Tuesday, April 5, 2011

An old problem: elder abuse

Excellent comments here in the last few days after we introduced the case of Kathleen Palamarek, the 88-year old woman rescued by BC Ambulance paramedics from near fatal narcotic poisoning in the care facility where she is forced to reside against her will. Denying Mrs. Palamarek the right to live at home with family members of her choice denies that hospital space to a needy citizen who has no other options.

Read How things work, when they don't work for detail.

Joan L., commenting at the first article, notes the failure of the BC Ombudsperson to deliver a timely final report on Senior's care. The subject has been under review far too long. Recommendations made in 2009 by the Ombudsperson have not been implemented. One of those orphaned suggestions leaves seniors almost completely vulnerable. It called for,
"a reliable and objective process to monitor and evaluate the degree to which residents’ rights are respected."
That is like the income tax department operating without reviews, audits or assessments. How is that government trusts profit making healthcare businesses to do the right thing but not taxpayers? For too many operators, rules without enforcement allows operations without rules. Pioneer citizens who should be enjoying their last years are stacked in warehouses of the moribund, mere commodities of a callous BC Liberal government.

The apparent passivity of the Ombudsperson in this matter relates to the enabling act. She had promised to have a report ready in fall 2010 for delivery to government stakeholders, with public release in 2011. The Ombudsperson website has not updated its public comment in 8 months. That alone is inexcusable. I presume, with confidence, that the Ombudsperson's action is stalled by government officials.

We should renew our applause for Ms. Turpel-Lafond, the Representative for Children and Youth. She refused to be slapped down or put off by imperious bureaucrats. She went to the public and waged war to fulfill her duties assigned by law. That resulted in a new Minister, a new Deputy Minister and negotiation of a new comprehensive working arrangement between the Representative and the Ministry.

The Representative delivered heroically. Perhaps the same degree of integrity and courage is not found in the Ombudsperson's office. As Joan L. asks,
"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?"
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  1. Like the public school system, the long term care system requires family support for it to be effective. A large part of the problem is that a lot of families want to check in their elderly parents at the door and then leave them. Same as parents who want to leave them at school and let teachers do the rest. They are usually the ones who use private schools and scream about how bad the public system is.
    Most people leave their parents at the door. That has been my experience. Yet if family members came two or three times a week, looked after their individual needs and kept an eye on what was being prescribed and what was not being done etc, then you have some control over that persons experience. That is how the staff prefer it be done.
    Please don't overlook individual responsibility because it matters a great deal.

  2. You identify one reason why the Victoria case is so strange. Medical professionals know that family care at home is usually preferred. One that I consulted about this story says that people are routinely encouraged toward homecare even with more severe medical challenges than Mrs. Palamarek. The test is do they have caring family with appropriate facilities.

  3. Anon 4:21 That's a good point about how families often hand their children to strangers to care for them, and do the same with their parents. However, you seemed to miss the fact that this Victoria woman's family has been fighting to be permitted to provide a home for their mother. Also I personally know of two different people in different BC cities who have been threatened by nursing home staff that they will be banned if they don't stop hanging around so much. It's awful for them now when they go to see their elderly parents, because of staff attitudes. They aren't being disruptive either. Your ideas are good ones, and that's how it should be but something isn't right about how nursing homes are being operated today.

