Healthcare, News, Social Work/Helping Profession/Mental Health

Seeking Action for Safety in Long Term Care Facilities

Advocacy, one of the core competencies in the profession of social work. It is one skill that I was taught both in graduate school and as a professional over the past 15 years, it is a skill I take to heart.

On February 9, 2013 a documentary W5, Crisis in Care, reported by Sandi Rinaldo and the CTV team of investigators, was released. This investigation uncovered horrific statistics and stories of abuse taking place in Long Term Care facilities in Canada. The focus was on residents with dementia assaulting and killing other residents.

http://watch.ctv.ca/w5/latest-episodes/w5—crisis-in-care—february-9-2013/#clip862011

After viewing it, the natural human response is to wonder how something this horrendous could happen. Further questions of who is at fault and what solutions will facilitate the needed changes, come to mind as well. Finger pointing and blaming will not provide solutions or changes. Staff that work in residences and Long Term Care (LTC) facilities, for the most part, are very good at their job and demonstrate the skills of empathy, compassion, and hard work.

A team of three dedicated professionals who all belong to the professional LinkedIn group, Gerontology Professionals of Canada, decided to team up to formulate a response to the W5 documentary, Crisis in Care. Eleanor Silverberg, BA, Psych, MSW, RSW drew up the initial draft and is the main author, asked Angela Gentile, BSW, RSW and  Victoria Brewster, MSW for their contributions. Seeking Action for Safety in Long Term Care Facilities was completed on February 20, 2013, and was forwarded to the following individuals/organizations as of February 23, 2013:

•W5, Sandi Rinaldo, the investigative team and the producers
•Federal Health Minister, the Honourable Leona Aglukkaq
•Alzheimer Society of Canada, CEO, Mimi Lowi-Young
•Alzheimer Society of Ontario, CEO, Gale Carey
•Alzheimer Society of Manitoba, CEO, Sylvia Rothney
•Federation of Quebec’s Alzheimer Society, CEO, Sandro di Cori
•Ontario Minister of Health and Long Term Care, Deb Matthews
•Quebec Minister of Health and Social Services, Dr. Réjean Hébert
•Manitoba Minister of Health, Hon. Theresa Oswald
•Canadian Alliance for Long Term Care
•Healthy Living, Seniors and Consumer Affairs Minister of Manitoba, Hon. Jim Rondeau
•Misitere de la santé des Services sociaux- Services Quebec

The site, Action for Safety, created by social worker, Angela Gentile will continue to be a place where updates will be provided, as well as a place where other professionals, families and concerned individuals can express their views, working together on behalf of the vulnerable residents in Long Term Care facilities.

It is worthwhile to read the full response which describes the issues, provides some examples of assaults and deaths that have occurred in Canada while making suggestions for solutions. It is not possible that these horrible tragedies have only occurred here in Canada. It is not possible that budget cuts, reduced staff, lack of education, and a lack of awareness only effect Canada when it comes to LTC facilities and the disease of Dementia.

The link to Action for Safety has been shared with friends, family, colleagues, on social media through LinkedIn, Twitter, and Facebook with an end goal of obtaining solutions to a very serious issue. This will continue along with contacting media to further bring the issue to light and raise awareness.

It is necessary for professionals to unite over a cause while advocating for needed change and I consider myself fortunate to have been a part of this project. A special thank you to Eleanor Silverberg and Angela Gentile!

Written by Victoria Brewster, MSW

Social Work/Helping Profession/Mental Health

Skills of Helping Professionals

by Victoria Brewster, MSW

How were you educated at school whether undergraduate or graduate? Was it a ‘just the facts’ orientation or an empathic, client-centered model?

Is there room for both? Sometimes we have to be stoic, impassive helping professionals, but I would like to think most of the time we are empathic, compassionate and ‘in the moment’ with our clients.

We must adapt to the situation, to the client and be ‘in the moment’ for a particular situation. If we are not adaptive, what kind of helping professional are we? Adaption, attention, being attuned to both the client and ourselves is so important.

Even more important is being tuned into ourselves, our own internal dialogue, our feelings BEFORE meeting with a client and while meeting with a client. The ability to adapt and change, to make sure our own internal dialogue or feelings are kept in check is important.

