servitude or suffer the pain. Your choice and only your choice of who you are and want to be.
    My mother was kidnapped from her home, placed in care where she promptly fell cracked her hip and was given an unnecessary operation to put a pin in that was not required and from which she never recovered from the anesthetic and subsequently died(murdered). They also tried to steal everything she owned but she was way to smart for them and already had everything arranged so they could not get their hands on it so they murdered her.
    Revoke all consent to being one of theirs or you will likely find yourselves in the gulag of the Public Trustee in your twilight years.

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  11. From my experience when caring for my mom,threats to move the resident are constant at the first sign of any concerns being rasied by the family. The rules of admission for long term care, clearly state that no one should be admitted to the facility unless they can be safely and adequately cared for. The dismal reality in my opinion, is that no one in Long Term Care, is cared for safely or adequately, under the current situation. Please note, I am NOT slamming front line workers who I have spent nearly as much time advocating for as I have for the residents. They are put in an impossible situation and are the first ones thrown under the bus when something goes wrong. The bottom line is there is not enough staff. I put the blame squarely on management and the government which allows such lax enforcement of rules and regulations to exist. On paper it looks like everything is covered, but in fact, nothing could be further from the truth.
    My questions are:
    1) when they do not even meet the basic rules for admission, why are the facilities permitted to keep their doors open at all, let alone admit new people?
    2) Where in the world, any place this side of sanity, was it decided that because someone is sick or old, or cannot speak for themselves, their rights as a citizen are not protected?
    3) When were the Health Authorities permitted to create their own version of the laws and of the Canadian Constitution?
    In my experience, I faced off with the authorites so many times and clearly used the terms criminal neglect, abuse and exploitation, not to mention criminal fraud (for taking money for a service then not providing it)only to learn the government gives the facilities language to keep them clear from prosecution. They also provide exemptions from many of the very serious requirements listed in the Residential Care Regulations that came into effect in Oct of 2009 (I think that was the date).
    It is a horrible situation.

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  12. Where is BC's Ombudsperson on this issue, I wonder?

    Elder abuse by care facility staff is rampant across BC. Bullying of their families by facility staff and health authority bureaucrats is common.

    To great fanfare Ombudsperson Kim Carter announced she would conduct an Inquiry into Seniors HealthCare in BC.

    The reason Ms. Carter said she decided to hold the Inquiry was because of the hundreds of complaints her Office had received about elder care. She immediately held public information gathering sessions across BC. Everyone was full of hope that finally serious attention was being paid to this growing, horrific problem.

    Ms. Carter announced her Inquiry almost 3 years ago, in August 2008.

    She has never produced the final Inquiry report. If I didn’t deliver on an important project for that long, I’d expect to be fired from my job. Ted Hughes never took that long to produce his stellar report on the problems with Child Protection in BC. Thomas Braidwood never took that long to sort through the tasering death of Robert Dziekanski. Even the Air India Inquiry was completed faster. Why is it taking the Ombudsperson’s Office so long?

    Why is no one in the media asking about this? Why is no politician talking about this? Premier Clark said she wants to bring change. Producing the Ombudsperson’s long-lost report would be a great opportunity.

    And what about the NDP? Why aren’t they raising cane? They have a leadership contest underway, a perfect opportunity to demand to see this long over-due report.

    People may point to the release by the Ombudsperson in Dec 2009 of an interim document, something that looked like a hastily-produced response to a flurry of questions since the one year anniversary of the Inquiry had passed. This document, labelled “Part 1”, was anchored on a grand-sounding Residents’ Bill of Rights something she demanded be posted in every care facility. She said that that was the result she was most proud of.

    The truth is, the BC Residents’ Bill of Rights is the butt of many bitter jokes now. The elderly victims of BC’s “care” facilities know full well some pretty poster isn’t going to prevent them from the whims of staff when no one’s looking. Families too know that the document is a Fairy Tale.

    The Ombudsperson also pointed to another recommendation, namely that Family Councils be established in all seniors care homes, and this is happening. However, these councils are not being universally welcomed by care facility management, who often insist that facility staff sit in on council meetings, which naturally just discourages family members from engaging in genuine discussions about their concerns.

    I wonder how many elderly people have since died unnecessarily and prematurely, or are living in fear and despair because no one was there for them for these past three years?

    What happened to all that hope way back in August 2008?

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  13. Although the government hype makes it sound as though the Ombudsman is the final answer that will deal with the horrors of this situation, bottom, line is that they have no authority at all to force anybody to follow even one of thier recommendations. They can and do make some good recommendations but if nobody has to adhere to them then what difference does it make?
    The same with the Patient review board. When all is said and done, they can recommend until they turn purple but nobody has to follow anything they say. Nothing.
    From my own experience and in my own opinion, I believe they spout off these pseudo-options simply to pass us on to somebody else and get us off their back. At best it is a false sense of security and at worse, well I don't even want to go there.
    The previous writer correctly (I think) implied that the residents bill of rights is worth little more than the paper it is written on. The facilities are simply given too many exemptions for too many things, to believe they would give any weight to a piece of paper. If they can (and do) tramp all over the resident's Canadian Constitutional rights, then why on earth would we believe they would have to do differently with a posted bill of rights? The comments in this column have clearly stated peoples real expereinces as opposed to what is on paper.
    The same with the family councils. They are only as strong as the family members attending them (or as strong as the management allows those families to be). In fact I was told, by the facility manager, at one family council meeting that I was not 'allowed' to talk about things like staffing numbers, staff training levels, or situations that looked like blatant breeding grounds for abuse or neglect. He said that family councils were meant for fund raising and for things like decidng if the grass needed to be mowed more often, or possibly even what color the dining room might be painted. Seriously. He then produced a totally bogus paper that he claimed confirmed what he was saying. None of it was true, but he still succeeded in scarng off the majority of the family members in attendence because they were afriad they were out of line. They were also afraid and justifiably so (as wrong and horrible as that is), that if they continued to push for answers their loved one would suffer repercussions. As has already been talked about in this comment section, residents are threatened with removal from facilities all the time. In some terrifying cases it is the opposite and family members who make too much noise are arbitrarily written out of the equation, their rights to their loved one removed. The elderly person is basically stolen and virtually tossed into the black hole I have come to see as the belly of the beast.
    To this point, I have not found a place to go for help, that has any actual authority. It all looks good on paper and appears to cover all the bases, but the bases being covered are not for residents or the families who love them.

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  14. These people who make comments who are they. Why don't they leave their names and contract addresses. I have a blog with all my contact info. What are these people afraid of? http://voiceofgoneballistic.blogspot.com
    audreylaferriere@yahoo.ca

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  15. Quoting Audrey Jane Laferriere "These people who make comments who are they. Why don't they leave their names and contact addresses." "What are these people afraid of?"

    Audrey, I'll give you one reason, it's regarding a client of ours. Here is what a physician told our client,regarding their un-lawful detention and committal case in B.C. "If you complain, or try to attempt to correct the false information in the ER physician's consult report, you may be committed for a very long time" In our client's medical records the physician wrote, "Does not understand 'Let sleeping dogs Lie'."

    Our concern is more about those who don't write and why, when they see abuse or have been abused themselves.

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