klaus
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Oct 25, 2010, 10:55 AM
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Ontario: bureaucracy devouring shrinking healthcare budgets
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In these days of diminishing healthcare resources it’s interesting what the Ontario healthcare bureaucracy considers to be “important” in long-term care (LTC) facilities across the province. Currently there is a witting list for spaces in these facilities to become available and it isn’t unusual for someone to be sequestered in a hospital for upward of two years waiting for a long-term care bed.
Rather than ensuring that more such facilities are created to deal with the province’s burgeoning demand for LTC, the bureaucrats are coming with ever newer and more novel approaches to complicate the lives of families and individuals currently in the system.
The latest such brainstorm is a move to ensure that LTC residents’ ability to move is not constrained in any manner, regardless if such constraints ensure the safety and security of the resident. Imagine a patient confined to a wheelchair may not have that chair’s seat belt fastened without written permission of the patient or the patient’s family. Similar rules are in effect that govern the use of wheelchair trays. Such trays are considered an impediment to the patient’s mobility, regardless of the problems these devices solve, particularly in making meals easier to eat.
Patients in LTC facilities usually sleep in hospital beds and hospital beds have bed rails that ensure the patient cannot fall out of bed. One can only imagine the extent of the damage to an aging person’s body should he or she inadvertently fall out of bed onto the floor, which in LTC facilities is usually made up of a hard stone-like composite. Yet LTC operators are now being prohibited by the province’s health bureaucrats from putting these rails up during the night unless the patient or the patient’s family expressly requests it in writing.
So LTC residents and their families are being sent reams of paperwork to sign for consent to use Personal Assistance Service Devices (PASDs) or consent to utilize restraints, such as wheelchair seat belts or bed rails.
It’s all in the interest of preserving the patient’s dignity by not constraining voluntary movement in any way. While protecting the patient’s dignity is a laudable endeavor, one would think that doing so at the risk of creating conditions that could conceivably cause grievous damage to the patient is another matter altogether.
Then there is the time and paperwork involved in keeping up with the new requirements. Staff at LTC facilities are now required to generate a paper trail of consent forms justifying the use of “restraints” and educating residents and their families about the pros and cons of using these methods to ensure patient safety.
Resources at most LTC facilities across the province are stretched so thin, that staff has difficulty in keeping up with patients’ hygiene and bodily function needs. As I wrote in these pages on June 18, 2008, the Ontario Federation of Labour (OFL), the union representing long-term-care workers in Ontario, complained to the Ministry of Health and Long Term Care that the staff levels at Ontario’s LTCs was too low to even allow for frequent diaper changes. The Ministry’s response was to test some more absorbent diapers, which then health minister George Smitherman wore for a day to see how well they worked.
Clearly, bureaucratic considerations precede patient comfort when it comes to LTC in Ontario. Rather than find ways to increase the paperwork in nursing homes, the government should focus on setting higher standards for care and then ensuring these standards are met by hiring sufficient staff to do so.
Klaus Rohrich is President and Creative Director of Taylor/Rohrich Associates Inc., a marketing and advertising firm that specializes in niche marketing retirement real estate developments
http://www.maturitymarketing.com.
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