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Province Taking Knife to Long-term Care

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From the Guest Column Section of The Lethbridge Herald, Friday, June 5, 2009.

A few nights ago, I discovered my 75-year-old father trying to eat his soup with a knife.

My father – a minister for the last 40 years – has Alzheimer’s dementia. The disease has eaten away his once-complete vocabulary of contemporary and King James English. The bible he once held to memory and quoted by heart, is now nothing but a familiar object he opens and fights to acquaint himself with like a child struggling with his first book. He can no longer spell, and so, can no longer write letters of prayer and encouragements to the sick, lost, and heartbroken. His once prodigious powers of oration are completely decimated, yet even so, by force of will, through frustrated, desperate tangents, fumbles and gestures, he tells us every day that he wants to minister, to live.

My father cannot minister again, because Alzheimer’s is killing his brain. The disease has destroyed the reasoning powers and memories he needs to live without constant care. He does not always recognize or remember the toilet, so, he may soil himself or the floor. Sometimes he tries to step into a television set to help a character in trouble, or will slap at the screen to try to stop a crime. In his disease-inflicted paranoia, he will sometimes turn on his caregivers. Some days or weeks he only drinks at all if prompted to, and has already been hospitalized for kidney infection related to dehydration. When in his anxiety and his great desire to do his life’s work he escapes and wanders, he will cross a street into heavy traffic or fall asleep in a snowbank. Lately, when we see him struggle to swallow – we wonder if he faces the horrible death by asphyxiation or starvation suffered by many with Alzheimer’s because they eventually forget how to swallow. It has only been with constant attention, minute-to-minute care and the enduring love and patience of family and community that my father has lived from one day to the next.

Recently, I brought my parents to live with me here in Lethbridge, to be sure dad would get the extra, professional care he needs and deserves at this cruel stage in our lives, and also to relieve my mother who was exhausted and on the the verge of a stroke (220 over 120). Our home is kitty corner from St. Michael’s Health Centre, which would be a short, merciful walk for my mother to visit her spouse of 41 years, if he were admitted there. Two weeks ago, a kind staff member of St. Michael’s gave me a tour of their locked dementia unit. It was perfect. Friendly, qualified nurses and other staff, bright, welcoming and beautiful facilities, secured outdoor gardens, a greenhouse, a cafe for visitors to share meals with interned loved ones, and even a chapel where my tour guide said services of my father’s denomination could be arranged. My guide also showed me an empty bed.

Thrilled that at last the right kind of help was literally within sight, I almost ran home to call the Chinook ACCESS number to begin the process of eventually getting dad into a long-term care facility. I told the ACCESS agent that we would like our dad to eventually be placed at St. Michael’s, for the sake of both my parent’s health. The agent, however, replied that St. Michael’s cannot be our primary choice because for the last month there has been a governmental directive to stop all referrals there. She said the government is shutting down the long term care facilities at St. Michael’s as part of its shift to move senior care to outlying designated assisted living facilities. She said the government has based its approach on a study showing this would be better for senior care.

I immediately called an administrator of St. Michael’s to ask why they would give me a tour of the locked dementia unit for my father, if there is already a moratorium on new placements to the facility, in order to shut it down. The administrator said St. Michael’s had not been informed of the moratorium, but she indicated she was not surprised that the Government of Alberta was moving its agenda along in such a way, without even informing the key players.

I have since learned that the government’s health ministry seems to be using its new “super board” to quietly cut services and care options in order to move seniors where their additional necessary care will be delivered on a hodge-podge, fee-for-service basis – a kind of quiet partial privatization of health care. I have learned this may be done to shift nursing resources out of senior care in order to back up a super board claim that there is no nursing shortage in Alberta. I have heard that emergency room wait times are increasing because of backlogs caused by more hospital beds being occupied by seniors waiting placement in the necessary but disappearing long term care beds. When done so secretly, who can know what, why, or where this is going?

Meanwhile, it is public knowledge that the Alberta government intends to cut 7,000 long term beds necessary for dementia patients like my father across the province, as part of the “Chinook Model” for senior care, for which Lethbridge has been the guinea pig. This, presumably, is based on the government’s report claiming this would be better for senior care, the report the ACCESS agent referred to in our phone call. Since that call, I have found scores of medical reports and articles warning that we are at the cusp of an epidemic of Alzheimer’s, with the most conservative estimates predicting rates to triple in the population in the next two decades (www.alzheimers.ca “The Rising Tide”). It seems the government is going one direction while the future is going the other.

Yesterday, my father was “certified” and admitted to the geriatric assessment unit where he will be sedated, treated and observed for 30 days while his placement options are considered, and while it is determined if and where there is an appropriate bed for his care in the region (and while beds sit empty at St. Michael’s for the transition). The wonderful nurses in the unit have already noted that dad cannot do the simplest things to care for himself; they, too, have seen him trying to eat his soup with a knife.

I spoke this morning with a woman whose mother nearly died in a designated assisted living centre in Lethbridge because she was incapable of fending for herself – and that after some fight, her mother is now thriving in a long term care facility. I will not allow my father – who has given his whole life to others – go some place where he will have no right to the 24-hour care or protection he needs to survive, where he would certainly die before his time. I have 30 days to show Albertans what their government and its so-called health ministry are doing to their parents and grandparents and their own future health. I will fight to show that like my father’s dying brain, the Alberta Government is myopically choosing a knife where other tools are necessary.

Please help us fight the government’s agenda and its super board’s tactics, and help us keep St. Michael’s and the province’s other 7,000 long term care beds open. We have 30 days.

Virgil Grandfield

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