MAiD: A passing … but not gently into that good night

MAiD: A passing … but not gently into that good night

Lorraine “Lani” Hudelson | Born March 13, 1941, Died December 13, 2018 | Arriving Honolulu International Airport June 1961

By Pat Carl

I still don’t know why she wants me present at her passing. I’m not a particular friend nor even a steady acquaintance.

When I asked her, “why me?” Lorraine — Lani to those who know her best — says, “You’ve always been honest with me.”

So, honest at her end, I can say:

She’s angry.
She’s difficult.
She’s needy.
She rages.

She’s insistent.
She’s determined.
She’s intelligent.
She’s driven.

Her life’s been difficult from the beginning and, at her end of days, even more so.

The kindnesses of caregivers can’t help. The absence of close family doesn’t matter to her.

No home care, no hospice care, no drugs, can alleviate it.

Only the pain, the terrible, terrible pain.

Her brain injury affects all the primitive areas of her brain.

She suffers from:

Insistent fatigue.
Unbearable headaches.
Visual challenges.
Personality flux and confusion.
Lack of coordination.

She can’t:

Concentrate.
Remember.
Sleep consistently or well.
Process information.
Control impulsivity.

She has difficulty with:

Loud noises.
Controlling her emotions.

But the worst of the pain comes from her inoperable spinal stenosis that is progressively damaging her nerves.

Affected are her:

Gait.
Balance.
Dexterity.
Grip.
Bladder and bowel functions.

She believes her earliest doctors were not thorough enough with their investigations into her symptoms, but she feels cared for and comforted by her later ones.

***

Today, a rainy, windy, stormy December 13, she is dying with the help of those doctors and with the support of a few witnesses.

One of those witnesses, my partner, Megan, has truly befriended Lani in her darkest hours. She has run errands to the grocery store and the pharmacy and she has sat patiently with Lani and absorbed her angry outbursts for hours at a time.

She and I arrive at Lani’s home at 1 o’clock. We are greeted at the door by her sister, Pat, who flew into Comox a few days ago and has helped Lani get her house in order. They’ve talked with her lawyer, and her banker, retrieved her will from a safety deposit box, gone to the post office and filled out a change of address card.

When I hear this, I smile a bit, wondering what forwarding address they used for Lani.

Lani is sitting in her recliner eating Poppycock, a Christmas sweet made with nuts and popcorn all covered in caramel.

“Why not?” she says. “I don’t have to worry about diabetes anymore. I should have a treat before I die.”

Gallows humour, so typical of Lani.

Next to arrive is Lani’s primary physician, Dr. Usmani. He brings with him a silver case, the size of a small piece of luggage.

Ah, the instruments of death, I speculate.

I know Dr. Usmani has completed whatever course work is required to be certified to assist a patient who wants to die, but this is the first time he’s actually completing the procedure himself.

That’s why Dr. Reggler, the next person to come through the front door, is with us. He’ll make sure that everything goes as it should this day, that no steps are inadvertently forgotten.

A sort of certification process, that thought jumps to my mind, as the doorbell rings again and an intern, whose name I never did catch, walks into the living room. He immediately goes to Lani and shakes her hand.

“Thanks for letting me observe.”

Seems uncomfortable, I observe, but what else is there to say?

The final person to arrive is Wendy. At first, I think she’s a friend of Lani’s and I’m a little relieved that Lani has more people in her life than just doctors.

But no. Wendy’s the nurse who’ll assist Dr. Usmani.

What has happened to Lani’s friends? Where is the rest of her family? I’m disconsolate, but understand more fully why I am here, a mere acquaintance.

Her pain has hollowed out her life, has reduced it to the bare essentials, to the doctors who can alleviate her pain.

We’re all here now. Dr. Usmani asks Lani to sign some documents.

“I’ve practiced my signature,” she says.

Spinal stenosis affects fine motor function, I recall.

With that done, Lani gets up from her recliner, not without trouble, and says, “Let’s get on with it, then.” She reaches for her crutches, her crucking futches according to Lani, and moves slowly, but independently, down the hall to her bedroom.

Once there, she climbs into her hospital bed, a relatively new purchase. It can be raised and lowered at the head and knees.

