Wednesday, May 10, 2017

( the RAI was not designed to be a budgeting model but rather a patients' medical needs one) and largely ignored in the funding model non medical care needs ( ie. bath frequency, social interaction, personal attention and stimulation, grooming,,etc) one can see how change, even on a single facility basis carries explosive political potential.

Elder Advocates of Alberta Society
From: Dr. Edward S. Redshaw
2034-198 Street
Alberta. T6J5T7
To: Chief Administrator of a Facility
Dear Madam/Sir:
My name is Dr: Edward S. Redshaw. My mother-in-law, Mildred Silvera, 96 years of age with Dementia, and my brother-in-law, Bernard Silvera,77 years of age, seriously mentally and physically challenged are residents in Millwoods Shepherd’s Care Centre where they have been for 3 years and 11 years respectively.
Over the years I have observed, at first hand, the DETERIORATION of QUALITY OF CARE provided to the VULNERABLE, VOICELESS, my loved ones, by OVERWORKED,
overwhelmed CARE WORKERS trying to do their utmost in this regard. They are stymied at every turn by funding and other limitations imposed by the Alberta Health Services.
On May 15, 2008, Ron Liepert, Progressive Conservative Health Minister, announced the creation of Canada’s first province wide, fully integrated health system “Alberta Health Services (AHS)”.
Starting April 1, (Appropriately All Fools Day since we were all deceived) 2009, The AHS implemented the Patient Care Based Funding Program (PCBF) for Long-Term Care (LTC) funding.
Shortly after the Alberta PCBF program was reviewed by The Centre for Health Services and Policy Research. The result of the Review showed that the PCBF program was flawed and put forward 27 recommendations to be considered. It appeared that, these were ignored and the AHS maintained the PCBF as implemented. The deterioration in quality care to residents commenced. There were staff and benefits reductions,
increased facilities non-compensated operating overhead through wage settlements, mandatory staff educational standard requirements, imposition of the two bath
requirement, and so on.
In May, 2015, the NDP assumed power in Alberta. They inherited the PCBF program. Various attempts have been made by several of us: The Elder Advocates of Alberta
Society, Alberta Continuing Care Association, Alberta Association of Seniors Helping Seniors, John Pray, CEO and President of Shepherd’s Care Foundation, and others.
Individual activists such as myself have published letters in the media, sent numerous correspondence to the Premier, Health Minister, MLA’s and so on. No response. My MLA, Richard Feehan tried to intercede on my behalf. He was likewise
ignored by the Health Minister. There are personal activists here in Alberta who have been BANNED from LTC facilities for speaking out and are even now facing LAWSUITS initiated by facilities. A very sad situation.
The SITUATION NOW IS: With the creation of LEVEL 4, which requires human souls to be in need of 24 hours complex care before being eligible for LTC, the LTC facilities have essentially been converted into Palliative Care facilities.
With residents now requiring an ongoing demanding levels of care, the workloads and STRESS LEVELS of care workers in LTC facilities have increased dramatically.
AHS HAS BECOME AN ENTITY TO ITSELF. and it would appear that the Health Minister has lost total control of the situation. AHS is now the LARGEST GOVERNMENT EMPLOYER
 in Alberta having over 108,000 employees. As was said about Dr. John Cowell when he was appointed boss of AHS “All the bigshots of AHS, that bloated, out of touch,
arrogant outfit infected with a sense of entitlement, a successor to other bloated, out of touch arrogant outfits, now answer to a man who criticized them for how they
operated and suggested better.”
CONTINUING CARE in Alberta is FUNDED 21% LESS than the national average. RESIDENTS of LTC facilities are now regarded by the Health Minister and AHS AS DISPOSABLE,
discardable liabilities NOT WORTH BEING FUNDED sufficiently to ensure them a dignity of life that they have earned.
I feel that it is time for all the Long-Term Care Facilities to UNITE AS A COALITION and make it absolutely clear to the Premier, Health Minister and AHS that the CURRENT
SITUATION IS UNACCEPTABLE and untenable. The PCBF has to be completely overhauled to ensure our VOICELESS, VULNERABLE residents receive the quality of care they deserve.
I will be mailing this correspondence to as many of the Long-Term Care Facilities as I am able.
I am asking that you respond to me by E-Mail at:
1) Whether you are satisfied or unsatisfied with the current funding to your Facility.
2) Whether or not you would be prepared to be a member of a Coalition to make
representations to the Premier, Health Minister and AHS regarding the restoration of appropriate funding and other necessary considerations to Long-Term Care Facilities.
This is a very disastrous situation and I trust my request will receive your most serious consideration.
Yours truly,
Edward Redshaw I am now in the process of mailing out 124 of 248 letters. It will be interesting to see what responses I receive, if any. There is a great deal of fear out there about saying anything.
April 29 at 1:58pm
Arthur Dear Good old Alberta. The best place in the world if you are healthy, wealthy and young.
Edward Redshaw I am 82,trying to stay as healthy as possible, not wealthy but OK. Growing old is worrisome these days. Just can't get the support of young people in the battle to make things better for the elderly. Sad.
11 hrsEdited
Julie Ali Don't worry Edward, the young people are going to be helping out. And when families unite, government is going to have to do its job of protecting the most vulnerable citizens in the continuing care system because we're going to vote out every party that simply ignores this situation as the NDP folks have been doing -just like the PCs before them.
Reply12 hrs
Arthur Dear Long Term Care is sort of a political third rail which, I believe, is being addressed quietly with an increased emphasis on individual Care Planning and family contacts. It is, however, a public service with poorly defined and virtually unlimited pote...See More
Reply11 hrs
Edward Redshaw I beg to differ. Long-Term Care is not being addressed quietly or at all.
I received though the Freedom of Information almost 600 pages covering the past few years of minutes of meetings involving AHS and Continuing Care branch. Long-Term Care is never
 discussed. The emphasis is on Continuing Care and keeping people in their homes.
You go into Long-Term Care you become a forgotten person.
The following is an extract from the RAI ( Residential Assessment Instrument) information site. This Instrument is designed for a perfect world where each resident would receive individual care and live happily until passing to the great beyond. In our real world it is just used to try and get AHS to provide a bit more funding. Sad.

