Seniors’ care needs must trump what’s expedient for the system
Re: “Consistent policy for move to long-term care urged,” June 6 Health Minister Fred Horne is being disingenuous as he responds to the Health Quality Council of Alberta report. The issue of frail seniors languishing in acute-care beds has been with us for years; any suggestion that the solution is imminent is laughable.
The aging demographic, like global warming, is an inconvenient reality. As with global warming, millions have been spent on piecemeal plans which do little to confront the magnitude of the problem. Meanwhile, compromised seniors continue to languish in emergency rooms, and are warehoused needlessly on acute-care wards, awaiting a fate not infrequently determined by a course of action calculated to be the least problematic to the system.
Alberta has been favoured with a remarkable generation of seniors, many of whom have lived through armed conflicts and economic depressions, and all of whom have dealt with the vagaries of life encountered over 80-plus years. For many, often by a combination of good luck and good management, the present supports are adequate. Many dedicated individuals, groups and organizations help make this possible.
A substantial group, however, is less fortunate: Their health issues render them vulnerable. Too often they are confronted with an inflexible healthcare system which focuses on their deficiencies and vulnerabilities. Expediency is the overriding principle. There is substantial risk their valid wishes and concerns will be ignored by a mechanistic bureaucracy. Personal directives, created to protect a senior’s rights, are not infrequently summarily enacted (in perverse negation of the spirit of the Dependent Adults Act), thus removing an individual’s decision-making capability.
Providing optimal care is a great challenge that directly involves thousands of Albertan seniors and their families. This problem will become exponentially greater as the proportion of seniors increases to a point that will threaten to overwhelm our health-care structure.
Attempts at generic solutions will, in most cases, fail. Each case requires a requisite amount of deliberation, balancing the rights and wishes of an individual with those of their families and of society.
Care of chronic conditions must be undertaken by health-care providers in a co-ordinated, collaborative manner, not unfairly thrust upon ER personnel. Home-care managers must be given adequate support and resources to care for appropriately selected seniors, allowing them to continue living in their own homes. A functional, coherent system of facility-based care is needed to appropriately address the needs of their residents and must not be driven by expediency and profit motive. Families must advocate resolutely, but fairly, while acknowledging the limitations on services a healthcare system can be reasonably expected to provide.
Meaningful action must begin now, and must be sustained. Douglas Duke , MD, Edmonton