Fear, Loathing Stalk Health-Care Reform – Toronto Star

Behind closed doors at Queen’s Park, Health Minister Eric Hoskins and a team of senior bureaucrats are preparing to unveil a massive reform of the health-care system that will impact the lives of every single resident in Ontario.

But Hoskins is running into a wall of opposition and criticism from vested interests in the system as he tries to push ahead with the most significant health-care reform in 50 years in Ontario.

At the same time, a pervasive sense of fear has dominated the closed-door talks that Hoskins has been holding in recent weeks with health-care leaders — a fear that prevents many participants from speaking their minds openly lest they face reprisals from agencies they rely on for funding.

These issues are so prominent that they threaten to delay Hoskins’ proposals — or even derail the entire process.

This is important because Hoskins, who deserves praise for trying to clean up the mess in the health-care system, especially in the home-care sector, needs to win wide support for his proposals if they are to have any chance of success.

The reform package, expected to be presented to cabinet in April and then tabled in the legislature in May, is intended to improve dramatically how patients are handled from the moment they first need treatment until the day they no longer require services at home or in their community.

At the heart of the reform package is a dramatic reorganization of the home-care system.

The reforms come in the wake of a series of damning reports that showed the current system of home and community care is a disaster, with bosses at Community Care Access Centres (CCAC), which co-ordinate home care, receiving whopping pay raises and working in lavish offices while front-line health workers saw their wages frozen for 10 years and thousands of patients received inadequate or no care at all.

Hoskins is proposing to scrap the 14 bureaucracy-laden CCACs and to shift much of their work to the province’s 14 Local Health Integration Networks (LHINs), with the goal of saving more than $200 million and directing the savings to much-needed front-line services.

Over the past two months, Hoskins and his ministry have staged a series of “stakeholder engagement” meetings with hundreds of senior health-sector professionals. He had hoped these sessions would provide an opportunity to receive fair and honest feedback on the reform package.

Too often, though, the outside professionals have been holding back on their opinions, feeling it is too risky for them to stand up and speak out against the LHINs, who they rely on for money, or the health ministry itself.

This issue became apparent during a survey of senior health professionals released last week by Ted Ball, a respected health transformation analyst who has worked in the field for some 40 years.

Ball found that many of those who answered the survey said they did not feel “safe” speaking truth to their LHIN funder and to the health ministry officials.

Said one CEO, “The focused questions at these consultations were about implementation issues, so I was not going to put my organization at risk and stand up and tell the LHIN and [health ministry] officials that their plan to increase their micromanagement of the delivery system was a bad idea.”

Indeed, 69 per cent of the nearly 200 top officials answering the survey said they had little or no confidence in the consultation process. Some 61 per cent said they had little confidence in the LHINs’ ability to undertake the expanded role and nearly 60 per cent lacked confidence in the health ministry’s ability to manage the LHINs.

The three words most used to describe the LHINs were “inefficient,” “inexperienced,” and “bureaucratic.”

Three words used often to describe the health ministry were “controlling,” “insular” and “bullying.”

Hoskins knows the path forward in the next few months will be difficult.

He must win over the people who feel threatened, assuring them that their voices really do count. But it won’t be possible if only the bean-counters at Queen’s Park and the vested interests in the CCACs or big institutions are allowed to get their way at the expense of the needs and wisdom of patients, front-line workers and primary-care agencies.

Only by working together can our health-care system be fixed — and the fear and loathing finally come to an end.

Toronto Star
Posted by Living Assistance Services – Senior Home Care

It’s a Family Affair: How to Deal with Resistance from a Loved One

A Family Meeting

Arranging a family meeting can be a great opportunity to have a discussion about the care your loved one should be receiving, (or wants to receive). It may seem obvious, but remember that he/she is the one who will be making the necessary choices about how to live their life, not you or another family member, (unless, of course, there is a very serious health concern and your loved one is being quite unreasonable and is disregarding this health concern). Your loved one should always be at the centre of every discussion. If you do not involve your loved one, it may be more difficult to find solutions that are acceptable. You may find that your loved one (and possibly other family members) show signs of resisting a family meeting. If so, and it becomes very clear they would like to put off discussing the issues involved for a while, don’t push them into having a meeting.

Realize that they may need some time to prepare for such a discussion. Approach them a week or two later and make the suggestion again if they continue to resist, be a bit more assertive, make sure that they understand that you (and your family) want this meeting because you care about them and are concerned about their well being.
A family meeting demonstrates care and concern on the part of the family, and this how of concern alone may be enough to convince your loved one that they should consider some form of home care before their health deteriorates further.