In keeping with objectives set forth in the Institute of Medicine (IOM) study completed in 1986 that made recommendations to improve the quality of care in nursing facilities, the RAI (Resident Assessment Instrument) provides each resident with a standardized, comprehensive and reproducible assessment. It evaluates a resident’s ability to perform daily life functions and identifies significant impairments in a resident’s functional capacity. In essence, with an accurate RAI completed periodically, caregivers have a genuine and consistently recorded “look” at the resident and can attend to that resident’s needs with realistic goals in hand.With the consistent application of item definitions, the RAI ensures standardized communication both within the facility and between facilities (e.g., other long-term care facilities or hospitals).
10 hrsEdited
Arthur Dear Good quote.

Actually, at the regional and facility levels the RAI is used to keep spending down. Regional managers use RAI assessment compilations of medical needs to obtain computer derived staffing needs. Unfortunately, as I said, human desires/nee
...See More
Reply9 hrs
Julie Ali The use of the RAI creates a ton of paper to justify underfunding which is then explained to us as appropriate funding. Then the facilities tell families that they are losing money on patients. We are stuck between government spin and facility requirem...See More
Reply4 hrs
Edward Redshaw Well spoken Julie: You know it is difficult for persons who have not been exposed to the dirty underbelly of the Long-Term Care monster to really understand what is happening.

