Better system needed for treating dementia patients
Published on: May 6, 2016 | Last Updated: May 6, 2016 6:00 AM MST
Alberta needs a better dementia strategy and care system. FOTOLIA
There is a group of Albertans being treated as second-class citizens. They have a second-class illness and get second-class treatment in our so-called universal health-care system.
How else can you describe a health-care system that either refuses to treat or knowingly aggravates a patient’s condition. Whatever happened to: “First, do no harm?”
My mom is 85 and has dementia. Watching someone you know fade away into a life of fear and confusion is hard. What makes it harder is seeing her condition either ignored or made worse.
On New Year’s Eve 2015, Mom fell and fractured her pelvis. She spent about 10 weeks at Calgary’s Rockyview Hospital. But while she was being treated for her fractured pelvis, all therapy for her dementia stopped. Therapy — including book reading, music appreciation, social engagement, outings — is vital for people with dementia, many of whom are frightened because they don’t understand what’s going on. It alleviates their anxiety.
Why was this therapy dropped? “Because we’re not funded for that,” was the explanation.
Instead, agitated dementia patients were strapped into chairs and put in hallways, so that overworked staff could keep an eye on them, but with few opportunities to actually help them. Staff levels were so low that one night, only three weeks after fracturing her pelvis, Mom was able to get off her bed and walk off the unit, past the nursing station and out through the heavy doors without being seen.
If you had another illness, say cancer, and you fell and broke a pelvis and were admitted to hospital, would the cancer treatment be stopped? Of course not, because the system recognizes cancer as a real illness that needs treatment. Dementia, it seems is different.
Are we any better at dealing with dementia outside hospitals? It appears not. As Mom’s care needs have changed, she has been forced to move four times in less than four years — and faces another move in the next year or two — if she survives.
Despite knowing that moves accelerate the decline of dementia patients, our system focuses on different types of facilities (supportive living, long-term care, acute care) rather than on what the patient needs. This means that to get a different level of care, the patient has to be moved to a different type of facility.
In Mom’s new long-term care (LTC) “home,” there is an almost constant noise of patients screaming. “Help! Help! Help!” “Mommy! Mommy! Mommy!” “Aaacck. Aaacck.” “I’m afraid!”
It is, literally, bedlam.
Mostly what people with dementia need during these moments of anxiety is someone to comfort them. But there’s not enough staff.
Our health-care system will give you expensive medication or radiation therapy or surgery if that’s what it is needed to treat your condition. But if all you need is a caring hand and a soothing voice, then you’re out of luck. Why? Dementia, it seems, is different.
The Alberta government has promised to build 2,000 public long-term care and dementia spaces. We desperately need these beds to relieve the strain on hospital emergency rooms and acute-care beds.
We also need to ensure that we build the right type of beds and the right type of system, one that doesn’t treat dementia as a second-class disease. Let’s build a system where the care comes to the patient, rather than moving the patient to access the care. That means removing the profit element from health care, so patients aren’t forced to move because they’ve been evicted when their care becomes a threat to a corporate bottom line.
In Alberta, nearly half of all LTC beds are in shared rooms. In B.C., about 75 per cent of LTC residents have their own room and bathroom and the B.C. Ministry of Health has a target of 95 per cent single-occupancy rooms.
Let’s not just build beds, but build homes. Let’s give these long-term residents their own room and bathroom. Let’s treat them like respected seniors.
We know how to do this. There are some good facilities in Alberta — but the waiting lists can be up to two years.
Let’s fix the system now — because it’ll be our turn before you know it.Terry Inigo-Jones is a member of the Public Interest Alberta Seniors’ Task Force