Category: Dementia

123_1-42cb7524b64b3022764517278e4b6411da85b6d0

Staffing Shortage Underserves Long Term Care Residents

10Aging, Cognition, Dementia, Featured news, Health, Loneliness, Social Life February, 17

Source: Chris Marchant on flickr, Creative Commons

In the summer of 2014, I volunteered at a long-term care facility (LTC) in the Peel Region of Southern Ontario. Most of the residents who lived there were diagnosed with some form of cognitive impairment, primarily dementia. I saw first-hand the unfortunate reality of understaffing, and how it leads to deficits in patient care.

As the elderly population has grown, Ontario has seen a 22% increase in admission rates of LTC residents as of 2014. And the number of residents with cognitive impairments is especially high. According to the Ontario Long Term Care Association’s 2014 annual report, 62% of residents have Alzheimer’s disease or another form of dementia resulting from stroke, developmental disability, or traumatic brain injury.

Patients with cognitive impairments may have other mental health disorders as well. The Canadian Institute for Health Information (CIHI) indicates that 25.9% of residents in Ontario long-term care homes have shown symptoms of depression through 2013 and 2014.

In my time volunteering at the LTC, I noticed that residents often refrained from socializing because they were unable to take part in events due to memory deterioration, speech issues, and physical ailments such as paralysis or arthritis. Most residents required staff to transport them from one place to another and though they worked hard to support residents, there were simply not enough staff to supervise these daily activities.

Jane (name changed for anonymity), the Supervisor of Activation at an LTC in the Peel Region, spoke to the Trauma and Mental Health Report about this issue. Jane is responsible for organizing activities that motivate elderly residents to engage in social interaction and improve cognitive well-being.

Jane agreed that one of the biggest challenges for LTCs is staffing:

“Year by year, the case load of different residents is increasing, but with such little funding we do not have enough staff to support their needs. If residents aren’t participating in daily events and activities, their cognitive functioning is negatively impacted.”

A University of Ottawa study found that between the years 2000 and 2010, over 60% of residents with multiple cognitive deficits lacked stimulating therapeutic activities and social support. It showed that while residents received sufficient assistance with physical needs, such as feeding and changing, cognitive functioning continued to worsen in areas like memory and attention.

Jane also explained that despite research emphasizing the importance of activities that are engaging, staffing shortages make it difficult for these activities to be held in LTC homes:

“We need more activation staff for art therapy, music therapy and physiotherapy as these activities are beneficial to residents’ cognitive functioning. However, many activities are cancelled or postponed because of a lack of staff to facilitate the activities and monitor the residents. A few years ago, residents only needed one staff member or nurse for assistance, now they need two or more people. Sometimes, they’re left waiting for support.”

But perhaps the real issue here is funding. Adequate funds are necessary to increase the amount of staff within LTCs, so that residents can develop social relationships, participate in interactive activities, and improve their cognitive functioning and capabilities. Jane agrees:

“Funding hasn’t increased yet the resident conditions are changing and they require more care. The caseload is increasing, with little funding.”

Funding should also be allotted for appropriate staff training. LTC residents with cognitive impairments have a unique set of needs. According to the University of Ottawa study, residents require assistance in areas such as memory retention and engaging in regular social activities to help them interact and feel like recognized members of their community.

Making use of mental health first aid programs, such as the workshops offered atConestoga College and the Baycrest Health Sciences’ Geriatric Mental Health Serviceconference, can go a long way in improving the services staff provide.

As a past volunteer for an LTC home, I have seen the impact of limited support on residents’ lives. Greater funding and more staff to facilitate therapeutic activities are crucial to optimizing the care residents receive and to ensuring better cognitive functioning.

–Afifa Mahboob, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

One Woman’s Suicide Reignites Right-to-Die Debate

One Woman’s Suicide Reignites Right-to-Die Debate

00Aging, Chronic Pain, Dementia, Featured news, Law and Crime, Philosophy, Suicide October, 15

Source: torbakhopper/Flickr

“I will take my life today around noon. It is time. Dementia is taking its toll and I have nearly lost myself.”

Gillian Bennett chose the right to die in the backyard of her home on Bowen Island. On August 18th, 2014, wrapped in the arms of her husband of 60 years, she said goodbye with a tumbler of whiskey and a lethal dose of barbiturates.

At age 85, Bennett had been living with dementia for over three years. During her lucid moments, she would ruminate on the impact of her suffering on family, and the burden she would become on the healthcare system at large.

Bennett wanted to live and die with dignity; she viewed spending her remaining days in a nursing home as anything but.

The retired psychotherapist voiced her wish to end her life on her own terms before losing “an indefinite number of years of being a vegetable in a hospital setting, eating up the country’s money but having not the faintest idea of who [she is].” Her family and friends supported her decision.

“In our family it is recognized that any adult has the right to make her own decision.”

Bennett’s conversations became the inspiration for deadatnoon.com, a website that hosts her goodbye letter. In it, Bennett explains her reasoning for wanting to die on her own terms and makes a plea to re-open the debate on assisted suicide for the elderly and terminally ill.

Every day Bennett felt she was losing another part of herself. Small lapses in memory were followed by an inability to keep the days straight and a decline in physical capacity. Soon, she would not have been competent enough to make decisions about her life. She wanted out before that happened.

She considered three options. The first was to “have a minder care for [her] mindless body” despite financial hardship on her family. The second, to settle into a federally funded facility at a cost to the country of $50,000 to $75,000 per year. The third, to end her life “before her mind [was] gone.”