Love your comment. Can I save it for future use? Can I use your name as the author, or is that a no no with the legal stuff pending?
3 hrs
Arthur Dear Well let's face it Julie. Home care is the governments priority. Age in place is turning out to mean rot at home and hopefully die in place. Lots of money is going into RN's and others to run around dropping in once or twice a day monitoring data, sometimes providing other actual care services. In many ways the RN checks are a waste of money. Remote monitoring capabilities in today's world are such that an HCA could attend home patients while one RN monitored many patients at once with check ins by the HCAs
Beyond that while home care may be an ideal because few patients look forward to long term care very few of those at home have anybody in the house beyond, sometimes, a partner of similar age. A significant portion of LTC patients are dementia patients staged beyond any capability of home nurses. You really have to ask why so many so fear LTC.
As a further observation working conditions in LTC's are so heavy and so stressed a significant expansion of beds or care hours per patient might be impossible. There aren't enough nurses.
Thank that Alberta hero, the drunk, Klein for the run up to this mess. Thank the last thirty years of conservative hucksterism convincing young Albertans they live in a world class province with the lowest taxes anywhere when in fact the elites have ripped off the cream of resource profits and are going to leave the rest of us with a ruined ,poisoned and derelict homeland while they take and run.
Reply3 hrsEdited
Julie Ali Arthur Dear I have to say that there are many problems in the LTC system. I don't believe that Mr. Klein is to blame for this mess. He wasn't a good premier but certainly he was just the mouthpiece for the PCs. The real brains behind the transfer of long term care and really all of continuing care to the private sector comes from the brain trust of the Tories. The Tories aren't the only ones who don't want to deal with continuing care. The Liberals in BC are similarly engaged in transfer to the private sector. The NDP in Alberta have already shown us that they are willing to transfer the money to the private sector. So really no matter who we hire--PC, NDP or Liberal no one is willing to deal with the problems of the continuing care system. I am curious why no one wants to deal with the problems in the continuing care system. If they are able to shovel a ton of public cash to the private sector this means that the money is present for care plus profits. So what this sort of privatization deal indicates to me is a complete abdication of responsibility of government by all parties to our most vulnerable citizens. The political parties aren't interested in citizens and most particularly in the citizens who are on the way out. So what does this situation leave us with? We have the families. We understand that none of the political parties give a damn. We simply take our votes and keep firing political parties until they begin to give a damn. I have no expectation this sort of change will happen soon. But the baby boomers are coming up. We're not known to stay silent or inactive. We're going to kick government rump. Failing this kicking of the rump we are going to simply do the work ourselves that government will not do and in the process we are going to expose the complete abdication of government to do any work in this area. What are we paying government folks for? To sit on their rumps? If so -and if they don't want to work for us then let us decrease our taxes and do the work that government will not do ourselves. And let the private sector do the job with the money we save in taxes.
Reply2 hrs
Julie Ali Also home care is inefficient service delivery with a high cost and little benefit to the people. It may be what people want but it is a poor use of public dollars. The only up side for government is that they don't have to build expensive facilities and staff them. The home care gimmick is a pretty neat one for the government and folks are fooled by the spin. A decent continuing care system that is adequately funded with good staff:resident ratios may not have the comforts of home but is a better use of our tax dollars for much better health care delivery with true accountability. In other words, we are being spun and the spiders are taking in the flies of citizens. But there you go.
2 hrs
Edward Redshaw Again. Well spoken Julie.
Reply2 hrs
Edward Redshaw Well spoken Arthur. Julie's and your comments should be compiled in a manuscript and somehow be made mandatory reading for the incompetents who are in positions of power.
Reply2 hrs
Julie Ali Unfortunately Edward we are living in times of spin and until we actually have problems we believe what we were told. I believed what I was told until confronted by the non-compliances, the lack of staff training, the failures of the government to do anything. Now we have a new case of non-compliances at Lacombe where nursing students have to tell AHS and Alberta Health of the problems that their audits should have indicated. We have the family in Grande Cache begging for help for their mother. It's pretty sad. And we have government under the PCs and NDPCs tell us --don't worry we'll take care of it once the news gets to media. Why is government and the health authority MIA? I guess again, no one gives a damn. The spin is to pretend to care but the reality is no one cares. It's all a fairy tale and we were once so innocent.
Reply7 mins
Julie Ali AHS investigation discovers serious problems at Lacombe long-term care facility

More from Keith Gerein
Published on: May 9, 2017 | Last Updated: May 9, 2017 9:22 PM MD
Reply2 minsEdited
Julie Ali Tucker added 4 new photos — with Tammilee Rideout-Tucker.
April 27 at 12:55pm · 
PLEASE SHARE!!!! It breaks by heart to have my mom in a emergency room bed were at least dad can now visit her . A care home in grande prairie has abused my mom for the last time . We are now taking up space in an emergency room while awaiting for a doctor to help us find a spot . The care home today slammed the door in my face as I tried to talk to them. As I had to remove mom s belongings out of there so the abuse can't continue. Dad fought with them for years with documentation and pics plenty of proof to put them under . But everyone turns a blind eye to the abuse and call it un founded . The judge without any looking at foundings or proof just say your banned and any further cost comes to dad? How does a retirement man pay for lawyer fees. I want this banning my dad from the care home for a full year without visiting rights to go viral . He has legal guardianship to be her voice from a court but means nothing . How does the justice system work ? She cannot speak for herself . Please share the shit outta this . Media here I come
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