A caregiver’s hard decision: help wanted

A caregiver’s hard decision: help wanted

Is it okay to strap a loved one into a wheelchair?

BY DELORES BROTEN

So we have come to a point where my love is walking … meandering, staggering … around with his eyes sometimes closed. His legs are buckled, he leans sideways or backwards and it is truly scary. It looks like he could fall any minute, and he could. Not all the time but a lot. And he sometimes does fall, and quite often nearly does. He usually won’t sit down for long.

The care home aides and nurses want … or suggest, that he needs to be strapped into a wheelchair. To prevent falls. They are as terrified as I am when walking beside or behind him. He could hurt himself or them.

And he has fallen a few times … kind of sliding to the ground in confusion when his legs don’t work. No injuries yet. “I don’t know what is wrong with my leg,” he says.

Neither does anyone. It is a guess but probably it is a possible bout of sciatica, part the pain meds, possibly the dementia closing down another segment of the mind, but mostly because he can no longer orient vertical, up and down. That was an early problem. Now he doesn’t know where is upright and can’t tell his legs what to do. The dementia is taking away even that.

Top photo: Don Broten at Miracle Beach in better days. Above photo: A more recent image

So it is a safety issue. But I cannot see the advantage or the care in strapping him down like the worst kind of tortured prisoner and I am refusing to sign the paper.

It is illegal to restrain him without my okay.

And I am NOT okay with this.

Over the two-and-a-half years we have been there I have seen this. The patient starts strapped down for safety but is taken out and up on their feet for a walk 20 minutes a day. At most. Soon of course they can’t walk at all and life becomes a Brody chair. Where they lie swearing and trying to get out, while the care machine rolls on around them and staff gossip and go for breaks.

Then, unlike when they were mobile, the patient-victims really ARE swiftly parked and ignored. Oh fed and cleaned and cooed at from time to time, but that’s about it. No interaction except with family. Even the recreation aides don’t have much to offer once they are parked.

I want to puke. This is not humane.

Many of the parked recognize that I am a friendly face and make some kind of happy contact. But like everyone, I walk on by, with other things to do.

Part of me thinks wildly that i could bring him home, transform our house … foam on the floors and clear out the furniture such as it is, and extra care aides. Let him wander and fall safely in his strange fragmented world. Bring him home.

But foam doesn’t clean well and it is not that simple. It is the 36-hour job.

We don’t have family willing or able to take shifts and we don’t have that much money to get a suitable house, transform it and hire help. That is for the one percenters. For us, we are beyond lucky to have public care. Many don’t.

There is also my own slowly eroding remnant of a life to consider – although at moments like this it doesn’t count for much, and those who depend on my work. That must count too.

On the other hand my own mother was strapped in a chair because she kept trying to walk when she was totally paralysed on the left side, with resultant dementia. And there was no other choice. But she was not drugged and never parked. She had my father with her 24/7.

I have no idea what kind of love and determination that took. After she died he regained a huge amount of mental capacity and resilience. He did see what was coming for my love and me and told me not to do as he had done.

Comments and advice are welcome, here (on her blog), on Facebook, or by personal email. I need some help with this.

Delores Broten is one of British Columbia’s many thousands of unpaid caregivers. She is the editor of the award-winning Watershed Sentinel magazine published in Comox. She wrote this for her blog “CaringCV,” and is reprinted here with permission. She may be contacted at editor@watershedsentinel.ca. 

 

FURTHER READING: Read Delores Broten’s blog, “CaringCV”  

 

The buck (doesn’t) stop here

The buck (doesn’t) stop here

Island Health fails public accountability scorecard

By Stephen D. Shepherdson

The key to maintaining the public’s confidence in its government departments and agencies, is the concept of public accountability. Nothing touches Canadians like the delivery of healthcare services. Island Health’s board of directors met people in the Comox Valley last week and heard from five different groups making formal presentations.

The gap between the serious nature of the issues presented by community representatives and the response provided by Island Health is staggering. Island Health acknowledges its accountability but does it, in fact, hold itself accountable?

