Friday, August 11, 2006

Choosing LTC facility

It is now time for Dad to be placed into another care center. I spoke to Gay and I spoke to case Community Care Access Centre (CCAC) case manager, Kathleen, who said that we have to put him on a waiting list. She says it is best to get him on a list soon, before it becomes an emergency to get him from a hospital into a nursing home, as he can be placed anywhere up to 150 km away. I do some research.

We look around and have a tour through Leisureworld in Gravenhurst. I do not think that there would be much difference in these government-subsidized institutions and we are pleased with the Gravenhurst location. We have to find a location that suits us, since we know we’d be visiting a lot. I filled in the forms and take power of attorney for him. Dad is no longer able to make decisions. His cognitive functions are quite limited. He cannot even keep track of his pills anymore and telling time is now beyond him. There are a number of forms. His attention and memory are gone, but he isn’t a risk for running away; he simply needs 24 hour nursing care.

There are many booklets explaining what kind of facility this is. I duly read all the information. Brian is incredibly helpful in sorting through it with me. He had place his mother into such care several years ago. I am numb when we visited – seeing all the seriously ill patients. The Alzheimer’s floor was the most difficult. Brian’s stepfather had had this condition and he knows what to expect. Brian asked all the right questions for me. He knows the questions to ask having done this for his mother and stepfather.

When a person’s needs become more severe, or they do not want to remain at home a placement coordinator will help and be actively involved in admitting a client into a Long Term Care Home LTC. There are rules and regulations regarding access to LTC. The process begins with a home visit, if one has not yet occurred through previous access to services, an assessment of the client’s capacity. When a client can no longer secure adequate care at home, there is a decision to place the client and navigate them through the process of finding a Long Term Home Care placement. If they choose to stay at home, often-family members have no recourse, unless they are deemed incapable of making this decision. The case manger is in charge of this protocol.

The client, or designated advocate should the client be deemed unable to make this decision, can take advantage of a Long Term Home Care placement and begins to sign a series of papers, The case manager has permission forms such as permission for CCAC to gain access to information from the doctor, and a facility choice list, which is reviewed by the case manager. Sometimes, if client has dementia issues and behaviours that are beyond the ability of a Nursing Home, or extra nursing care, then they must move to a chronic care hospital. They are deemed ineligible for this more intense care if they can drive, or manage their own needs. Then they are advised to go to a Retirement Home. Files are shared with the Long Term Care Homes on their facility choice list, names will go on waiting list until bed is available: whether it be a private room, or not, or the type of accommodations they have requested on their facility choice list. The client must choose no more than three homes, based on location and physical requirements. We made this choice for my father based on proximity to our home.
As spaces become available that facility will contact the case manager, or the client. When bed offer comes you have a few days to accept the bed offer. It is pointed out that should a resident be admitted to the hospital the bed could be kept reserved for medical leave for 21 days. Otherwise they lose their bed placement and are discharged from the Long Term Care Home. If a resident requires a psychiatric assessment they may stay away for as long as 45 days, this is the only exception to the rule.

We traveled an hour to Orillia to rent a walker. Dad had been borrowing one. The government subsidizes it up to 85% - providing the patient is not in palliative care. What difference this makes I do not know. But the funding isn’t there if the patient isn’t going to last long enough to make the paperwork worthwhile, methinks. We do not care. We need to keep him safe and to allow him to move around. He is not happy with this, but we have rented it. We have to pay one month in advance. Now the trick is to get him to use it. He likes to put his shoes, newspaper and other things in the basket. It is a great item to have – I wished he’d been using one before but only “sick, old people” use them he tells me.

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