I note the impressions in the carpet that mark the foot of her original bed, and ponder, A memory not quite disappeared.

As Lani lies back on a stack of pillows and raises the head of the bed a bit, her sister climbs into the bed with her, sits next to her, and holds her hand.

We are finally all settled and Dr. Usmani explains the procedure. “There will be four injections,” he says. “The first one will put Lani to sleep; the second will eliminate any pain that the other injections may cause; the third will deepen Lani’s sleep; the final one will paralyze her muscles.”

Stop her heart muscle, I think.

Lani doesn’t seem disturbed by this list at all. She’s heard it many times by now.

Dr. Usmani asks for her verbal consent to proceed. He does this three times. Each time she responds in the affirmative.

The last time she says, “Yes,” and turns to her sister and says, “I’m scared.”

This is the first crack I’ve seen in Lani’s resolve.

“Of course, you are,” her sister says. “But this is what you want.”

“Yes, it is, “Lani visibly swallows, her teeth grit, her face settles determinately. “It’s way past time for this.”

Dr. Usmani begins the series of injections. Megan walks to the foot of Lani’s bed and holds onto Lani’s legs, supporting Lani one last time as she leaves us. Lani falls asleep.

Fifteen minutes later, after listening to her heart through his stethoscope, Dr. Usmani says, “She’s gone.”

Pat, a religious person, tells us how she justified witnessing Lani’s death. “God would want us to help her come home to Him.”

I think how this comforts Pat, though it’s a perspective I’m sure Lani doesn’t share.

For me, the years-ago Catholic, I silently repeat the beginning of Psalm 23:

Yea, though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me, thy rod and thy staff they comfort me.

Later, Dr. Reggler straightens out Lani’s legs, Wendy lifts Lani’s head and removes the pillows propped behind her. They both straighten the comforter covering Lani.

The doctors and nurse leave soon after. “Stay with me,” Pat asks, “until the funeral home comes?”

We agree. We reminisce about Lani.

I remember what Lani said, “I am not choosing to die…I am dying anyway. What I’m choosing is how and when and where to die.”

The funeral attendants arrive bringing a stretcher with them. I’m startled: They’re both women. Why do I think that unusual?

Moments later, they wheel Lani out of the bedroom and down the outside ramp Lani had built when she could no longer manage the porch steps.

Lani’s favourite plaid blanket drapes her body.

Salut to you, you most uncompromising woman. You have not gone gentle into that good night.

Pat Carl is a writer and a participant in the Comox Valley Civic Journalism Project. She may be reached at pat.carl0808@gmail.com

 

 

 

 

 

 

ABOUT MAiD

Patients and their families have many decisions to make when faced with end-of-life care or intolerable suffering.

Legislation governing Medical Assistance in Dying (MAiD) was passed by the Federal Parliament on June 17, 2016. This means medical assistance in dying is now legal in Canada when provided within the purview of the legislation. 

Under the new law, doctors may provide medical assistance in dying to capable, consenting adults who have a grievous and irremediable medical condition that causes enduring, intolerable suffering and who are at a point where natural death is reasonably foreseeable.

British Columbians seeking medical assistance in dying should speak with their physician or other primary care provider or their local health authority.

For more information, click here

No word yet on the promised new long-term care beds

Photo by George Le Masurier BY GEORGE LE MASURIER s a strike by care workers at two Comox Valley assisted living facilities enters its sixth day, many people are wondering what happened to the 151 additional long-term care beds promised by Island...

Vaccine available for the virus headed our way

Vancouver Island health care professionals say a serious virus will hit the Comox Valley in a few weeks that will threaten the lives of those most vulnerable. Fortunately, they have a vaccine.

24 new care and respite beds opened at St. Joe’s

St. Joseph’s has transformed the third floor of its former acute care hospital into a temporary but attractive long-term care facility, until Island Health can build a promised 150 new beds in the Comox Valley. The announcement of contracts on the new beds has been delayed

ALC patients temporarily moving to St. Joseph’s

The former St. Joseph’s Hospital is being called back into action. Some patients in acute care beds at the Comox Valley Hospital, who are waiting for residential care beds, will move to St. Joseph’s to alleviate the new facility’s chronic overcapacity

A caregiver’s hard decision: help wanted

Caring for her husband who suffers with dementia, Comox resident Delores Broten struggles with a hard decision. He’s falling now, but should she approve strapping him into a wheelchair? It seems inhumane, and she’s reaching out for help.