They did well in coming to the community. The public forum itself is important in terms of demonstrating accountability to taxpayers and the community being served. There are a number of positive initiatives underway such as the neighbourhood care model for homecare.

As measured against the high-level expectations embodied in the BC Taxpayer Accountability Principles (June 2014), Island
Health might give itself a passing grade. From the viewpoint of this taxpayer, there is much opportunity for improvement.

For example, how did the board and its presenters perform against the principle of ‘respect’? Did they engage in “equitable, compassionate, respectful and effective communications that ensure all parties are properly informed or consulted on actions, decisions and public communications in a timely manner”?

Did they “proactively collaborate in a spirit of partnership that respects the use of taxpayers’ monies” (BC Taxpayer Accountability Principles, June 2014)? In my view, they substantively missed this mark.

Island Health staged the forum in a manner that avoided any need to directly address the specific concerns of the community members assembled. Despite advance knowledge of the points of view for the five presentations they selected, no attempt was made to meaningfully address the concerns presented. By comparison, considerable hard work was put into the community’s presentations. 

Advance questions from the public were answered in a written handout that, in most cases, provided unclear and confusing responses. 

Communications specialists would call the room set-up ’confrontational’ in that it made the presenters accountable to the public in attendance while the board sat on the side as the public’s observers. The meeting was adjourned early omitting the Question
Period for questions from the floor as referenced in the published agenda.

It is disrespectful to ask people to do something and then ignore their efforts and point of view. The board lost an opportunity
to address the questions raised or even give the community one positive take-away.

What does good public accountability look like? First, leaders are clear in acknowledging the situation or issue being addressed. Second, leaders use facts and stories that deal with people to frame the issues. They employ facts and analyses that reflect current results, describe activities underway and identify root causes of the issue or problem. Third, leaders acknowledge limitations and constraints and are careful to address constituent expectations.

FURTHER READING: B.C. Taxpayer Accountability Principles

What did we hear or not hear on March 29? We did not hear that the board holds itself accountable, there was no “the buck stops here” moment.

There was no acknowledgment of issues like the need for more home care support services (except an oblique reference to working on it), the inequity of the current residential care bed allocation, and the immediate need for more residential care beds than planned. Even if solutions are not readily available, acknowledgment of issues is key to public accountability.

It was not clear that stories about people’s experience at the new Comox Valley Hospital and its state of cleanliness were heard by the board and management. The reaction was defensive, failing to differentiate between ‘unusual and critical’ vs. ‘normal’ issues with a new hospital start-up.

That reaction does not make me feel that the Board and management are in control. I would have expected to hear an acknowledgment that we are experiencing problems and this is what we are doing to resolve them. 

Finally, in terms of public accountability, we must be careful not to attribute responsibilities to Island Health that are the responsibility of the BC Ministry of Health. Financial resources are not infinite, they are limited. But Island Health is accountable for its allocation of entrusted resources, the quality of healthcare service delivery, operational improvements, employee engagement and morale, and community relationships.

The community wants and needs Island Health to be successful on all of these dimensions; after all, these are the services we need in our community. Words on a website and declarations that “we do all those things” are well intended. But, if the board and management do not acknowledge the need for direct action when issues are raised with them, then public accountability claims ring hollow.

Stephen D. Shepherdson, Comox, is a retired management consultant and operations management specialist. He wrote this commentary for Decafnation, and may be contacted at: sshepherdson@shaw.ca

 

Seniors groups criticize VIHA RFP as too little, too late

Seniors groups criticize VIHA RFP as too little, too late

In presentations to the Island Health board of directors, three Comox Valley seniors advocacy groups criticized the recent residential care bed RFP, said Island Health doesn’t provide us with an equitable share of resources and exposed mistreatment of seniors and a new hospital that isn’t clean

 

Judging by the “surprisingly” large number of Comox Valley citizens who flooded the Crown Isle ballroom March 29 to hear their concerns presented to the Island Health board of directors, there is a widespread belief that the health authority has shortchanged the north Island, especially in health care for seniors.

Five community groups made presentations to the board, which did not speak or respond, except for brief remarks by chair Leah Hollins.

