Seniors care in spotlight
Fatality report urges more specialists
Afatality inquiry report into the death of a 75-year-old Calgary resident of a long-term-care home is urging the province to examine how Alberta delivers health care to the elderly.
Alberta is facing a shortage of geriatricians as aging baby boomers place new strains on the health-care system, provincial court judge Anne Brown noted in her report.
She called for a number of changes, including a plan to graduate more geriatric specialists, better demographic tracking of the province’s aging residents and improved communication between health-care professionals who take care of frail seniors.
The fatality inquiry report, released Monday, looked into the Aug. 7, 2008, death of Kathleen Brock.
The Calgary woman suffered a bad fall in June 2007 that sent her first to the hospital, then to Southwood Care centre for long-term care and rehabilitation. While living at the care home, she suffered a series of falls, including tipping out of her wheelchair three times and falling out of bed when reaching for the telephone.
On July 24, 2008, she was being driven in a Handi-bus when she fell out of her wheelchair, landing on the moving vehicle’s floor.
The next day, she was eat- ing a sandwich around 2 p.m. when she started slurring her speech and complaining of a bad headache, according to the report. She was rushed to hospital for surgery to deal with a brain bleed. She died almost two weeks later of “acute subdural hemorrhage,” one of the deadliest types of head injuries.
Bill Moore-Kilgannon, executive director of Public Interest Alberta, said he was concerned that, according to the report, a nurse at Brock’s care home said “staffing issues” prevented them from checking on the senior every couple of hours the night after she suffered the head injury.
His organization hears similar staffing concerns from other residents of long-termcare centres.
“These facilities need to have an appropriate amount of staff such that in a case of emergency, they have the ability to monitor closely.”
In her report Monday, Brown suggested the health workers caring for Brock the day she fell in the bus weren’t sharing important information with each other.
“Despite the fact that ARBI (Association for the Rehabilitation of the Brain Injured), Southwood and Ms. Brock’s doctors were all professional individuals or organizations involved in delivery of healthcare services to a 75-year-old on blood thinners with a previous history of stroke and brain bleed, the compartmentalized context in which each was providing its services inhibited timely sharing of important information,” Brown wrote.
The judge recommended Alberta undertake a public awareness campaign to inform about the health dangers facing a person on blood thinners who suffers a fall. She also suggested a task force bringing together the province’s health regulatory bodies look at a model of care that improves information sharing and figures out a less-expensive way to provide diagnostic imaging services.
Further, the province should develop a plan with universities to graduate enough geriatricians in the next decade, she wrote.
University of Alberta chairman in healthy aging, Dr. Adrian Wagg, noted there’s an “ongoing, chronic shortage” of geriatricians across he country. Yet few residents choose to specialize in the area, said Wagg, the U of A’s director of geriatric medicine.
The intense, fiveyear specialty training period, and relatively low fee for service reimbursement at the end of the training can dissuade potential candidates, Wagg said.
Monday’s fatality inquiry report also urged bus operator Southland and the Southwood care home to step up training about the serious risks of falls, especially when dealing with head injuries to elderly patients on blood thinners.
It noted since Brock’s fall, the buses have had cameras installed so the driver can view passengers. A Southland spokeswoman said the company has developed training for drivers that focuses on elderly patients. “We’re looking at all the recommendations,” said Natasha Gleiser.
No one from Alberta Health Services was available for an interview Monday.
“This was a tragic incident and our thoughts remain with the family. Alberta Health Services is currently reviewing the recommendations and leanings resulting from this inquiry,” said a health superboard statement. “These recommendations will help guide our efforts to improve the level of care we deliver to elderly and geriatric patients in Alberta.”