The buck (doesn’t) stop here

The key to maintaining the public’s confidence in its government departments and agencies, is the concept of public accountability. 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?

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

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

No word yet on the promised new long-term care beds

No word yet on the promised new long-term care beds

Photo by George Le Masurier

BY GEORGE LE MASURIER

As a strike by care workers at two Comox Valley assisted living facilities enters its sixth day, many people are wondering what happened to the 151 additional long-term care beds promised by Island Health last year?

The critical shortage of long-term care and respite beds in the Comox Valley continues to cause problems for at home caregivers, many of whom are exhausted and in crisis. And it causes overcapacity issues at the Comox Valley Hospital, where patient s who need long-term care are stuck in acute care beds.

The contract award for new beds is already three months late and, according to an Island Health spokesperson, no announcement is imminent.

Island Health issued a Request for Proposal for 70 new long-term care beds over three years ago, but cancelled it a year later, and issued a new RFP this year. The health authority said it would award contracts by Aug. 31 of this year.

When it missed that deadline, Island Health said the contracts would be announced later in the fall. Now, three months later, the contracts have still not been awarded.

Asked what is holding up the awarding of contracts, Island Health spokesperson Meribeth Burton said, “Awarding a long-term care contract is a complex, multi-stage process. We want to ensure we are thoughtful in our decision because this facility will serve the community for decades to come.”

Island Health could give no date when the awards would be announced.

“We understand the community needs these additional resources and is anxious to learn when the contract will be awarded. We will be able share more details with the community once a project development agreement is finalized with a proponent,” she said. “We don’t have a firm date, but we will let you know as soon as we can.”

Burton said Island Health still pins the timeline for opening the new long term care beds at 2020.

In the meantime, 21 long-term care patients were relocated back to the former St. Joe’s Hospital, which reopened and renovated its third floor to create an additional and temporary long-term care facility. St. Joe’s already operates The Views for about 120 long-term patients. The new facility in the old hospital is called Mountain View.

The move was planned in part to relieve overcapacity issue at the Comox Valley Hospital.

Despite Island Health’s efforts, overcapacity still plagues hospitals, stresses staff

Despite Island Health’s efforts, overcapacity still plagues hospitals, stresses staff

Photo by George Le Masurier

BY GEORGE LE MASURIER

This month, like last month, and the month before that and every month since the two new North Island Hospitals opened last year, they have been overcapacity.

So on most days, staff at the Courtenay and Campbell hospitals struggle to find space to put as many as 30-plus extra patients, and the peak hospitalization season that coincides with the influenza season is just getting started.

Overcapacity at the brand new hospitals is not the only critical health care need in the Comox Valley — see the sidebar story on long-term care beds — but it is a serious issue for overburdened hospital workers. And it does not bode well for communities with growing populations, and for whom the capacities of these hospitals were expected to be adequate until 2025.

The new Comox Valley Hospital opened on Oct. 1, 2017 with staff and patients budgeted for 129 beds. It was almost immediately plagued with overcapacity.

Patient numbers soared as high as 178 within a few months, a situation that has continued throughout the year and led to predictable consequences.

Staff trying to care for up to 49 extra Comox Valley patients became stressed and exhausted. They took sick days to recover, which created daily staff shortages and exacerbated the workload problems, according to sources.

Overcapacity also plagues Campbell River Hospital, where the maximum 95 beds were opened quickly and still runs overcapacity.

And it is not good for patients housed in makeshift accommodations at both hospitals.

Dermot Kelly, Island Health executive director for the region, told Decafnation that all hospitals across BC have overcapacity issues, and that the two North Island Hospitals are following an official Overcapacity Protocol.

Kelly said the protocol includes a number of steps to mitigate the overcapacity problems, including “working to reduce the length of stay within hospital, and improve access to care in the community.”

Community access measures include “increasing Home Support hours, implementation of Overnight Care Teams, new specialized services for those with Mental Health and Substance Use Challenges and improved supports for those who are medically frail,” he said.