Three of the five presentations bemoaned gaps in health care for seniors, one asked Island Health to give back land it owns in Cumberland and another asked the board to include breathing clean air as a criteria in awarding Community Wellness Grants.

Here is a summary of the three presentations relating to health care.

Comox Valley Elders Take Action

Jennifer Pass, representing more than 70 members of this group, criticized Island Health for how seniors are treated at the Comox Valley Hospital, the cleanliness of the hospital and for its slow response to a critical lack of residential care beds in the region.

Pass recounted the story of an 88-year-old woman, an avid gardener, who experienced serious hand pain and, on the advice of friends, called an ambulance at 7:30 p.m. to take her to the hospital. She waited 14 hours, until 10 a.m. the next morning, before a doctor told her she had arthritis and lectured her on wasting ambulance time for such a trivial matter.

But a second opinion the woman sought later revealed she actually a severe nerve condition relating to her spine. She’s been scheduled for neurosurgery this summer.

Pass also told the board about an 88-year-old woman who experienced a possible Transient Ischemic Attack (TIA — a mini-stroke) and arrived at the emergency department with blood pressure of 185. She was told she “wasn’t a spring chicken anymore” and that she was wasting the ER’s time.

It was later determined by her own doctor that a conflict between two of her drug prescriptions had caused the problem.

These two anecdotes showed that hospital medical staff are “making assumptions about people’s health and diagnoses based on their age … and the elderly are being treated with disrespect,” Pass said, “as if their medical conditions aren’t important.”

Decafnation has received numerous similar reports of mistreatment, which have been reported in a series of articles and as recently as this week.

But Island Health CEO Kathy MacNeil told reporters after the meeting she hasn’t heard of these or similar incidents. That’s surprising from the CEO because people have filed complaints through the official VIHA process.

FURTHER READING: Island Health CEO disappointed by poor treatment of elderly

Pass also commented on the lack of cleanliness in the hospital. During a visit for day surgery, she tried to use one bathroom that had feces on the seat, and other bathrooms that were also filthy.

She was told the dirty bathrooms were a consequence of having so many elderly patients awaiting placement in residential care who were incontinent.

“Seems like the preconditions for a perfect storm,” Pass said.

Pass cleaned one bathroom herself. She also observed beds that hadn’t been cleaned or remade for days.

Sources have told Decafnation that the hospital is generally dirty — dirtier than St. Joseph’s Hospital ever was. They said the uncleanliness is a result of the inefficiencies of public-private partnerships (P3), where housekeeping is contracted out and not as closely managed. 

FURTHER READING: Dissecting a a P3 — Part 1

Pass also criticized the recent Request for Proposals to build “up to 120” additional residential care beds that Island Health hopes to open sometime in 2020.

“That’s too long to wait for new beds,” she said.

In response, Island Health board chair Leah Hollins said, “Bad news is good information. It’s good to hear these stories.”

Power of 5

Melanie Olson spoke on behalf a group of five “frustrated” family caregivers who are trying to keep their loved ones who are suffering with dementia at home.

Olson said their group shares the distress of more than one million unpaid, family caregivers in British Columbia, but with the added frustration of accessing too little support services provided by Island Health for the Comox Valley.

She noted that people over age 65 comprise a higher percentage of the Valley’s population than Victoria, and that it’s nearly 50 percent higher than the provincial average. And, that demographic is growing rapidly.

Yet, residential care beds and support services for family caregivers lags most other communities.

The shortage of residential care beds in the Comox Valley, which Olson estimated at a minimum of 160 beds, is only one of the factors plaguing caregivers.

But the experience of trying to get a loved one onto the list for a residential care bed can be long and frustrating. It’s at least a 12-month wait list, and the patient must not only meet the “complex care” requirement, but must also exceed the care that Community Health Services (formally called Home and Community Care) are able to provide.

But the lack of access to Adult Day Care (ADC) programs and respite beds is just as concerning for Olson’s group.

Respite beds give caregivers a chance to take an extended break (up to two weeks) from the 24/7 job of caring for loved ones. There are only three publicly subsidized respite beds in the Valley and one is not secure enough to accept dementia patients.

