Last week, the Toronto Star launched Begging for Care, an investigative series looking at how the province is dividing up the $1.1 billion allocated for its “Aging at Home” program. The Star highlighted some of the difficult experiences Ontario seniors faced when laying in limbo in an acute care hospital bed, while on the wait list for a long-term care home. Others desperately needed home care services to continue living in their own homes or to support family members who were caring for them.

The state of health care is coming around full circle. Health care professionals and politicians alike are starting to listen and call for change. For example:

• The Canadian Medical Association (CMA) has announced a town hall, Health care in Canada: Time to rebuild medicare, to be held March 1 (http://www.healthcaretransformation.ca/en/).
• Toronto MP Carolyn Bennett is also hosting a town hall, Caregivers and Homecare, 1:30 p.m., March 6, at Christ Church Deer Park, 1570 Yonge Street.
• Ontario Health Minister Deb Matthews was recently quoted by the Hamilton Spectator, saying: “Long-term-care homes are people’s homes and there should not be coercion as they move into that home.” (http://www.thespec.com/news/ontario/article/491214--province-to-hospitals-stop-threatening-1-800-fees).

People are aware and ready for solutions, which is reflected in the online posts and comments about the Star’s Begging for Care series (http://www.thestar.com/news/article/941693). Many are frustrated, scared and want answers. We have personal observations, experiences and opinions, and are not afraid to share them.

In my opinion, the challenges people face is the cosmic complexity of trying to navigate the health care system. Patients are falling through the cracks, lying in hospital beds and struggling alone in their homes with little or no help, resources or alternatives. Our health care system is hugely disconnected. There are three silos – acute care (hospitals), primary care (doctors) and community care (home care) – that need to start working in tandem and better understanding how their own goals and actions affect each other and their patients.

In my role as a care advisor I’m presented with many situations and one that comes to mind is how well we (public and private organizations) can sometimes work together to find the best care for someone. One of my first advisory clients told me she just couldn’t do it alone anymore. Both her parents wanted to stay in their home but needed help. Her father had physical deficits and her mother early dementia. They made a great team until one of them ended up in hospital and could no longer live independently or safely at home. My role was to help them navigate the health system and facilitate care arrangements … to help them solve the health care puzzle.

Some of the important pieces in this puzzle are:

• Learning about your community health resources – both public and private.

• Getting in touch with your government care program to find out what’s available.

• Investigating volunteer and non-profit organizations in your community that provide support services.

• Being proactive about managing your health (e.g., monitor your own blood pressure) and communicating the results back to your health care professionals.

• Looking into online health information resources and services:

1. The Patients' Association of Canada (http://patientsassociation.ca/)
2. Your provincial health ministry (http://www.health.gov.on.ca/en/)
3. Community directories such as Find Help 4 Seniors (http://www.findhelp4seniors.ca/)
4. Or pick up the phone and call me at 416-992-4280 or email me at jhickey@bayshore.ca

The time is now. We need collaborative change. $1.1 billion is a fair chunk of dough, in the case of Ontario. We need to spend it wisely, be patient-focused and monitor patient outcomes as well as the impact we have on each other’s services. This will enable us to provide one health care service – our health care service.

Caring@Home: Staying connected is a must for long-distance care...

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Staying connected is a must for long-distance caregivers

Generations have existed for centuries. Lately, people are paying more attention to generations and the impact they have on everyday life, as many baby boomers are caught between raising their own children and looking after their elderly parents. Me, personally, I’m stuck in the middle, and it’s sometimes difficult. I look after two teenage daughters who live at home and regularly keep in touch with my 82-year-old mother who lives independently in her own home an hour away. Statistics Canada estimates almost one-quarter of the 1.65 million Canadians over the age of forty-five who are providing care to a parent or in-law live over an hour away.