And, he said the hospitals are working to increase access to Adult Day Programs and respite services “to better support the needs of patients and caregivers in the community.”

And the Comox Valley Hospital recently opened an additional 17 beds, for a total of 146 open beds (of the hospital’s maximum capacity of 153) with increased staffing levels, and moved out 21 long-term care patients, most of them going to a renovated floor at the former St. Joseph’s General Hospital.

Island Health has also increased the number of surgeries at the two hospitals, Kelly said. While that has reduced surgery wait times, it has also increased the number of hospital visits and stays.

But those efforts have so far not reduced patient levels to capacity or below.

The number of admitted patients ranged from 160 to 170 throughout October, reaching a high of 177 on Oct. 12. Those numbers are expected to increase significantly as the annual influenza season gets underway this month.

Sources have told Decafnation that extra patients at CVH have been housed in an unopened section of the emergency room. These patients are on stretchers, without standard beds or the same healing environment as regular rooms.

The Campbell River Hospital also remains dramatically overcapacity, but unlike the Comox Valley it has no unopened space to house them. Sources say patients are parked in hallways.

 

Overcapacity raises staff issues

A CVH source, who requested anonymity, said the overcapacity issues have kept staff morale low.

“We opened up a new ward and the morale is still not wonderful,” a source told Decafnation. “We are overcapacity everyday, and patients are getting discharged too early. I know this because the exact same patients that were discharged are back two days later.”

“People are without beds and there’s a full ward of aging population in the emergency overflow areas,” another source said. “We put elderly people in the pediatric ward sometimes. This causes so many issues.”

For some CVH workers, stress is caused by too many vacant positions, which forces staff into overtime, and because some departments didn’t get extra staff when the last hospital ward was opened.

Kelly said there were 91 vacant staff positions as of Dec. 6 between the two hospitals, which he blamed partly on the region’s rental and housing affordability issues that “directly impacted our ability to fill vacant positions and retain staff.”

Campbell River sources tell Decafnation that their hospital had more than 130 admitted patients last week. The hospital was designed for a maximum capacity of 95.

Campbell River staff are concerned that patient-to-nurse ratios are not being met. Overtime is rampant, they say, and staff is “being run off their feet.”

“Patients are now located in emergency rooms,” the source said. “Third floor sunrooms have been converted to bedrooms and two patients per room is common.

“There are rooms where one of the two patients has an infectious condition that should be in isolation.”

Our source said they feared this could cause a MRSA or similar infection alert.

But Kelly said Island Health’s Over Capacity Protocols ensure safe care in the hospitals.

“In cases of over census, guidelines for care have been developed to ensure we provide the best care possible. Our main goal is to provide safe and effective care in the most appropriate setting possible,” he said.

And he praised the hospitals’ staff as “incredibly passionate and dedicated, sometimes under challenging circumstances.”

 

 

 

 

 

 

NO WORD YET ON PROMISED 151 LONG-TERM CARE BEDS

As a strike by care workers at two Comox Valley assisted living facilities enters its sixth day, many people are wondering what happened to the 151 additional long-term care beds promised by Island Health last year?

The critical shortage of long-term care and respite beds in the Comox Valley continues to cause problems for at home caregivers, many of whom are exhausted and in crisis. And it causes overcapacity issues at the Comox Valley Hospital, where patient s who need long-term care are stuck in acute care beds.

The contract award for new beds is already three months late and, according to an Island Health spokesperson, no announcement is imminent.

Island Health issued a Request for Proposal for 70 new long-term care beds over three years ago, but cancelled it a year later, and issued a new RFP this year. The health authority said it would award contracts by Aug. 31 of this year.

When it missed that deadline, Island Health said the contracts would be announced later in the fall. Now, three months later, the contracts have still not been awarded.

Asked what is holding up the awarding of contracts, Island Health spokesperson Meribeth Burton said, “Awarding a long-term care contract is a complex, multi-stage process. We want to ensure we are thoughtful in our decision because this facility will serve the community for decades to come.”

Island Health could give no date when the awards would be announced.