That leaves two for a large population of caregiving families. Caregivers are entitled to five weeks respite a year, but they don’t get it. Last time one caregiver needed respite, the entire next year was booked by the end of December or early January. A shortage of beds, means caregivers have to schedule respites too far in advance.

There is one private respite bed available at $223 per day, which most families cannot afford.

The situation is similar for ADC programs, where caregivers can take their loved ones for one or more days per week. But multiple times are virtually unavailable to due the area’s large demand. There’s a two-month wait list just to get ADC for one day per week.

Olson told the board she was disappointed the RFP for “up to 120” new residential care beds doesn’t include any requirement for ADC programs or respite beds.

Olson also asked the board for more access to home support services. She said the home support policy is to provide 120 hours, but only provides about 20 hours in the Comox Valley.

She said funding more caregiving training programs and providing practicum opportunities at Comox Valley facilities could help ease caregiver stress, which has reached the breaking point in many cases.

In an August 2017 report, B.C. Seniors Advocate Isobel Mackenzie said 31 percent of unpaid caregivers were in distress in 2016, the highest in Canada.

Board chair Hollins said in response that “there’s no question we need to put more dollars into the community.”

Seniors Voices Comox Valley

Peggy Stirrett spoke on behalf of a grassroots seniors advocacy group that has collected data from a broad spectrum of community inputs to put a big picture perspective on a local crisis.

Stirrett’s PowerPoint presentation used data to show that the demand for seniors health care and related services has already outstripped local capability and is destined to get worse.

She told the Island Health board that the RFP for “up to 120” new residential care beds does not adequately address the Comox Valley’s demographics or the rate at which the population will grow.

The group’s data suggests there is an urgent need for up to 506 additional residential care beds.

Seniors Voices chart shows the Comox Valley has a higher concentration of seniors

Therefore, building “up to 120” beds by 2020 will neither solve the problem for seniors needing complex care facilities, reduce the distress of family caregivers or diminish the overcapacity problems afflicting the Comox Valley Hospital.

Stirrett said the Comox Valley has a higher concentration of low income households than the provincial average and a higher percentage of them are low income seniors. We also have almost 13 percent more people over the age of 75 than the Greater Victoria area.

But, Stirrett said, “the Comox Valley gets less than its fair share of the resources.”

She plugged data into two different formulas used by the provincial government for calculating a community’s need for residential care beds.

In the first formula, based on 75 beds per 1,000 people aged 75 and over, the Comox Valley should have 525 residential care beds, but has only 374 available.

Calculated as a percent of of the age 75 and over population, the Comox Valley has only 5.4 beds while Victoria, with a lower concentration of over 75 population, has 12.6 beds. The Valley’s ratio is the lowest on Vancouver Island.

“By any calculation we could develop,” Stirrett said, “an equitable allocation could be anywhere between 151 and 506 additional beds … This suggests that 120 additional beds is not enough ….”

She said the group is alarmed by wait times for residential care beds of a year or more and a hospital operating at 138 percent capacity.

“We can only imagine how difficult an experience this is for those seniors who are directly affected … and how much the uncertainty adds to their anxiety,” she said.

Stirrett implored the board to add more residential care beds immediately, even considering using St. Joseph’s capacity as an interim solution.

They also asked Island Health to develop a long-term residential care bed plan for the Valley that addresses the equity issue and takes our unique elderly demographic into consideration.

Finally, Stirrett asked the board to publish information specific to our local area on a regular, timely and transparent basis to help community groups assist seniors with their healthcare needs.

 

FURTHER READING: Decafnation series on the Comox Valley Hospital; Island Health RFP for residential care beds; The Views considering a bid for more beds

 

The Island Health board meeting that wasn’t a board meeting

The Island Health board meeting that wasn’t a board meeting

Without public notice, Island Health holds its March board meeting a day early in Victoria, doesn’t address Comox Valley Hospital issues at “public forum” in Courtenay. But seniors health care advocates make passionate pleas for more resources

 

Those among the several hundred people who packed the Crown Isle Ballroom yesterday (March 29) expecting to attend a meeting of the board of directors of the Vancouver Island Health Authority (Island Health) came away confused.

