A new plan to shuffle residents in the St. Michaels auxiliary hospital in Lethbridge to a new “designated assisted living” facility is a prime example of cuts in standards and services in long-term care says the United Nurses of Alberta.

“This is a prime example of the huge cuts in services that has caused the crisis and horror stories in Alberta’s long-term care system,” says United Nurses of Alberta Vice President Bev Dick.

“The residents at St. Michaels are in an approved hospital because they need a high level of nursing care,” she says. “Now they will be shuffled off to designated assisted living with no registered nursing care.”

St. Michaels Health Centre currently has 200 auxiliary hospital patients and the plan is to move them to a new assisted living facility or to other nursing homes. However, the two licensed nursing homes in Lethbridge have only 12 vacancies between them.

“This is just the latest instance of long-term care residents switching to assisted living where there is no on-site professional nursing care,” Bev Dick points out. “The Auditor General Fred Dunn pointed out in his report that inadequate staffing is one of the main problems creating the scandalous conditions.”

“Adequate Registered nurse staffing is critical to protecting residents and ensuring safe care,” Bev Dick says.

“The MLA Task Force looking into the long-term care crisis, should look at this happening right now, even as they are considering what the standards should be, these vulnerable residents will see their level of care drastically cut.”

UNA made a presentation to the MLA Task Force in Edmonton last week.

“It is time to reverse the crisis in continuing care – by requiring measurable, clear standards for reasonable levels of qualified staffing, including staffing by Registered Nurses,” Bev Dick told the MLAs.

Two years ago, nurses at the Lethbridge facility successfully got a court injunction preventing St. Michaels from laying off nurses.

“Our nurses were concerned that St. Michaels was risking patient care by cutting nursing staff,” Bev Dick noted.

The court decision prevented the layoffs pending an arbitration decision on the staffing levels. The arbitration panel finally ruled that as an approved hospital, St. Michael’s did not have to meet the staffing regulations under the Nursing Homes Act.

“St. Michaels was getting around the minimal standards in place under the Nursing Homes Act. Switching to designated living is another way to do that,” Bev Dick noted.

Courtesy The United Nurses of Alberta

May 12, 2009

Mr. Cal Dallas MLA, Red Deer South
#703 Legislature Annex,
Alberta Legislature

Dear Sir:

RE: SUPPORTIVE LIVING ACCOMODATION LICENSING ACT

The above named proposed legislation which is before the legislature is an extremely important piece of legislation which will ultimately affect thousands of Alberta senior citizens.

We urge that that the proposed Supportive Living Accomodation Licensing Act be sent to committee for further examination before it is placed before the House for final assent by the legislators.

Many of these facilities have been in place, housing vulnerable Albertans, for over a decade, unlicensed, unregulated and unmonitored. We are aware of some of the difficulties that seniors have had to deal with.

We would be grateful to be in receipt of your response in regard to this most urgent matter by the 26th of May, 2009.

Yours truly,

Elder Advocates of Alberta Society,

c.c.
The Honourable Ms. Mary Anne Jablonski, Minister for Seniors and Community Support Services
Mr. Tim Wiles, Deputy Minister, Seniors and Community Supports
Dr. David Swann, Leader of the Official Opposition

Response

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The Reality of Such Facilities?

The “Dumbing Down” Factor.

Because these facilities are not subject to the Nursing Homes Act, there is no legislated requirement to have a Registered Nurse on site.(though presently some do throughout the day i.e. Vista Village, Pincher Creek, AB.). There may be an RN on 24 hour call.

LPN’s may be on site though their services will be stretched thin, necessitating professional nursing care, dressings and even medications to be administered by care aides who may have little or no training. This all takes us back to the 80′s when persons were hired off the street to give care to nursing home residents – some us worked in those situations – we lived it!

In one such facility, the Director/ Administrator had no professional health care training whatsoever. Her work experience included charge of the local Seniors Drop In Center.

Furthermore, residents who are very ill, are sent by ambulance to emergency wards because there is no one in the facility who possesses adequate assessment skills. Therefore situations that could have been remedied or dealt with by a professional RN becomes a hospital trip. It also becomes a frightening experience for the older person.

The Cost Factor.

In a nursing home setting, the Nursing Homes Act defines the following types of services as basic care in long term care facilities which is covered by the basic fee of approximately $1,400.

1. accommodation and meals;
2. facilities services;
3. necessary nursing services;
4. personal services;
5. therapeutic and special diets as required;
6. drugs and medicine specified by the Minister for use on a routine or emergency basis as prescribed by a physician;
7. routine dressings as required;
8. life enrichment services.