“We understand the community needs these additional resources and is anxious to learn when the contract will be awarded. We will be able share more details with the community once a project development agreement is finalized with a proponent,” she said. “We don’t have a firm date, but we will let you know as soon as we can.”

Burton said Island Health still pins the timeline for opening the new long term care beds at 2020.

In the meantime, 21 long-term care patients were relocated back to the former St. Joe’s Hospital, which reopened and renovated its third floor to create an additional and temporary long-term care facility. St. Joe’s already operates The Views for about 120 long-term patients. The new facility in the old hospital is called Mountain View.

The move was planned in part to relieve overcapacity issue at the Comox Valley Hospital.

 

 

 

Vaccine available for the virus headed our way

Vaccine available for the virus headed our way

By George Le Masurier

Vancouver Island health care professionals are warning about a serious virus headed our way. Fortunately, there’s a vaccine.

 

Vancouver Island health care professionals are warning about a serious virus predicted to hit the Comox Valley in just a few weeks. The disease will hospitalize many and in some cases threaten the lives of those most vulnerable.

Fortunately, the Comox Valley Public Health Unit has a vaccine that can protect against the disease, and prevent its spread throughout the community.

It’s called the ‘flu shot.

North Island Medical Health Officer Dr. Charmaine Enns said her offices started distributing the vaccine in October to Comox Valley medical offices and pharmacies, where most people get their annual vaccinations. And more people are getting them this year, probably due to a particularly bad epidemic last year.

Enns said the health unit had distributed more doses in the North Island by the end of last week — 35,000 — than it had last year in total. That mirrors Island-wide figures: 218,000 doses distributed so far this year, compared with a total of 225,000 during the 2017-2018 season.

But even this year’s upward trend in vaccinations isn’t enough, Enns told Decafnation. Only about 29 percent of the total Island population was vaccinated last year.

“The higher the vaccination percentage, the less likely the virus will spread,” Enns said. “We call it herd immunity. The vaccine protects those most at risk, and lessens the chance in others of transmitting it.”

The concept of herd immunity is how the world has eradicated major killer diseases. Vaccines have eliminated smallpox, which killed more than 500 million people, and has nearly vanquished polio. When more people get immunized, the risk factor diminishes for everyone. And that reduces the cost to the public health health care system.


The purpose of providing ‘flu vaccine is to reduce the likelihood of severe complications and death from influenza


 

Enns said those most at risk at the elderly and the very young. About 3,500 Canadians died last year, including several on Vancouver Island, from complications caused by influenza, such as heart attacks and pneumonia.

A recent study by researchers at the University of Toronto found that the risk of heart attacks jumped by 600 percent within the first days of an influenza infection.

Enns said public health can only estimate the number of deaths and hospitalizations caused by influenza, because it isn’t the disease itself that kills. The virus causes inflammation in the body, so the arteries in someone with heart disease close up more and trigger a heart attack or stroke.

The danger is similar for people with chronic respiratory conditions, such as asthma, or with kidney issues.

The University of Toronto study, which examined 20,000 patients with confirmed influenza, also found that the ‘flu shot reduced the risk of a heart attack or stroke by 20 percent, and infected people were less likely to be hospitalized.

About 538 people were hospitalized with confirmed cases of influenza on Vancouver island last year. But the number is probably many times higher because infected people don’t often get formally diagnosed.

Because the influenza virus mutates frequently, the Canadian Centre for Disease Control produces a new vaccine every year based on estimates of those mutations. As a result, the vaccine is usually between 60 percent and 70 percent effective.

“But it’s a good as we’ve got,” Enns said. “People who’ve had the ‘flu shot won’t get as sick and especially the most vulnerable. The purpose of providing ‘flu vaccine is to reduce the likelihood of severe complications and death from influenza.”

Some of the most vulnerable are frail seniors resident on long-term care facilities, due to their age and the probability of having health issues.

Enns said that makes it more important for those who care for them and visit them to get vaccinated and mount up their own immunity.

A cold weather virus

Medical professionals have puzzled over why influenza virus strikes hardest every year from November through March. Some theories suggested the short days and lack of sunshine, causing a vitamin D deficiency. Others theorized that people are crowded together indoors.