  4. Okay.....this is in response to the anonymous writer mentioning families who drop their person at the door. Fact is when my mom was in care for 2.5 years, I was there a minimum of twice a day, 7 days a week, 365 days a year. If I had to be away, my daughter and/ or close friend went in my place, because I did not trust that I could leave her alone. She had advanced parkinsons disease and had great difficulty swallowing and they did not have enough staff to help her eat (it was a very slow process)or certainly, to have regular drinks of water. I was there more than some staff members and i did see what is and is not happening and I am telling you straight up that you DO NOT have control over anything they don't want you to have control over. Doesn't matter how much noise you make or where yu try to take it. (refer to the April 6 comments from the last article regarding this subject, because you will see that there is no place to take it).
    It is great to have caring families and ours absolutely was one( as are most of the people commenting on the last article), but you still may not have the ability to care for someone at home at a certain point. With my mom's illness and after she broke her hip, I did not know how to safely lift her or transfer her as she was unable to assist in any way and was very fragile. She did live with me for five years prior to breaking her hip and ending up in long term care and if I could have brought her back home I would have done that.
    It is a delusional thought process to believe that there are services in place for people to remain safely in thier homes. Even with Home Support in place, those workers often have ten minutes to actually spend at someones house before they have to be at the next appointment. they are allotted 20 minutes for each case (rarely longer) and that includes travel time between clients. When those workers leave someone with dementia (or, as is usually the case, with multiple diagnosis), that they know cannot be safely alone, they are devastated. They are trained to care for people and yet the system that is in place does not allow them to do their job the way they so desperately want to do it. They try, but they can only be so many places at any one time.
    Do you have any idea what it is like for elderly spouses who physicaly cannot care for their partner? I know how difficult it was trying to care for an elderly parent, but the dynmaics of a spousal relatonship is something else altogether. People who have been together 6o years, have to walk out the door leaving thier partner behind because they cannot physically care for them. Do you honestly think anybody wants to do that? Elderly spouses are the first ones bullied into submission by the system when they are threatened with having their visitation rights removed if they don't keep quiet. they force themselves to believe their husband or wife is okay and being treated well because they don't know what else to do.
    Yes, there are some family members who choose not to see anything they don't want to see. They probably have their reasons that may be something I can't understand but I would not sit in judgement of them, because I don't know their story.
    Still when you get to the gist of it all, the people in long term care pay 80% of their income to stay in the place. Whether they even have family or not, should not have bearing on the lack of service that is provided for the money they pay. Any other business that took money to provide a service then did not provide it and in fact put the paying person at great risk, would be charged with fraud at the very least.

  5. We desperately need a Seniors' "watchdog" in government, someone independent and strong to explore the issues and to make recommendations which will be followed.

  6. I totally agree with the anonymous statement posted at 3:03 on the 6th. We do need an independent watchdog and we desperately need whistle blower legislation as well. Many staff members have tried to sound the alarms only to be held hostage by confidentiality agreements they have signed which rarely protect the residents but which frequenty serve as a shield to hide appallingly bad practices by the facility. Front line staff have tried many times to get help for the residents only to be told the facility will sue them for breech of confidentiality if they talk. We need so many things in place to help and the awful fact is these people don't have time to wait for things to change. These are the last months, weeks, days, sometimes hours of someones life and they deserve to live every single minute of it with dignity and respect.
    This blog is the frist place where I have found anybody willing to devote time or space to this subject and I am so grateful for that. I think we have had some really good dialogue the last few days and I hope that it continues. Thank you Norm Farrell.

  7. NOTbestplaceinworldApril 7, 2011 at 10:03 PM

    I'm an animal lover, but still I find it quite alarming or curious or sad, depending on my mood of the moment, that our new premier and cabinet acted so swiftly and firmly with regard to the death of the sled dogs (they didn’t even wait for the investigation to be concluded). And, Mrs. Palmarek and hundreds, maybe thousands, of elderly nursing home residents languish in fear and filth in nursing homes across BC. I smell public relations at work on this sled dog story (sorry as I am for those animals), but really, the premier attends the minister's conference to "announce" they are going to treat animals more humanely?!? Where is the inquiry into Mrs. Palmarek's shameful treatment?

  8. You understand the game, NOTbestplaceinworld.

    Liberals promised the toughest rules in the world to protect animals just as they promised the strongest environmental rules for northeast oil and gas and they promised the most open and accountable government in all of Canada.

    Promises and unenforced rules are easy. Actions speak louder. They have steadily cut the budgets of all the public agencies that might ensure the rules are actually followed.

    Look at the failure to have a powerful independent advocate representing seniors in care. They are blocking the Ombudsperson's report because it shows how hollow their words are.

  9. Really excellent comparison! I too am an ardent animal rights protector (as I am for any living being who does not have a voice)and signed my name to the petitions, facebook pages etc. surrounding the sled dog horror. So why then, is the same level of abject shock and disgust not generated, over what is happening to our seniors? I would venture to guess that the company which owned the sled dogs has felt a huge financial and PR backlash for their appalling actions. Why are the seniors care facilities and the government which allows them to operate as they currently do, not feeling the same public outrage?
    Norm's words that 'promises and unenforced rules are easy' is directly on target, in my view. They can put all sorts of flowery things on paper to make it sound like everything is okay, but when the cold, harsh light of day hits the reality, the picture is anything but pretty.



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