Showing posts with label health. Show all posts
Showing posts with label health. Show all posts

Sunday, 12 January 2014

False expectations.

In the last few days several newspapers in Canada have carried stories of Hospitals apparently sending home patients, to find that they died a few hours later. Their condition was worse than what the doctors in Emergency service thought or the Nurses in charge of discharging patients followed established procedures sending patients on their way not realizing that the patient was alone and had no one to care for them at home.

The practice of clearing beds is not a new policy, it is one which was implemented in many Canadian Hospitals in the mid 1990's as Provincial health budgets were slashed by politicians in a drive to be seen as business minded, bringing the concept that a health care facility could be run like a factory producing widgets, ''Be efficient and Work Smart'' was and still is the philosophy behind it all.

Our politicians in Canada understood that our current health care system instituted in the 1960's needed reforming to control costs. Many a Province  spend a very large part of their operational budget on health costs. But how to reform a system seen by most Canadians as a Sacred Cow without committing political suicide, this is the crux of a complicated question.

It is Winter in Canada and this winter 2013-2104 has seen the effects of dramatic climate change, the temperature in much of Canada has been severe and this brings a host of problems not encountered often before.  So people are more vulnerable in many ways and if you are not in good health or elderly then you are more at risk, sometimes as the news stories show, at a far greater risk than one would expect. What as also changed in the last 25 years or since 1990 is the way government services are provided, in this case hospital care.  Politicians in an effort to please the public have been slashing budgets and services, what we knew or came to expect in terms of services before 1990 and what is done today is totally different.  With cuts there are a lot less services and people are expected now to look after themselves or make private arrangements. This means, making sure the hospital room is cleaned properly, that meals are served and follow diet, that medication is dispensed and bed sheet are changed for clean ones. In some Provinces a small tip or favour to hospital staff can ensure better service.

Last year  I was invited to a business dinner with various people who had in common that they worked in providing social services to the population in general. Next to me on my left was a big Hospital administrator from Northern Ontario and on my right was the head of the Soup Kitchen in the National Capital region. The Hospital Administrator was explaining that the Government of Ontario to get more mileage out of its budgets in order to provide more efficient health services, I love the buzz word ''efficient'' what ever that means, he had to ensure that people do not spend any more time than absolutely necessary at the hospital and doctors and nurses where asked to work as a team to ensure that the patient be looked after, treated and then released quickly.

What happened next was to ask the individual to continue his or her convalescence at home and let families look after the relative in need. This way with a minimum of beds available much more people could be processed, again a word I love, it has that mechanical ring to it. This in turn would lower cost, it is all about money and little else.

I told him that this was a fine in theory but the public at large was not aware of this plan or if they are it is at a very superficial level, not believing that this might apply to them or their loved ones. At any rate this is the here and now and this is the way it works.

But in Canada many a politician has made his or her career by claiming that financial disaster is at hand due to difficult times, they never explain what they actually mean by that. So the easiest thing to do is to portray yourself to the electorate as a pro-business and cost cutting kind of politician who will solve all problems by downsizing and cutting or slashing budgets, making the government so small in can fit in your bathroom. This is called ''thinking outside the box'' and is suppose to look smart.

The politician being careful of course to NOT ever mention or explain that you are also getting rid of services in the process. The latest is to require all to have a computer and be online in order to access Government Services. You are not online too bad we do not want to hear from you, you do not exist, but we fully expect you to vote for me at the next election.

Again in this cynical political approach the over 65 crowd which represent a very important segment of our society in Canada are pushed to the margin.

In recent weeks more stories have come forward about how hospitals have sent home often in the middle of the night elderly patients without enquiring if this person had anyone to take care of them.