But most health professional now accept the conclusions of a 2007 study at Mount Sinai School of Medicine in New York: cold, dry weather keeps the virus more stable and stays in the air longer.

‘Flu season in Canada starts in the eastern provinces and moves west as temperatures drop. Calgary has already been hit hard, with 510 confirmed cases since August.

In southern latitudes, the main ‘flu season runs from May until September. In the tropics, there is no real ‘flu season.

Why you should get the ‘flu shot

The ‘flu vaccine is our best defense against the virus and will not only protect you, but also the people you know and love.

–You can’t get the ‘flu from the ‘flu shot. It’s impossible. The viruses used to make the flu shot are dead. The worst side effect is a sore arm.

— It takes about two weeks for the vaccine to fully mount your immunity, so it’s best to get the shot early.

–Healthy people need to get a flu shot to protect people at risk and those who are not eligible. Newborn babies and adults with abnormally weak immune systems usually can’t get ‘flu shots. Their only protection comes from others getting the shot, and keeping the spread of ‘flu to a minimum.

— Influenza is a more serious infection than you may realize. It will exacerbate any underlying health conditions you already have, and may cause new problems, which for some can be deadly.

— It’s hard not to qualify for a publicly-funded (read: free) vaccination.

 

No word yet on the promised new long-term care beds

Photo by George Le Masurier BY GEORGE LE MASURIER s a strike by care workers at two Comox Valley assisted living facilities enters its sixth day, many people are wondering what happened to the 151 additional long-term care beds promised by Island...

Vaccine available for the virus headed our way

Vancouver Island health care professionals say a serious virus will hit the Comox Valley in a few weeks that will threaten the lives of those most vulnerable. Fortunately, they have a vaccine.

24 new care and respite beds opened at St. Joe’s

St. Joseph’s has transformed the third floor of its former acute care hospital into a temporary but attractive long-term care facility, until Island Health can build a promised 150 new beds in the Comox Valley. The announcement of contracts on the new beds has been delayed

ALC patients temporarily moving to St. Joseph’s

The former St. Joseph’s Hospital is being called back into action. Some patients in acute care beds at the Comox Valley Hospital, who are waiting for residential care beds, will move to St. Joseph’s to alleviate the new facility’s chronic overcapacity

A caregiver’s hard decision: help wanted

Caring for her husband who suffers with dementia, Comox resident Delores Broten struggles with a hard decision. He’s falling now, but should she approve strapping him into a wheelchair? It seems inhumane, and she’s reaching out for help.

The buck (doesn’t) stop here

The key to maintaining the public’s confidence in its government departments and agencies, is the concept of public accountability. 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?

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

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

24 new care and respite beds opened at St. Joe’s

24 new care and respite beds opened at St. Joe’s

St. Joseph’s has transformed the third floor of its former acute care hospital into a temporary but attractive long-term care facility, until Island Health can build a promised 150 new beds in the Comox Valley. The announcement of contracts on the new beds has been delayed

 

An almost brand new long-term care facility will open in the Comox Valley this week. Island Health is moving 21 patients who are currently in acute care beds at the Comox Valley Hospital to Mountain View, the renamed and completely renovated third floor of the former St. Joseph’s General Hospital.

The move, which begins on Wednesday, Sept. 5, is necessary because patients needing an alternate level of care have contributed to chronic over-capacity at the one-year-old Comox Valley Hospital (CVH).

A facility planned and budgeted for 129 admitted patients has been overcapacity since it opened last October, reaching as high as 178 patients, roughly 40 of those are patients who no longer need acute care but have nowhere to go given the Comox Valley’s critical shortage of long-term care beds.

Island Health has promised up to 150 new long-term care beds for the Valley, but has yet to award contracts for them.

The Request For Proposal said contracts would be awarded on Aug. 31, but an Island Health spokesperson has told Decafnation that the health authority hasn’t finished evaluating all the proposals. It’s now expected the contracts will be awarded later this fall.

In the meantime, Michael Aikins, Administrative Officer of The Views at St. Joseph’s, said reopening and renovating space in the former hospital for the 21 patients and three respite beds has created a flurry of activity.

St. Joseph’s has had just a few weeks to transform the medical/surgical third floor into a secure and comfortable long-term care facility.

