Northern Health and provincial government face tough questions on long term care policies.

The unfortunate passing of a 96 year old Prince Rupert woman has both Northern Health and the Provincial Government on the hot seat over senior’s issues. Gary Coons the MLA for the North Coast brought up the case of Verna Sevigny, a 96 year old woman who had been waiting for 18 months for a spot in Acropolis Manor, only to be deemed too healthy for the long care facility

In a rather tragic story, she remained living at home where she recently fell and broke a hip; subsequently she passed away a week and a half ago after suffering a number of complications resulting from her fall.

In a complicated string of events, she was once listed as a candidate for a bed at the Manor but at that time, chose to stay home instead. Once she felt ready to take a spot there, she was deemed as no longer needing the facility. It’s a situation that seems a bit hard to fathom, considering her advanced age and state at that time. If she was listed as a prime candidate a few years ago, surely she would still be a candidate for the first available space later on.

The entire process of getting seniors into proper institutional care as described in the Daily News article below, seems to be the creation of a convoluted bureaucratic process designed more to put off seniors than to provide for them. A lengthy checklist of requirements needs to be considered before anyone seems to be eligible to be granted a spot in the system, even if it seems pretty obvious by their day to day living that a person is in need.

It calls into question the treatment of seniors regarding long term care, as well as the policies in place to make sure that they are provided with the best care the province can offer. It’s a very sad story and its unfortunate ending places that issue prominently on the front burner.

While it’s laudable to want to see seniors remain in their homes as long as possible, sometimes that is not a realistic, nor a proactive move. Northern Health and the province need to explain how these things are happening and what steps are being taken to make sure that repeat instances don’t take place.

The Daily News provided a complete examination of this very sad situation as their front page story in Thursday’s paper.

RUPERT SENIOR’S PLIGHT IS DISCUSSED IN LEGISLATURE
MLA asking why Verna Sevigny was unable to get the care she needed
By James Vassallo
The Daily News
Thursday, March 8, 2007
Pages one and two

The recent death of a Prince Rupert woman who was denied a place in Acropolis Manor reached the floor of the provincial legislature this week.

“Verna (Sevigny) was 96, and on a wait list for 18 months for long-term care,” said North Coast MLA Gary Coons. “She was told she was ‘far too healthy for admission.

“Shortly after being rejected for long-term care, she fell in her home and broke her hip. She passed away a week a half ago from complications resulting from her fall.”

Coons asked Health Minister George Abbott to explain why Sevigny could not get into Acropolis Manor.

“The Minister was pretty cavalier in dismissing the concerns of people from Prince Rupert,” Coons said. “That’s not a surprise. They don’t want to talk about their broken promise of creating 5,000 new long-term care spaces.”

Marion Weir, who helped Sevigny with such things as her shopping and advocated for her in dealing with Northern Health, said there was no doubt the woman belonged in Acropolis Manor. Despite having her assessed three times in the last four years, she said the health authority would not recognize the critical need.

“Even as Verna lay in palliative care before she passed away, I met up with the home assessment guy and he says to me ‘if we just get her past this pneumonia, I’m sure she’ll be well enough to go to assisted living,” she said. “This lady wanted to be looked after for her remaining days, but they’ve changed their attitude about so many things I just don’t know where to go any more.”

Weir explained that Sevigny was assessed four years ago and identified as being a candidate for the long-term care facility as soon as a bed opened up. However, once one did, Sevigny decided she wasn’t ready to give up her home, prompting her to be taken off the list. Once she did feel ready for Acropolis, she was no longer assessed as needing the facility.

“She wasn’t even cooking for herself anymore because she was afraid there might be an electrical fire or she’d forget about something on the stove – she was even boiling her meat because she was afraid to fry it,” said Weir. “The stairs down to her laundry were dangerous, her carpet needed to be stretched out, she was tripping over it and she had lost weight so her shoes didn’t even fit her properly any more.”

“There were all these little things and they just kept saying because her mind was there, she was healthy. The government keeps saying we want people to stay home as long as possible. Doesn’t Northern Health see that if they want these people to stay home they need more help?”

The assessment process is a comprehensive one, says Angela Szabo, Northwest Home and Community Care director.

Szabo said the process is used across Canada and looks at needs in their entirety, including functional, psycho-social, spiritual and environmental states as they relate to health.

“What the assessment does is it red flags areas of actual or potential problems,” she said. “It tries to look at the entire individual and the areas that they could experience challenges in their day-to-day life.”

That information – which includes things like recent and past accidents stemming from health issues and how the person’s living space may impact that – is used to develop an individualized health services plan to determine what health care resources they need. It’s only when all those community resources – home support, home care nursing, the adult day program, respite services have been exhausted that patients find themselves in a facility like Acropolis Manor.

“If (an) individual had no family, was receiving 4.5 hours of home support seven days a week, attending the adult day program for bathing twice a week, receiving meals on wheels three times a week, in there 90’s, had arthritis and was blind, yes they’d be eligible and placed as a priority on our wait list for facility based care because their health determinations are considered high, they’re considered to have multiple red flags,” she said. “When someone has maxed out our community resources… and it’s still not enough to sustain them safely from a health and a risk perspective in their home, those are the individuals that our complex care environment is structured for.”

As well, when it comes to helping people with that list of community-based health services, Northern Health stresses that it ultimately has to be a about a person’s health status.

“It is the health needs that are the important things for us to ascertain rather than the age,” said Sue Beckerman, Northwest Health Service Administrator. “I think people can say they were 80, they were 90 this was going to happen some time, but that’s not always the case.

“That’s why we don’t focus on age. We certainly have a number of frail people in the community that are in their 30’s and people in their 50’s and 60’s who area lot thicker than people in their 80’s and 90’s.”

As to Sevigny’s death, Szabo adds everyone is very sorry that she passed away, but NH can’t prevent the terrible health consequences that may result from a senior falling. However, they are working to identify and help those most at risk. The Frail Elderly Collaborative, a pilot project taking place in Prince Rupert and two other Northern Communities, brings together a wide range of participants from doctors to family members to develop a coordinated strategy on falls.

“One in three seniors at any given point in time will have a fall and I think that we have to recognize that no matter where our seniors are, whether they’re in facilities or the hospital or the community they’re at risk due to the aging process,” she said. “(But for) individuals that are at a high or more risk than others (we’re working on) a coordinated plan of care and support services for them that is basically to a deeper level in the community providing more services, more supports instead of just closing down the office at five o’clock.”