Some suggested ways of dealing with resistance are:
  • If your loved one’s health and/or safety are at issue, say so, and push the discussion forward.
  • Involve others, such as, physicians, a social worker, or a case manager.
  • Use community resources to help everyone ease into the ‘care at home’ process. Meals on Wheels or a no- obligation consultation with our agency, are some examples.

Make sure you have focused on what your loved one feels are their issues, not just what others in the family think are the concerns. Your loved one will be much more accepting of your point of view and wishes if they can relate them to their own situation.

It is often wise for family members to discuss the issues among themselves before having a family meeting with their loved one. This will give family members an opportunity to organize their thoughts and for the family to develop a strategy. A united front will help to show your loved one that all of you are concerned about the same issues. The statement “strength in numbers” certainly does apply here.

Living Assistance Services – Senior Home Care

Talking With Older Drivers

The growing number of older drivers and today’s driving complexities has increased the concern expressed by many family members and friends about the safety of a loved one. These decisions about driving are difficult for older individuals to make on their own. This guide is to initiate the conversation and assist you when the time is right to discuss driving and your elderly relative, loved one or friend.
More information is available at the Ontario Ministry of Transportation website: www.mto.gov.on.ca

Questions & Answers

What can I, as a family member or friend, do if I am concerned about the driving ability & safety of someone older who continues to drive?

Firstly, recognize that driving is very important as it is often our primary means of getting around.
Secondly, if there are other family members or friends available, communicate with them to see if they have made some of the same observations and discuss how you may be able to help the driver.

What can family members and friends do when a driver continues to drive against the advice of their doctor and others?

It is best to maintain a sense of trust in your relationship, being honest and persistent. Encourage your loved one to make a decision or reduce or stop driving as appropriate. Be aware that seniors who lose the privilege of driving often feel lonely or anxious because they have fewer opportunities to be with friends or involved in activities. If your loved one will not listen to reason you may want to discuss the problem with his/her doctor to find out if there are any medical reasons that should be reported.

If an older driver stops driving, what alternative means are available?

Most areas in the city have subsidized alternative transportation services, (if you qualify), such as the TTC’s Wheel Trans. Our agency can also arrange for transportation or simply check your Yellow Pages telephone book for alternatives. Be sensitive to the older person’s feelings. Expect some emotional reactions and do what you can do to help them through this trying time.

The Warning Signs

COGNITIVE Reaction time is one of the most crucial functions to safe driving. This slows with age but increasing distance between other cars and objects may help some older drivers.

VISION Good vision is essential to safe driving. An older person may notice difficulties focusing on objects and switching focus from near to far. The ability to see fine detail may diminish. Peripheral vision may also change with age. This is significant, since about 98% of what we see when we drive is seen first peripherally. Driving at night may become more difficult due to clarity and eyesight issues. As we get older, we need more light to see clearly. Approaching headlight glare may make it harder to adjust.

HEARING Some hearing loss is common among people age 65 and older. High pitched sounds may become less audible than low pitched sounds. This is important because horns, sirens and train whistles are high pitched. Studies show people who have hearing difficulties are more likely to be inattentive to their surroundings. Family and friends who suspect an older person doesn’t hear well should recommend a hearing exam and offer to go with the older person to get one.

The Bottom Line

It is important to understand that even after taking steps to correct diminished eyesight or hearing, and after successfully avoiding adverse reactions to medication, an older person still may not feel comfortable behind the wheel. Encourage the older person to discuss this with you, another family member, friend or doctor. As a family member or friend, you must be sensitive to this insecurity to effectively help your elder loved one.

Living Assistance Services – Senior Home Care

When Is Home Health Care Required?

Generally speaking, home care is required when a loved one is a threat to their own well being or he/she needs assistance with the activities of daily living. These activities include, but are not limited to: meal preparation, bathing, dressing, grooming, errands, shopping and medication reminders.
Recognizing for the first time that your loved one requires home care can be the most difficult, yet most important decision you may contemplate on his/her behalf. Many seniors requiring home care will not welcome a stranger into their home willingly. Even if a caregiver is present only to provide basic living assistance, there often is a tendency to perceive the caregiver’s initial presence as a loss of independence.

It may be helpful to review this short list of indicators to help analyze your senior loved one’s particular situation.

This list contains situations which, in our experience, provide a reliable indicator of when help is required.

