Monday, October 22, 2012

The Nightmare

This is an article that I wrote a few weeks ago and pitched to a couple of Canadian newspapers.

Two major newspapers passed on it, but the beauty of having my own blog is that I can publish it anyway. In the future, I'll publish essays such as this on my blog first and then pitch elsewhere. Blogs are always being mined for ideas, mostly without credit.

It can sometimes be a very short drive from "inspiration" to "plagiarism"-but that's life in the electronic age.

So, here is an essay I wrote about The Nightmare of caring for a disabled or infirm relative in Ontario, with the dates updated to reflect the couple of weeks that have passed since I put it together.
In August this year Sarnia, Ontario mother Colleen Cunningham made a threat that she probably never thought she would ever utter. The double-lung transplant recipient, who suffers from arthritis threatened not to pick up her severely disabled 21-year old son Nathan from respite care on August 28, 2012.

Also in late September, 84 year old Doris Landry had the fortune, orperhaps gross misfortune to live past the 90 day grace period forgovernment-funded “Home First” palliative care in her home-she just didn’t die within the allocated time. So Landry is now allowed to keep her medical equipment, but has outlived her allocation of 8 hours of care from a personal support worker per day.

These are the choiceless choices that families in Ontario are forced to make as a direct result of gross inefficiencies and waste within the public health system. It is now time for citizens to demand greater accountability and more innovative solutions for long-term and palliative care for able bodied and disabled citizens. 

Unless they can privately fund their relative’s care (on top of paying into the public system), families are forced to use monopolistic government “solutions”. At the very least, the government might deign to consider alternative suggestions made by humble citizens who live the daily, recurrent nightmare of not being physically able to care for their ailing, dying or disabled relatives.

We are constantly being told that there is not enough money in the system for long-term care placements in the province of Ontario.

Becky Boersma, a senior director with Community Living, was quoted recently saying that one-to-one care for someone like Nathan Cunningham would cost upwards of $250,000. That figure is astonishing. How much of that money goes to overhead? How much of that money goes to the actual for the direct, personal care of the disabled?

Figures from the Ontario Ministry of Health indicate that home care costs $31.87 per hour, that long-term care costs $52,841 per year and that acute inpatient and newborn care costs an astronomical $363,555 per year. A chronic inpatient costs $224, 142 per year.

These figures are not fiscally responsible or sustainable. And it almost goes without saying that institutional care is not always the best “solution”. 

For less than the $250,000 that it allegedly costs to take care of someone like Nathan Cunningham 24 hours a day, three (or more) teams of caregivers could be employed in the home. Canada offers a very generous and attractive live-in caregiver program.

Could the live-in caregiver program not be incentivized, and perhaps include basic first aid training? Could such a program not be implemented in homes for average Canadians who would actually prefer to keep their loved ones at home?

There are large numbers of trained medical and para-medical professionals around the world who desire to come to Canada. Even those with strong caregiving skills and no official credentials can be trained to care for a disabled or terminally ill individual in the home.

A live-in caregiver program designed specifically for home care could not possibly cost our public system more than the current behemoth-like structure we have today. The overhead could not possibly exceed the status quo.

It’s hard to think of anything more painful than parents wanting their disabled children, but not being able to physically care for them. It’s hard to imagine how in a country as great and prosperous as Canada, we tell 84 year old citizens with cancer that that they have lived passed their 90 grace period and are therefore not “entitled” to any more of our help. 

It’s an untenable and un-Canadian.

The money is in the system, but wasted in layer upon layer of inefficient and indifferent bureaucracy. 

If there is political will, there can be a political solution.

Canadians deserve better value and more humanity from the system that we are required to use.