She felt compelled to choose the third, dismissing the other options as “ludicrous, wasteful, and unfair.” At the end of her four-page letter, she encouraged readers to consider the ethics of assisted suicide.

Canadians are familiar with the debate on euthanasia. Beginning with the landmark Rodriguez v. British Columbia decision, euthanasia has been revisited by the courts many times.

In 1991, Sue Rodriguez, who was suffering from ALS, attempted to petition the Supreme Court of Canada to allow assistance in ending her life. The court refused her request.

Despite the decision, she passed away with the aid of an unknown doctor in 1994.

A similar ruling was made in the Robert Latimer case. Latimer was convicted of second-degree murder in 1997 after killing his severely mentally disabled daughter, Tracy, whose condition left her in constant, unmanageable pain.

In 2011, the B.C. Supreme Court ruled that the ban on assisted suicide was unconstitutional following a challenge from another ALS sufferer, Gloria Taylor. The federal government appealed the ruling and, in 2013, the B.C. Court of Appeal upheld the ban.

Bennett’s decision to end her life revived the debate. In February of 2015, the ban was struck down again by the Supreme Court of Canada. Federal and provincial government has been given twelve months to create legislation in response to the ruling. 

Bennett, a woman who saw life as “a party she was dropped into”, made it clear she felt she was losing nothing by committing suicide. Described as smart, funny, and irreverent, she faced death the way she lived life.  

“Each of us is born uniquely and dies uniquely. I think of dying as a final adventure with a predictably abrupt end. I know when it’s time to leave and I do not find it scary.”

– Magdelena Belanger, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

164434-169107

One Woman’s Suicide Ignites the Right to Die Debate

00Aging, Dementia, Depression, Ethics and Morality, Featured news, Health, Memory, Politics, Suicide November, 14

“I will take my life today around noon. It is time. Dementia is taking its toll and I have nearly lost myself.”

Gillian Bennett chose the right to die in the backyard of her home on Bowen Island. On August 18th, 2014, wrapped in the arms of her husband of 60 years, she said goodbye with a tumbler of whiskey and a lethal dose of barbiturates. 

At age 85, Bennett had been living with dementia for over three years. During her lucid moments, she would ruminate on the impact of her suffering on family, and the burden she would become on the healthcare system at large.

Bennett wanted to live and die with dignity; she viewed spending her remaining days in a nursing home as anything but.

The retired psychotherapist voiced her wish to end her life on her own terms before losing “an indefinite number of years of being a vegetable in a hospital setting, eating up the country’s money but having not the faintest idea of who [she is].” Her family and friends supported her decision.

“In our family it is recognized that any adult has the right to make her own decision.” 

Bennett’s conversations became the inspiration for deadatnoon.com, a website that hosts her goodbye letter. In it, Bennett explains her reasoning for wanting to die on her own terms and makes a plea to re-open the debate on assisted suicide for the elderly and terminally ill 

Every day Bennett felt she was losing another part of herself. Small lapses in memory were followed by an inability to keep the days straight and a decline in physical capacity. Soon, she would not have been competent enough to make decisions about her life. She wanted out before that happened.

She considered three options. The first was to “have a minder care for [her] mindless body” despite financial hardship on her family. The second, to settle into a federally funded facility at a cost to the country of $50,000 to $75,000 per year. The third, to end her life “before her mind [was] gone.”

She felt compelled to choose the third, dismissing the other options as “ludicrous, wasteful, and unfair.” At the end of her four-page letter, she encouraged readers to consider the ethics of assisted suicide.

Canadians are not unfamiliar with the debate on euthanasia. Beginning with the landmark Rodriguez v. British Columbia decision, euthanasia has been revisited by the courts many times.

In 1991, Sue Rodriguez, who was suffering from ALS, attempted to petition the Supreme Court of Canada to allow assistance in ending her life. The court refused her request.

Despite the decision, she passed away with the aid of an unknown doctor in 1994.

A similar ruling was made in the Robert Latimer case. Latimer was convicted of second-degree murder in 1997 after killing his severely mentally disabled daughter, Tracy, whose condition left her in constant, unmanageable pain. 

In 2011, the B.C. Supreme Court ruled that the ban on assisted suicide was unconstitutional following a challenge from another ALS sufferer, Gloria Taylor. The federal government appealed the ruling and, in 2013, the B.C. Court of Appeal upheld the ban.

Bennett’s decision to end her life revived the debate. Following the publication of Bennett’s letter, Conservative MP Steven Fletcher went on record saying that assisted suicide in Canada has never been properly debated in Parliament. 

Fletcher has recently introduced two private member’s bills on assisted suicide. One will allow physicians to help patients end their lives under certain circumstances. The other will introduce a commission to systematically monitor the practice. 

How these bills will fare in Parliament remains to be seen, but Fletcher claims they have a strong chance of passing a second reading and moving to the justice committee. Additionally, the Supreme Court of Canada began hearing arguments on October 15th, 2014 on whether to uphold or strike down the current ban on assisted suicide. 

Bennett, a woman who saw life as “a party she was dropped into”, made it clear she felt she was losing nothing by committing suicide. Described as smart, funny, and irreverent, she faced death the way she lived life. 

“Each of us is born uniquely and dies uniquely. I think of dying as a final adventure with a predictably abrupt end. I know when it’s time to leave and I do not find it scary.” 

– Contributing Writer: Magdelena Belanger, The Trauma and Mental Health Report 

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report 

Copyright Robert T. Muller

Photo by #300091984/Flickr

This article was originally published on Psychology Today