Consider home care for your loved one if he/she:

  • Has been discharged from the hospital recently and believes he or she has recovered to a greater extent than is really the case.
  • Has physical limitations such as a loss of sensory perception.
  • Is undergoing rehabilitation.
  • Experiences short term memory loss.
  • Cannot prepare his/her own meals.
  • Is unable to achieve an adequate standard of personal grooming and hygiene.
  • Cannot maintain a satisfactory level of home cleanliness.
  • Finds family care giving efforts inadequate or unsatisfactory.
  • Is a danger to self or others while driving.
  • Cannot maintain his/her normal social lifestyle independently.
  • Makes family members’ lives unduly stressful.


Living Assistance Services – Senior Home Care


Are your Stairs at Home Safe?

Seniors are more at risk for falling on stairs than younger adults. A large portion of Canadians who visit hospitals after a fall on or from stairs in their homes are seniors. When seniors fall, the consequences can be severe. Falls resulting in injuries can occur even with a single step. Aside from environmental and behavioural, health reasons are contributing factors to why people fall on or from stairs. Health factors can include vision problems, balance issues, frailty and drowsiness. Falls on stairs can be a threat to health, independence and confidence. The physical consequences can be serious. Other consequences – particularly for older people – can be psychological effects such as lowered confidence and a loss of a feeling of safety, which might further reduce healthful mobility and activity.

The good news is – good planning and some simple steps can help with preventing falls and injuries. There can also be health benefits to using stairs. Climbing stairs contributes to the 30 minutes of physical activity we all need every day. Stair climbing increases leg power and may be important in helping seniors reduce the risk of injury from fall.


Living Assistance Services – Senior Home Care


What are Your Rules for Living a Happy and Rewarding Life?

To quote Abraham Lincoln, “People are just as happy as they make up their minds to be.” Or do you think happiness, ‘just happens?’
If you were to stop people randomly on the street and ask them if they were happy, chances are most of them would say, “Yes.”

Happiness can mean different things to different people. One kind of happiness is a sense of calm well-being. Another kind of happiness is a feeling of pleasant excitement. Older people (who are generally less focused on the future) are more likely to experience the calm type of happiness. A recent University gerontology program study identifies the predictors of happiness and depression late in life. Researchers posed questions that assessed happiness and life satisfaction. They discovered resources did not affect happiness but that “past life satisfaction” had a direct association, proving to be the key to happiness in oldest years.

What are your thoughts? What makes you happy? Have you noticed older people are happier?

Check out this fun & interesting list of rules to live by in the link below.

Let us know your comments.

Living Assistance Services – Senior Home Care

Vision Care Info for Seniors

Be Kind to Your Eyes!

Have you eaten your carrots today?

Studies show that a daily dose of the vitamins and minerals found in melons, citrus, carrots, spinach and kale may help slow the progress of age-related eye diseases such as macular degeneration.

Many changes to vision happen so slowly that you may not realize you have a problem. The most important thing you can do to protect your vision is to have an eye exam on a regular basis. As we get older it is normal that our vision changes. We may find it harder to read small print or it takes longer to adjust from light to dark.

Good eye sight is an important part of staying safe and independent. This is especially relevant for our aging population, as we all try to maintain our independence for as long as possible.

The most common reasons for age-related vision loss are glaucoma, age-related macular degeneration and diabetic retinopathy. For most seniors, normal age-related vision loss can be corrected or stopped with glasses, medication or surgery.

Have you witnessed someone spilling food or drinks on themselves because they misjudged where objects really were? Or have they fallen because of a missed step? These could be warning signs it’s time to visit the eye doctor.

Share your comments below on being kind to your eyes. Let us know – have you eaten your carrots today?

Living Assistance Services – Senior Home Care

Healthy Eating for Seniors

The saying “You are what you eat,” is true. A healthy diet provides the ingredients to build and repair bones and tissues and keep the complex workings of the human body functioning optimally. It also provides the mental and physical energy necessary for daily life – work, recreation, relationships and time with family. It is clear that a healthy diet also protects us from infectious illnesses and chronic diseases so that we may age with a minimum of ill health, pain and disability.

As people age, the need for calories decreases while the need for nutrients often increases. This can pose a challenge for seniors.

An important fact to consider is that seniors have higher rates of heart disease, cancer, high cholesterol and high blood pressure than the rest of the adult population. However, these diseases can be prevented or controlled through healthy eating. For example, did you know that broccoli controls blood pressure? This is a good tip because the majority of senior men and many senior women eat more than the recommended amount of sodium (salt). Decreasing the amount of sodium you eat can substantially reduce your risk of high blood pressure.

Do you have any tips on nutrition you would like to share? Let us know in the comments below.

Living Assistance Services – Senior Home Care