Medieval groaning board

My dad had an unsettling experience recently in a nearby hospital. He’s been living at home alone since Mom died last year. I’ve been noticing that he’s been getting less nimble. So of course the inevitable happened. He fell one day while sweeping his porch - a neighbour found him there a few hours later and called the ambulance. He went to the emergency room and was told he had a broken hip. If that isn’t bad enough, they didn’t put him in a real bed, they put him in a stretcher in the hallway. I was really shocked when I arrived there later that day.

He said he couldn’t get any rest because the lights from the nursing station kept him from sleeping and the staff were noisy. He said he had wet the bed once because no one came to help with a bedpan. This really upsets me! I talked to the nurses and they said they were at “overcapacity” and unfortunately dad would remain on the stretcher until a bed came open, or surgery…whichever came first.

What has our health care system come to??

Signed, “Dealing with Dad and this Disastrous thing called a Health Care System”, BC City.

 

Dear Dealing:

Your Dad is considered a “Frail Senior”. His experience is not unusual of patients in hospitals in BC, and in many places across Canada. Being a "hallway" patient is not uncommon to hear about. Hospitals in BC are usually at overcapacity, which correlates to sick patients like Jonathon sleeping on stretchers in the hallways; often without privacy, or the capability to readily summon help for pain control, or the wants of nature.

Canadians have claimed for five decades that we have the best health care system in the world. It may have been true at one point, it is true no longer. Canada spends 12% of its GDP on health care; it ties for first place with Iceland, yet has only mediocre health care outcomes in the 32 country OECD {Organization for Economic Development}. Canada is the only country in the world to outlaw the private purchase of health care services that are publicly administered, as per the tenents of the Canada Health Act. No other country in the OECD has replicated our single payer system. Our health care is not ‘free’, it is expensive to procure and manage. Its cost is hidden in our high taxes; free it is not.

When Medicare was developed in the 1950s it was designed to meet the acute care needs of a relatively young population, not keeping the elderly safe at home or housed in facilities. As such, the health care system can be compared to the Medieval Groaning Board; the health care system is buckling under the weight of the burden of caring for its aging citizenry.

As Dr. Simpson, new leader of the Canadian Medical Association said, “Canada’s health system ranks next to last (after the US) on virtually every measure of quality and access to care.” He continues on to say that no one would ever create a health care system like this today. (Andre Picard, 2014)¹. Dr Simpson maintains that caring for people in their own homes to the extent safely possible would save the health care system in Canada, $2.3B per year.

Many seniors across Canada, tired of dismal, ever-so-cold winters in the East, turn to BC for easier winters. The unpredicted costs are great socially and financially. Not only do they leave their families behind, but they leave their support systems too. This means when they age in place in their new BC home they require more resources. They increasingly face social isolation as opportunities to mix with their peers, and families become more limited.

Our health care system needs to provide more home based care to people like Jonathon to help prevent misfortunes that necessitated his untimely visit to the Emergency Room. In 2011, BC hospitals spent $7.4 B providing care to hospital patients, $1.7 B to Residential Care patients (nursing homes), and only $943 M to clients who live on their own in the community. (John Doyle, Auditor General of BC, 2013)².

BC and Canadian families are aging and Medicare struggles to meet their increasing health care requirements. These same families feel that there is a looming crisis regarding the ability of the health care system to continue to fund needed care.

Health care funding is a complex matter to be sure; there are a few tools that BC Ministry of Health uses that helps for funding allocation, called “Population Based Funding”. BC spends the least amount except for Quebec on health care per capita. We cannot argue that older adults require more resources. With BC having more older adults per capita than other province, why do we spend so little on health care? These are questions for others to answer, who are in positions to provide answers.

Jonathon can ask the health authority for home care support to stay safe and well in his own home. However, should he have a high retirement income - which many seniors do who move here from other areas - he will have to pay full price for home support services, either to the Health Authority, or to private service providers.

Health Authorities in BC have set important strategies and goals to change this dilemma but it will not happen overnight. Until the way that home care is funded and delivered (i.e cost shifting from acute care to community care) older adults and their families should not rely exclusively on a broken patriarchal health care system that is buckling under the weight of this Medieval Groaning Board. They should not be deluded into thinking that the current health care system will meet all of their needs at a level they expect. Instead, families and their loved ones should be proactive and ensure home support services are in place to protect the safety and dignity of their loved ones.

‘Dealing’, I suggest you talk to your local MLA, Ombudsperson for Seniors, and call the Patient Quality of Care office in the hospital your Dad is in. Share your story and be part of the voice that helps create change. I wish you both the very best in health and hope your Dad’s recover is a success.

Best,

Nurse Kris

 

1. Andre Picard. (2014). CMA slams Ottaws' inaction on medicare. Globe and Mail, A5.

2. John Doyle, Auditor General of BC. (2013). Health Funding Explained. Vancouver, BC: Office of the Auditor General.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.