In one case at the Grace Hospital in Winnipeg  on New Year's Eve when it was -40C, an elderly man was put in a taxi, wearing slippers and his pyjamas and sent home. He did tell the staff at the Hospital that he had no one at home and he did not feel well, nonetheless the procedures are the procedures. He was found frozen to death in a snow bank in front of his house the next morning by his care giver. He died of a heart attack and hypothermia did the rest. He had gone to the hospital complaining of symptoms like heart trouble, vomiting, fever etc. The staff obviously did not think much of it or where too short staffed to be able to care for him during the Holiday period.

Being short staffed to provide any kind of government service is also the common trend nowadays, it is called ''greater efficiencies'' by senior bureaucrats, one person is called upon to do 3 to 4 jobs. The other problem is that at night or after 6pm in any hospital, the staff is usually junior or new, fully trained but not as experienced as the Monday to Friday 7am to 6pm medical crowd, mistake can happen and often as we see today in the service sector, the new younger generation is too self-absorbed to notice anything outside of their zone of knowledge. A few days later the CBC reported that Grace Hospital is now involved in a second case resulting in the death of a patient.

This is only Winnipeg cases, similar cases of elderly persons being mistreated, neglected and dying happen in other parts of Canada each week, this is truly shameful and unacceptable.  In all cases, the politicians promise to look into the matter and change the procedures, all the while they are looking for a politically expedient answer.

One wonders, when the big management types in the different Provincial Ministry of Health came up with these procedures, did they think of all possibilities or were they just being ''efficient or cost effective'' in order to please their Minister with quick solutions.

I am willing to bet based on my own Government experience, that expediency took over from common sense. Not to forget the promised of a big bonus for anyone who finds politically easy solutions to difficult problems.

All these changes in the way services are provided never seem to take into account that in Canada, people in general do not live with their family and it is very common to see elderly people on their own without any close relatives to help them out. Often they live in another part of the country and cannot come rapidly in case of need. Care givers are very expensive and not for every budget. What drives all this is the politics of cutting taxes, smaller government and trying to make government function as if it was Walmart.

The lesson in all this for all of us is to be prepared and have a plan in case you fall ill or need assistance, do not count on the Government to help you out. The governments at all levels are far too enamoured of processes and procedures and providing a service is simply not part of the equations. As they say ''As long as the public believe we are providing a service that is all that matters''.

Being a senior, over 60 years of age in Canada is not a pretty picture, unless you are financially well off.  Another disturbing statistics in Canada, the number of suicides is the highest amongst Seniors over 80 years of age, this does not attract much attention, because most are male and end their lives violently. What a sad situation.




   

Thursday, 25 November 2010

Something I have learned since 7 July

On 7 July 2010, I started my diet with a dietician, a professional well known to many other health providers in Rome. She is very good and I lost a lot of weight around 12kg. I am so far 4 kg or 8 lbs short of my perfect weight. I did this to improve my health and also to get my blood pressure under control to a more normal level, it is not high, it is on the border, either over slightly or just normal.


What I learned during this process is how men can develop specific male health problems with the weight around their waist area, the fat in that area can cause with age a lot of serious health problems. Now this week I had surgery for an hernia, it was large and more serious than I thought. What I learned from speaking with the surgeon and the resident doctor was that male abdominal muscles are very important and should not be neglected, they play an important part in keeping everything in place. Unfortunately too many men do not seem to be aware of this fact and have soft abdominal muscles and thus many problems with their back and with hernias etc...   Lifestyles and drinking habits, lack of exercise and often deskjobs do not help.
I find that too often we are unaware as men of the dangers of poor habits, they are not discussed in the media and are not part of the general discussion in society. I for one was mildly aware of what I should do and also as you age needs change. The fact that the image we see is usually of young under 35 men and that programs of exercise or diet are focused on youth leaves anyone else older out in the cold, youth sells in the Marketing world, even with an aging population.

In North America it is a phenomenon of its own, you can easily find articles on women topic, from food to health, to fashion, education, work and career. Try finding anything about men, it is far more difficult and it is often very slanted. Same goes for medical or health information, information is not provided with the optic to grab the interest of a readership but is more focused on telling us about a problem without offering any solutions. If a solution is offered it is often a fad and will not last. So you need to get good advice from a professional.