“We’re doing everything we can to create a home-like environment for our new residents,” he said. “This will be their new home, and we want to make it a good one.”

St. Joseph’s has purchased new furniture and 32-inch televisions for each room, taken out walls, repainted everything, brought in a piano and a pool table and built custom cabinetry.

The former Intensive Care Unit was gutted and turned into a bright dining area. Other room have been opened up and combined into an activity area, a bistro and a lounge that features a wall of windows facing south overlooking Baynes Sound and the Beaufort Mountains.

The contract to reopen St. Joseph’s for long-term care is only for three years, until facilities to house the promised 150 new beds can be constructed. But Aikins said St. Joseph’s is doing “everything we can” to make it a first-class facility.

“We recognize that this will be their new home,” he said. “For some, it will be their last home, so we’re trying to make it special.”

The three-year contract will create approximately 35 new jobs in nursing, housekeeping and other services.

The St. Joseph’s kitchen, located in the basement of the 100-year-old hospital building currently serves more than 100 residents of The Views and the four hospice beds. It will also provide meals for the new Mountain View residents.

 

 

 

ALC patients temporarily moving to St. Joseph’s

ALC patients temporarily moving to St. Joseph’s

The former St. Joseph’s Hospital is being called back into action. Some patients in acute care beds at the Comox Valley Hospital, who are waiting for residential care beds, will move to St. Joseph’s to alleviate the new facility’s chronic overcapacity

 

Eleven months after the new Comox Valley Hospital opened, the Vancouver Island Health Authority (VIHA) will finally unburden its staff from chronic overcapacity.

And it will give Comox Valley family caregivers some extra opportunity for relief with three additional respite care beds.

VIHA has contracted with St. Joseph’s to open 21 residential care beds in the former acute care hospital site at the top of Comox hill. The beds will be available in September.

And the health authority said they will also convert space on the new hospital’s fourth floor, which was reserved for expansion, into a 17-bed residential care unit for mostly elderly patients who need an alternate level of care.

Norm Peters, Executive Director, Surgery, End of Life Care & Residential Care at Island Health told Decafnation that “By moving (ALC patients) to St. Joseph’s, it opens up acute care beds at the hospital for people who require acute care.”

Almost every day since the new hospital opened with 129 acute care beds, it has been dramatically overcapacity. The number of admitted patients has soared to 178 on occasion, nearly 50 percent higher than planned.

That has stressed workers at the hospital, which was budgeted for 129 patients.

FURTHER READING: Record 178 patients at CVH; Flawed planning at root of hospital’s problems

Most of the overcapacity has been due to patients in more expensive acute care beds who are waiting to transition to long-term care facilities. But the Comox Valley has had a dearth of long-term care beds for many years, so these patients have had no option but to stay in the hospital.

In fact, those in charge of designing the new hospital never planned for any ALC patients (alternate level of care). Hospital planners naively assumed that VIHA would have provided enough beds at residential care facilities such as The Views at St. Joseph’s, Glacier View Lodge or the Seniors Village.

The new 21 beds at St. Joseph’s are temporary until VIHA opens a proposed 151 new complex care beds sometime in 2020, if they can be built that fast. Contracts for those beds, spread among multiple providers, won’t be awarded until at least Aug. 31.

Michael Aikins, administrative officer for The Views at St. Joseph’s, told Decafnation that the 21 residential care beds and the three respite beds will be located on the third floor of the former acute care hospital.

While the new beds are detached from other Views patients, they will be cared for by Views staff who will follow St. Joseph’s policies.

Aikins said The Views was in the process of hiring care aides, LPN’s, housekeepers, dietary aides and will add hours in other support areas such as maintenance, payroll. They will reinforce their casual workers in all areas.

There will be crossover opportunities to maximize The Views’ resources, but the temporary ALC unit will have dedicated staff to provide day-to-day care to the residents.

St. Joseph’s will make some modest improvements to the hospital rooms that have sat vacant for nearly a year with some fresh paint, new furnishings and improved wayfinding.

St. Joseph’s Board of Directors Chair Chris Kelsey said the board is happy to help and provide support.

FURTHER READING: Island Health press release