Those in the standing-room-only audience hoping to hear the Island Health board address well-known problems at the Comox Valley and Campbell River hospitals, and perhaps announce some bold corrective measures, came away disappointed.

Yet, everyone left inspired by five community groups who spoke passionately, and pleaded with the board to serve the Comox Valley more equitably.

FURTHER READING: Pleas for better seniors care, supportive housing and clean air

The confusion arose because Island Health advertised the March 29 event on its website as a regular, official board meeting. It was not.

The board of directors actually met the day before, March 28, in Victoria, without any public notice on its website, probably breaking the government’s own rules on transparency.

Screen shot taken from the Island Health website at 3:53 p.m. March 29

There was no notice by Island Health that the March board meeting would occur at any time other than March 29, or in any other location than Courtenay.

When Decafnation contacted board liaison Louise Carlow via email after the meeting about the lack of public notice, she did not respond. Government workers are off now for the long Easter weekend holiday.

The only director to utter even a sound in Courtenay was board chair Leah Hollins, who opened the meeting by looking over the crowd spilling out into the Crown Isle lobby and saying:

“Fair to say, we weren’t anticipating this many people.”

After all the publicity given to the hospital’s poor planning, overcapacity, long emergency waits, staff shortages and low employee morale, she shouldn’t have been surprised. It would have been surprising if there wasn’t a large turnout.

Concern about the performance of our hospital and how Island Health has underserved the north Island runs that high.

Perhaps the board did fear a large gathering, which might explain why they held their official board meeting the day before in Victoria without any public notice, and did not adhere to their published agenda.

The meeting bypassed the agenda it posted on its website — most notably not allowing any time for questions from the floor — and launched into informative presentations by north Island Medical Health Officer Dr. Charmaine Enns, Island Health CEO Kathy MacNeil and five community organizations.

Not once did Hollins or MacNeil discuss problems at the Comox Valley or Campbell River hospitals, except at the tail end of the CEO’s report when she called the issues, which were first raised in a series of articles on Decafnation, as “growing pains.”

All that was missing in Island Health’s attempt to downplay issues that are having a serious effect on the lives of their employees and patients was a chorus of happy hospital workers smiling behind them on the podium.

Ironically, MacNeil inadvertently pinpointed the source of problems by noting that only about 15 percent of the people who at the two North Island Hospitals were consulted in the design process.

The 300 people MacNeil said were involved in the design process — out of more than 1,900 staff and doctors — were mostly senior managers and physicians. The few frontline workers who were consulted have told Decafnation their input obviously wasn’t heard or was ignored.

But while the board chair and the CEO shied away from addressing problems head-on in public, several of the presenters were more direct.

Jennifer Pass, representing the Comox Valley Elders Take Action group, told the board that CVH staff are disrespecting people based on age, and recounted two personal stories in support.

Pass also criticized the lack of cleanliness in the hospital. She shared a personal experience in the hospital where she saw beds left unmade for days and filthy bathrooms. Her observations coincide with those of several staff members who have spoken with Decafnation.

On health care for seniors, Pass said 2020 was too long to wait for new residential care beds. Island Health has issued a Request for Proposals to build “up to 120” new complex care beds, which MacNeil estimated would be opened “sometime in 2020.”

That concern was also voiced by Peggy Stirrett of the seniors advocacy group, Senior Voices Comox Valley.

Stirrett said the “up to 120” beds sometime in 2020 is not enough, and not soon enough.

“By 2020, (the Comox Valley) will need 100 or more beds than that, and by 2021 we’ll be back in the same situation as today,” she said.

Screen shot of agenda as posted on the Island Health website

Seniors Voices believes there is a current need for between 151 to 506 additional residential care beds based on several formulas used by the government itself.

“The Comox Valley has not received an equitable share of the resources,” she said.

Melanie Olson, spoke on behalf of the Power of 5, a group of “frustrated caregivers trying to keep their loved ones (with dementia) at home as long as possible.”