Being a long-distance caregiver can be challenging. Do you worry about how your parent or parents are coping? Are they getting to their doctor appointments and eating properly? And all the while you are wondering how to cram your work day so you can make it to your daughter’s school play. How do you ensure you can be there for everyone every time?
　
In my experience, most seniors I visit say the most important thing for them is to stay in their own home for as long as possible – whatever it takes. I recently received a call from an 80-year-old gentleman who was looking for help for himself and his wife. Both of his adult children live out of town, have careers and families of their own and provide as much support as they are able to. But they are at wits end and need help in their role as long-distance caregivers. They want to keep their parents’ wish alive and keep them in their home.
　
In my opinion, staying connected and communicating regularly with people we care for is the solution. We tend to notice when a picture is crooked because we see it every day. We realize when our son is starting puberty because his voice changes, and we feel relief when our daughter calls to let us know she made it back to her dorm room. The same should be true with respect to our parents – connect regularly with them and you will know if things change. Here are a few simple suggestions you can start doing today:
　
• Set a specific time to call each other every day, just to say hello.
• Identify a friend or neighbour who can be there when needed.
• Exchange your parent’s contact information with neigbours or someone who lives nearby that can help. Put it in your parent’s wallet. Plan for an emergency and be prepared.
• Get some help if your parent needs in-home care, support or someone to check in on them or shovel their driveway. You can't do everything and be everywhere.
• Hire a nurse to monitor their health and prevent serious health problems from occurring.
• Take care of yourself – you can't be effective if you are not healthy.
Social media can also help you stay connected with your aging parents and survive the sandwich generation. Think about it, we are the generation that joined Facebook to keep an eye on our children and what they are doing on these sites, and then realized the value social media had for us personally and in business. So why not create a Facebook page for our parents simply to stay connected? I practice what I preach and set my mom up with her own Facebook page. I’ll let you know how that goes in a future blog.
　
Parenting is the biggest job we’ll ever have and it gives us the most joy and stress at the same time. A recent quote I read states it well: First we are children to our parents, then parents to our children, then parents to our parents and finally children to our children. We will be where our parents are someday – so let’s pave the way now. Stay connected with parents – particularly those who don’t live nearby. It just might be the best peace of mind you’ll ever have.

Caring@Home: It changed my outlook on heart disease forever

http://nursejackiehickey.blogspot.com/2011/02/it-changed-my-outlook-on-heart-disease.html?spref=bl: "Each year the month of February is recognized as Heart Month, with tens of thousands of people across Canada putting their hearts into makin..."

It changed my outlook on heart disease forever

Each year the month of February is recognized as Heart Month, with tens of thousands of people across Canada putting their hearts into making a difference through support for the Canadian Heart & Stroke Foundation (www.heartandstroke.com). I felt it important to dedicate this blog to heart health, in an effort to help reduce the many unexpected deaths that heart disease brings.

The purpose of Heart Month is to raise awareness through education and prevention of diseases related to the heart. The Heart & Stroke Foundation believes that many Canadians are being ignorant and negligent about their food and life style choices, which increases their risk of developing heart disease. If you visit the foundation’s website you will find an enormous amount of valuable information. But the thing that stood out for me the most is the vast impact this organization makes – from repairing a newborn heart in its first moments of life to saving a woman's life from a deadly heart defect, to helping a parent recover from a disabling stroke or stopping cardiac arrest from taking its next life.

As caregivers in the home we may not have the high-tech equipment to monitor the internal workings of the heart and its affect on the body. So we need to be aware of the warning signs and listen to what the body is telling us. Human bodies are just like well oiled machines. With regular maintenance and good care they can run for many years and many miles. Our body requires dedication to maintenance and care, just like a well-tuned car. The reality is, if we don’t take care of our body, it won’t take care of us. I certainly am not telling you anything you haven’t heard before, but I do think it’s worth repeating.

I remember the first time I experienced the black hole of a heart disease. I was a fairly new nurse working a shift in ICU, when in came a 28-year-old woman admitted with chest pain. The medical staff initially cast a professional judgment that it must be stress or a panic attack, saying, “We see this all the time – young, hard working, highly stressed females trying to climb the corporate latter.” But we sure were surprised when the medically confirmed diagnosis came back: myocardial infarction or, commonly, “MI.” It changed my outlook on heart disease forever.

In my opinion, if we adopt some simple life style choices we can make a difference that can positively impact our health. By managing some of the most common and deadly cardiovascular risk factors we can change our path from destruction to construction. We cannot ignore the fact that we are what we eat and our level of physical activity can make or break us. An alarming study exposed that passivity and obesity can take almost four years off one's lifespan, high blood pressure two-and-a-half years and a eating low amount of fruits and vegetables just over one year. We become increasingly vulnerable to heart disease by living an unhealthy life at any age.

There are some simple lifestyle practices that could benefit your heart and prolong your life: staying active and exercising, managing stress, getting enough sleep, not smoking, minimizing alcohol consumption and eating healthy food. By incorporating the four food groups from the Canada Food Guide into your menu and including some physical activity into your everyday routine, you or your loved one might just avoid a serious heart problem.