However in assisted living facilities, some of the monthly costs which are assigned to the elderly client, above the basic rent, are (these vary from facility to facility):

• Basic rent which may be between $1,100. – $2,000 or more
• Meals 3 times a day (snacks) – $450 – $500
• Laundry bed linen – $30.00
• Medication administration assistance – $150.
• Blood pressure check – $50.00
• Blood sugar monitoring $150.00
• Assistance to dining area – meals – $150.00
• Bath – $25.00
• Hygiene care incontinent management – $150.00
• Companion services – $12.00 – $20.00 hour

The Accountability Factor.

This trend has produced a hybrid of choices for seniors, which on the surface, appears to be desirable. Free market choices.

However one assisted living facility which we have visited has a hotel catering license posted, another has a city rental accommodation license posted. In these instances, all is well as long as all is well. However if all ceases to be well, no one can be held accountable.

If the resident/family complains or the resident becomes unsuitable or for some reason undesirable to the administration, under such licensure, the elderly resident can be evicted without notice/cause.

Because of the difficulty of accessing long term care beds (Please see “The Long Term Care Bed Crisis (PDF)“, vulnerable, dependant elderly are forced into such facilities.

The Alberta Government is converting Long Term Care Facilities into Assisted Living Facilities known as Designated Assisted Living Facilities (as defined by Alberta Seniors & Community Supports).

In Alberta centres like Pincher Creek, Hinton and Lethbridge, these Designated Assisted Living facilities are replacing or have replaced long term care facilities, all under the watchful, approving eye of Alberta Health and Alberta Seniors and Community Supports. Some of the same elderly who were residents in a long term care facility suddenly find themselves residents in assisted living facilities. The care may not have improved but the cost has dramatically escalated. However they do remain in their own communities. Sadly, those who are too dependant and too ill, are sent out of their home community to a distant facility where it may be next to impossible for friends and family to visit, monitor, give comfort and care.

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The PERSONAL DIRECTIVES ACT CHAPTER P – 6 Part 2 (4) states: “When a determination of lack of capacity has been made under subsection (2), the person making the determination must provide a copy of the declaration to the maker.”

On Feb. 15/08, a close friend & an old neighbor of Mr. Washylk were evicted from Rosedale & informed that they were permanently barred from visiting Mr. Washylk.

His phone calls are being intercepted by front office staff.

He is being detained and isolated in the locked unit.

March 4, 2008

VIA FACSIMILE (780) 377-2384

Marilyn Wright RN,
Case Manager Supportive Living
Capital Health Authority,
Rosedale Griesbach Assisted Living

Terry Lynn Zorba, SW, Manager
Rosedale Griesbach Assisted Living

Laurie Allen RN
Designated Assisted Living Staff

Re: Mr. Nick Washylk, 89 years of age, # 129 Rosedale Griesbach Assisted Living Facility.

We speak in defense of frail, dependant elderly and therefore have an interest in this matter.

On February 15, 2008, without cause, a long time close friend, and an old neighbor, (both seniors) were evicted from Rosedale and informed that they were permanently barred from visiting Mr. Nick Washylk.

Phone calls made to his number are being intercepted by front office staff even though his phone is not on the Rosedale circuit. Callers are told his line is busy.

Mr. Washylk, a cardiac patient, has no call button in his unit and has no ability to call for help. He is being detained in a secure unit that often has little or no staff on duty especially at night.

Mr. Washylk is a multi-millionaire who wishes to return to his home and be cared for at home.

Recently four visiting seniors were summarily removed from the Chapel church service at Rosedale, they were attending with other residents. The police were called and what is not troubling, the police came to ensure that these four seniors were removed and left the grounds.

When you deliberately isolate Mr. Washylk and other seniors, you are acting in violation of the Protection for Persons in Care Act Chapter P-19,5.

This Act defines abuse to include:

1(a) ii “Intentionally causing emotional harm…coercing or restricting from appropriate social contact.”

Furthermore, a four year study published in the Archives of Psychiatry, suggests that loneliness and isolation can accelerate and even cause dementia and Alzheimer disease in the elderly.

It is deeply troubling that Rosedale staff have total power over the lives of Alberta citizens such as Mr. Washylk; citizens who are being detained and isolated behind locked doors and denied all Charter Rights, Human Rights and Constitutional Rights.

We shall be awaiting your reply and be grateful to be in receipt of such reply by the 15th of March, 2008. We trust that those to whom this has been copied will also respond to our concerns.

Yours truly,

Elder Advocates Of Alberta Society

cc.

Lorenzo Clonsero, CEO Rosedale Estates
Mr. David Korol, Deputy Chief of Police
Loralee Gaboriau, Director of Standards and Monitoring
Supportive Living & long Term Care Development