Olson told the board that Island Health’s support for family, unpaid caregivers is lacking, especially considering that they save the province an estimated $3.5 billion per year.

Hollins skipped over the 10 minutes set aside for questions from the floor (as specified in the agenda) and then abruptly closed the meeting with a tone-deaf remark.

“It’s clear there are many issues in health care. We’ll never be able to meet them all,” she said. “But we appreciate hearing from you today.”

Record 178 patients at CVH, VIHA board in Courtenay

Record 178 patients at CVH, VIHA board in Courtenay

The Vancouver Island Health Authority (Island Health) board of directors will hear several presentations today from north Island residents.

By holding its March 29th meeting in Courtenay, the board has given local residents an opportunity to voice their many concerns, which this website first brought to the public’s attention in a series of articles in January.

The board’s published agenda states that 60 minutes have been set aside for public presentations, but does not specify which community applications to make a presentation have been accepted.

But we can speculate.

The board is likely to hear about the lack of long-term care beds in the Comox Valley, problems caused by overcapacity at both the Courtenay and Campbell River hospitals, long waits in the emergency department and perhaps even a plea to reactivate portions of the now-closed St. Joseph’s General Hospital to mitigate some of these issues.

Some residents may express concern about the consequences of how poorly Island Health planned their new hospitals and have neglected regional senior care services.

We may even hear a plea from the Equal Access Comox Valley group to deny The Views at St. Joseph’s any of the proposed 120 new long-term care beds — perhaps any public funding at all — because the religious-based facility does not allow Medical Assistance in Dying on its property.

FURTHER READING: No MAiD, No Contract!; Decafnation’s hospital series

Concerned citizens should not expect that board members or executives will respond to public questions or presentations at this meeting, at least in any meaningful way. Precedent indicates that if the board responds at all, it will be through written statements or private meetings.

Nearly three months after Decafnation exposed that hospital planning failures have lead to staff shortages and other problems causing low staff morale at the Comox Valley Hospital, nothing has been done to address the issues.

Frontline workers have received no acknowledgement of the problems they face or asked their input on how to resolve issues, including hospital design flaws and inefficient Island Health procedures, that have left them overworked and frustrated.

The response from hospital management and Island Health executives has been that these problems are “normal,” and will work themselves out over time.

Meanwhile, the CVH reached a new record high in overcapacity last Friday with 178 admitted patients.

That’s 49 more patients than the 129 opened beds for which the hospital is budgeted and staffed. And it’s 25 more patients than expected by 2025, when hospital planners expected CVH to reach maximum capacity of 153 admitted patients.

Emergency room staff — where reports of wait times have stretched up to eight hours — are often on the front line of some of these problems.

One Decafnation reader wrote that the experience of her husband at CVH “was appalling, total ignorance of his recent heart surgery.”

The man had a heart attack and was treated well at CVH initially, and at Royal Jubilee Hospital where he had five-vessel bypass surgery.

But when he started bleeding into the bowel from Equis after his return home and went to the CVH emergency, he waited five hours to see a physician, and then kept on a stretcher (cubicle with a curtain) in the day surgery area for eight days with no shower and forced to use a commode.

Then he was transferred to the emergency overflow area and provided with a bed, but no shower, and discharged two days later.

“Sleeping on a stretcher, not being able to shower for 10 days and having to use a commode is not acceptable care,” said our reader.

The Island Health board meeting is open to the public. It starts at 1.30 p.m. in the Crown Isle Resort ballroom located on ClubHouse Drive.

 

120 complex care beds proposed for Comox Valley

120 complex care beds proposed for Comox Valley

The Vancouver Island Health Authority (Island Health) has reissued a Request for Proposals to add 120 new beds for patients requiring a complex level of care in the Comox Valley.

Island Health says it hopes to award contracts for the new beds in early May and expects they will open for patients sometime in 2020.

That’s good news for people needing complex care, and especially for their caregivers. The glaring and long-time shortage of complex care beds in the Comox Valley has distressed caregivers, and resulted in some horrific tragedies.

It’s also good news for Comox Valley Hospital workers. A workforce staffed for 129 admitted patients has been dealing with serious overcapacity issues — up to 170 admitted patients — since the new hospital opened in October.

