Hospitals Failing the Elderly

A second go round with spine surgery on my part, and dealing with Dad's continued fight with Parkinsons has depleted our family, and is behind the lack of posts on this blog for almost a year.


When I can, I will share in greater detail the absolute nightmare we have had since Christmas Day, when Dad was rushed to Trillium Hospital in Mississauga, Ontario with a significant seizure, double pneumonia, and a cracked rib due to a careless part-time caregiver who neglected to inform us that he had fallen.  She has since been terminated.


Since then, he has twice beaten back death knocking on his door, coming down with aspirative pneumonia, and a second and possible third seizure.  To top it off, numerous poor medical choices made by incompetent or unconcerned doctors and a surgeon who used a "standard" method to insert a peg tube as a means of getting Dad the nutrition he requires, have affected his recovery and state of health.


Unaware, ill-trained and ill-prepared nurses, a missing physiotherapist, and an occupational therapist that has done everything possible to undermine Dad's well-being are just some of the obstacles we have faced with the staff found on 5J at Trillium.  There are some real gems on 5J, and some compassionate and concerned nurses, who seem to be stuck behind a system that isn't working, mired in inflexible policies and procedures, and supervisors that would not be our first choice in management roles.   


We have had to use the Patient Relations Manager to help us intervene and be heard on many a medical mistake that nearly caused Dad his life. 


In a nutshell, Trillium Hospital is ill-prepared to deal with an aging population, specifically those elderly who have chronic, degenerative conditions such as Parkinsons and dementia.  Standard patients, or those with non-complex issues are probably fine.  But, the more complex cases pose problems that Trillium seems unable to accommodate or manage.  Actually it's quite shocking when you think of the massive change in demographics that we are undergoing, and the complexity of health concerns that accompany the elderly.  


It's one thing when you admit to such a gap, but its a whole other ball game when you are faced with obstinance and a single-minded team approach to freeing up beds as quickly as possible, usually at month's end, never mind the well-being of their patients.  


In the last couple of weeks alone they discharged a few of the other elderly patients on 5J, only to have one rushed back to emergency within an hour of discharge; the second one was rushed back within two days; and the third with a couple of weeks.  See a trend here?


It is why we micro-manage Dad's care, and why we have continually used the Patients Relations Manager to fight for better health care and a demand for changes to the Primary Physician and surgeon on his case.  It is why he is constantly monitored by my mother and new caregiver 12 hours a day, and why my brother has had to place his plans of launching his own business on repeated pause.


Just as an example, the Occupational Therapist has insisted that while Dad is sitting in a wheelchair or other seat, that no belt is used to secure him to that chair.  Her reasoning is that the peg tube placed in his abdomen would be compromised with the use of a belt.  We have patiently tried to explain that in the past, he has fallen out of such seating, when in a confused state he has attempted to rise from a chair.  It's a matter of his safety, which we have clearly communicated.  Besides which, there are ways to pad the area around the peg tube so that direct force from the belt would not interfere, but creative solutions are not a strong suit at Trillium.  Whether she realizes it or not, she has created a liability risk for Trillium, in that if he does fall, they will be held responsible for their decision.


It is exhausting to oversee and micro-manage Dad's care, but necessary at Trillium.  The stress has taken its toll on my brother and mother, who must fight constantly or be aware of any changes to Dad's health every day, while also taking care of me, post-spine surgery.  I fear for both of them, particularly the health of my mother.  As most families in this situation well know, it's the caregivers that often suffer the most.


On a positive note, I will take a moment to thank the wonderful team at Baycrest Hospital and the Movement Disorder Clinic at Toronto Western Hospital led by Dr. Lang, with whom we have consulted based on concerns that the direction Trillium was heading in or suggesting, was not in Dad's best interests.  Their on-going support and willingness to assist and inform, even though Dad is at a different hospital, exemplifies what healthcare should look like when the patient's best interests are first and foremost.  It also demonstrates that not all hospitals can have the necessary expertise to deal with all health issues, and consulting across hospitals in a public model, makes sense.


Many thanks also to Dr. Shulman, the head of the Geriatric/Psychiatric clinic at Trillium.  Dad has been a patient at Dr. Shulman's clinic at Trillium, for several years.  If not for his continued oversight of Dad during his stay at Trillium, I can't imagine where we would be.  


This is an area that is sadly lacking in funding and actual physicians who specialize in Geriatric care.  It took three years for Dr. Shulman to find an additional doctor to join his team, which is bursting at the seams with patients in crucial need of his services.  Where is that money Mr. McGuinty promised?  Where is the walk that accompanies the talk?  


Perhaps this is how healthcare is delivered in other hospitals across Ontario, but that is no excuse for what we have and continue to experience.  One way or another, when we have a few moments to breathe, we will share the details of our story with the public, and perhaps even write a guide to assist other families so that they can better navigate through what passes as healthcare for the elderly.


We all need to fight, shine a light on the glaring gaps of healthcare in Ontario and be heard loud and clear for our aging parents, relatives and friends, so that when they do enter the Ontario healthcare system, their journey is more supportive, compassionate, medically sound and less stressful.  


We should be able to enjoy what time remains with our aging and sick parents, rather than spending our time fighting a system that has become much like that conveyor belt in a manufacturing facility, churning out patients like widgets.  


Only quality is not the key benchmark or reason for being.  It's there somewhere on the list, but not in the top five.  


I question whether, for the elderly, it's even on the list.