So it is up to us individually to inform ourselves of what we should be aware, small things are often more important than we think.
Out of my hospital adventure I received these very nice flowers from my colleagues at the Office.

Saturday, 20 November 2010

Life in Rome

On Friday night we went to one of our neighborhood restaurant's called Stella Maris (Sea Star), the specialty is fish and it is owned by a family from Sardinia. The food is good and we being regulars and neighbors always have a table. Had some mussels and then some calamari and octopus a nice green salad and a little dessert, all with a nice Vermentino White wine. After dinner I asked the owner for a glass of Mirto which is a liquor made of Myrtle which is his specialty and is served with spice cookies his wife makes. He also surprised us with a plate of hot chestnuts to go with our Mirto. How very nice I thought, it is chestnut and Olive Oil season right now in Italy, in France its Beaujolais nouveau but here in Italy it is unknown. We  have 16,000 wine labels in Italy so Beaujolais is not exactly something people go for.

The chestnuts were good and hot to handle, delicious and on a cold night was just the perfect way to finish a meal, a luxury.

On Tuesday I will have a small operation in an Italian Hospital, being operated on by a Italian Surgeon all in Italian. I have been to Mexican and Polish Hospitals in the past and the service was always fine and
have really no problems with getting medical problems attended to. This time maybe because I am older I am a bit apprehensive, it is surgery, nothing complicated and the doctor is well recommended by everyone I spoke too. I suppose what bothers me is that with the stress of the operation is the fact that it will be in a foreign language.  I speak some Italian and I do understand what people are saying quite well, it is just that I have to make an effort to pay attention, so I catch the meaning of it all. The hospital is a private clinic and it is well known. But surgery is always a little stressful no matter what.
Because of this medical situation, I missed yesterday a private visit to the Quirinal Palace, a real shame.
I will not be able to go for lunch and the opera in Florence next week.  But I cannot put this off, it must be taken care of now.

So is life.

Saturday, 3 October 2009

The debate in the USA about Health care or not to care

I have been following the Health Care debate in the USA from Rome, I am surprised at the level of animosity. The hate in some comments is palpable, racism also plays its part. The ignorance of the commentators may they be private citizens or media personality is astounding. Comparing the Obama administration with Nazi Germany (1933-45) or Soviet Russia (1917-1989) is laughable, do any of these experts or commentators have any idea what life was like under the Nazis, if Obama was a Nazi, he would have physically eliminated all opposition by now, that is what you do, there would not be one Republican left alive and families would have been rounded up, shot or imprisoned. News media closed down, Fox News gone, its commentators would have met a horrible death. Same in Soviet Russia, no opposition allowed, obviously commentators use such example to create a sensation, but it is sad because it preys on the ignorant masses and stirs up hysteria. All the President really wants to do is to allow every citizen access regardless of financial resources to medical help and treatment if required. Any country in the world with a responsible government wants this basic minimum for its citizens.

You cannot have democracy only for the rich, the well connected or the special interest group, it does not work, it creates tensions and social unrest in any country. Socialize medicine works in many countries, Canada, the UK, France, Scandinavia, etc.. citizens of those countries have a better standard of living because of it. What is difficult to understand in the American debate, why all the fear.

An economic study today shows that Norway has the highest living standard in the world, Canada is at no. 4 and the USA at no. 13. Food for thought really. Another fact Cuba, that little island 90 miles south of Florida has better health care overall and lower infant mortality than the USA and it is all free. I would say this is pretty shocking when you think of it.

I am an outsider looking at the USA and I can only shake my head and wonder where is the Land of the Free going with this internal negative debate. President Obama should be praised for wanting to implement this health care policy, not put down. Let's hope that the voice of reason will be heard.