Most of those 30-40 unexpected patients no longer need acute care, but remain in the hospital because of the Valley’s shortage of complex care beds.

It’s a problem that dates back many years, but surprisingly the new Comox Valley Hospital was planned as if it would never have patients needing an alternate level of care.

That strategy might have worked, or at least diminished the current problems at CVH, except Island Health was slow in issuing a Request for Proposals and awarding the contract for new or replacement beds. And then, it cancelled the RFP completely.

On Sept. 30, 2016, Island Health issued an RFP for 70 new or replacement residential care beds for the Comox Valley. The press release said contracts would be awarded in April 2017 and opened in 2019.

But, on Aug. 3, 2017, Island Health cancelled the RFP, shortly after its board of directors decided the four hospice beds located at St. Joseph’s should be moved to a secular facility that could provide Medical Assistance in Dying (MAiD).

Tim Orr, the director of residential services for Island Health, told Decafnation that St. Joseph’s policy not to permit MAiD was one of several factors in the decision to cancel the 2016 RFP. The new RFP requires at least one proponent to provide end-of-life services including MAiD, and house six hospice beds.

FURTHER READING: Island Health RDP press release

What’s in the RFP?

The Island Health press release says the 120 new beds may be awarded to more than one proponent, and than the number of new complex care beds awarded to each proponent will be determined in the evaluation of each proposal.

“Should the RFP result in more than one successful proponent, at minimum, one of the selected proponents will be required to provide for six community hospice care beds and allow for the provision of MAiD (Medical Assistance in Dying) on site,” the release said.

And successful proponents must provide 3.36 direct care hours per resident day, as per provincial standards.

The release also states that the “new RFP includes flexibility for greater capacity in the future, opportunities for a full spectrum of complex care including innovative models of dementia care ….”
Community reaction

The community has responded to the Island Health announcement with cautious optimism.

Our sources believe that 120 new beds will relieve the stress on the new Comox Valley Hospital, but will not provide a complex care bed for everyone in the Valley who needs one.

Because there are so many nonpaid (mostly family member) caregivers in the Valley, and because only the most in need of acute care get into the hospital, that the Valley may actually need more than 150 and closer to 200 complex care beds.

Our sources expressed disappointment that the announcement didn’t include an increase in respite beds, adult daycare programs or resources for Community Health Care, a program designed to keep people at home as long as possible.

Will St. Joseph’s apply?

The wording of the RFP press release appears to open the door for The Views at St. Joseph’s to apply for additional beds without agreeing to provide MAiD on site, which is something the Catholic church opposes on ethical grounds.

The Views at St. Joseph’s already provides publicly-funded complex care beds that are mostly occupied by patients with dementia. The Views board of directors has outlined a vision for a dementia village” similar to Hogeweyk in the Netherlands.

A private operator in Langely, B.C. just announced that it will open Canada’s first “dementia village” next year. Verve Senior Living says the project will cost patients between $6,000 to $7,500 per month, but is open to working with the B.C. government to make residence more affordable.

What’s next

Island Health will accept proposals until May 11, but does not say when the contract or contracts will be awarded. It generally takes a minimum of two years from awarding a contract to its completion.

The Island Health board of directors will meet at 1.30 p.m. on March 29 at the Crown Isle Resort ballroom. People may ask questions in advance to be answered in written form at the board meeting, or make 10-minute presentations to the board if they apply by March 15.

In other North Island Hospitals news, Dr. Jeff Beselt has resigned from his position as the Executive Medical Director for the Comox Valley Hospital and Campbell River Hospital. According to a Island Health spokesperson, Dr. Beselt stepped down to focus on his family. Island Health named Dr. Jennifer Grace, of Campbell River, the interim EMD for the region, which includes Campbell River, Courtenay, Comox and Mount Waddington/Strathcona. You can view a farewell video for Dr. Beselt here, and read reviews of Dr. Grace here.

FURTHER READING:Canada’s first “dementia village;”BC retirement home chain sold to murky Chinese ownership group

 

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