Listen to your body and be aware of these warning signs for heart attack and stroke:

Pain – sudden discomfort or pain that doesn’t go away 
Shortness of breath – difficulty breathing or not speaking in full sentences
Nausea – sick feeling in your stomach or vomiting
Sweating – wet, cool or clammy skin
Fear – anxiety, denial or knowing something is wrong

The cliché “an ounce of prevention” rings true now more than ever. We rely on our heart every day and every beat, yet we often take it for granted and neglect how we care for it. So take control of your health and start today on your journey to good health. Don’t wait until you get a warning sign or are hit with a devastating diagnosis.
　

Caring@Home: Caring@Home: Pre-planning your visit to the doctor...

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Caring@Home: Caring@Home: I threw my nursing cap off and became...

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Caring@Home: Caring@Home: Fight Alzheimer’s disease by keeping ...

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Pre-planning your visit to the doctor’s office – is it the way of the future?

We pre-plan our life, our financial goals and our funeral. Is it time to pre-plan our visits to the doctor?  

Back in 2006, the College of Family Physicians of Canada conducted a survey that revealed 17 percent of Canadians do not have a family physician – nearly five million people! But even more concerning was that two million were looking for a doctor and couldn’t find one. With our aging population, we’ll see the number of Canadians seeking family doctors steadily increase. There is a looming crisis in primary care as more and more family doctors are feeling pressure to see more patients, as well as the frustrations of trying to access care for their patients.

How can we, as patients, help with this crisis? Can being prepared and pre-planning for a visit to the doctor benefit us?

Recently, one of my myNurse™ health management program clients expressed how stressful it was when she needed to take her mother-in-law to the doctor. Not only were there the challenges in arranging transportation, as her mother-in-law was wheelchair-dependent, she also needed to remember to gather her medications, bring documents she needed to show the doctor and reschedule her mother-in-law’s care with the Community Care Access Centre. She should have left home with a plan for the visit in her mind, but instead hurriedly departed thinking “Did I remember to bring everything?” When she returned from a day of adventure, she was so stressed and overwhelmed that she forgot everything the doctor told her. Could she have taken some simple steps to prevent this common occurrence?

In my opinion, if you come prepared you will have a more successful visit, which will benefit both you and your doctor. Family doctors on average have 10 minutes to spend with each patient, including asking medical questions, performing a physical examination, determining a diagnosis, prescribing a treatment plan and documenting the visit in your medical record.

Here are some tips they might help with your next visit:

1.    Buy a notebook and title it My Health Management Journal.

2.    PLAN AHEAD – write down your complaint or what ails you; what has changed with your health; how it has affected you.

3.    GET IN EARLY– try to book your doctor’s first appointment of the day or right after lunch. Don’t forget to bring your health card.

4.    PREPARE A LIST of your current medications or ask your pharmacist for a printout.

5.    DRESS FOR RESULTS – wear clothes that can be easily and quickly removed for examination (remember time is precious).

6.    FOCUS on the main problem with your doctor. You might have a host of things that are bothering you and various questions, but your doctor can only process so much in one visit.

7.    PROVIDE PERTINENT INFORMATION – tell your doctor the details about your ailment, which you recorded in your journal. Let your doctor know if you’ve received any treatment, seen any other health professionals or taken any medication.

8.    LISTEN and WRITE down what the doctor is saying (tell him what you are doing and that this is the best way for you to remember).

9.    REPEAT the treatment plan or advice your doctor gives you, so you are clear about the next steps.

10.  ASK QUESTIONS – don’t be afraid to ask your doctor to clarify anything you don’t understand. Never be afraid to call back; explain you were just in to see the doctor and there is something you didn’t understand; ask to speak with someone on the team. 

11.  FOLLOW THROUGH on the next steps, which could include following your doctor’s advice, getting a prescription filled or booking an appointment with another health professional.

12.  COMMUNICATE with your spouse or family whether you will need them to support you. Health care sometimes requires a team approach.

So the next time you need to go visit your doctor, follow these 12 steps and just, maybe, the visit that was over in a flash won’t leave you wondering exactly what the doctor wanted you to do. Pre-planning your doctor visits is part of pre-planning your life. Being in the driver’s sit of your own health is where you need to be, in order to get the most from each visit to your doctor.