There are times when we will have to ‘wear our feelings on our sleeves’ as the expression goes, otherwise we come across as inaccessible, flat, unapproachable and uncaring helping professionals.

It is important to evaluate yourself and improve in areas that are noted as needing improvement. That is what a performance evaluation is for. Also, if one facilitates groups to ask for feedback from the members both on content and your presentation. This is where we realize perhaps we speak to fast, too low, our facial expressions, tone of voice or body language do not match.

Being open to this feedback, a willingness to improve our skills and learn new techniques is so important.

Enjoy the professional journey and while doing so, relax and take a nice vacation to really give your professional journey the thought it deserves!

*First posted at: http://www.socialjusticesolutions.org/2012/11/21/skills-of-helping-professionals/

Neuroscience, Neuroplasticity, Neurolinguistic Programming

Resources on the Topic-Neuroplasticity

by Victoria Brewster, MSW

Some excellent books to read regarding Neuroplasticity:

The Brain that Changes Itself by Norman Doidge, MD- The discovery that our thoughts can change the structure of our brain no matter what age!

Frogs into Princes by Richard Bandler and John Grinder

This book is dated 1979, but is excellent and shares material from a 2 day workshop in January 1978 and focues on Neurolinguistic Programming.

It is not easy to get a copy of this and I have it currently thru inter-library loan at the moment. New, this book is very expensive, but it can be found on ebay and other sites in a used book format.

The Female Brain and The Male Brain by Louann Brizendine, MD, a neuropsychiatrist are also worth reading and describe in detail the female and male brains with neurological explanations as to why we are the way we are.

Neuroscience, Neuroplasticity, Neurolinguistic Programming

Molecular Genetics

by Victoria Brewster, MSW

Imagine my surprise to learn that genetics goes deeper than I originally thought in that the formation of the brain (think newborn brain cells here) cells, the very products of neural stem cells send out connections to expand in the brain which allow us to think, to move, to feel…..if there is a disruption in these connections or signals, disorders like schizophrenia, degenerative brain diseases and developmental disabilites occur. This is one of the areas being studied at the Weizmann Institute. http://www.weizmann.ac.il

*October 31, 2012

Healthcare

Canadian vs. American Healthcare

by Victoria Brewster, MSW

Healthcare for every American and Canadian is very important especially for those that are of lower income. Basics are covered here in Canada, but anything above? Everyone is entitled to a GP, but not everyone has one. Everyone is entitled to be referred to a specialist, but the wait can be a year. We have Medicare here in Canada or Universal Health Coverage, which is great overall and will cover routine GP visits and check-ups, many medications, surgery, tests, etc, but there might be a wait-list for any of the above. Overall, as a dual citizen of the U.S. and Canada and one who has accessed and used both healthcare systems, Canada’s is better.

Where else can a woman get pregnant, be followed by a physician or Ob/Gyn, obtain any needed tests or exams, ultrasounds, give birth to a baby and there are no additional fees attached? Yes, if one is working is is required that we obtain additional or supplemental health insurance, through our employer, but it is for things not covered by Medicare like, Dental, private Physical Therapy, private Occupational Therapy, Osteopath, Therapeutic Massage, Acupuncture, tests not covered by Medicare, glasses, or expensive hearing aids that are above what Medicare deems as necessary. Plus some of us have access to a Health Spending Account through our supplemental health insurance to cover orthodontics and the like. We also pay close to 15% tax on everything to help pay for all this.

I used HMO style health insurance in the states and because I was young and healthy I did not use it much so the few times I did, it was great. I do not think that is the case today after reading the various material that is available on the web, LinkedIn and other social media sites, blogs and such.

*Initially posted on http://www.socialjusticesolutions.org/

http://www.who.int/health_financing/universal_coverage_definition/en/index.html – Universal Coverage-a definition

*October 20, 2012

Healthcare

Healthcare and Drug Clinical Trials

by Victoria Brewster, MSW

Healthcare is a huge issue facing many individuals in the world and in reality those of us in the Westernized world should not be compaining even though there are many issues and problems with healthcare in the U.S. and Canada. I tell my kids regularly, ‘count your blessings that you were born and live in Canada.’

Other countries are not so fortunate nor do they have the financial means to even offer basics in healthcare to its citizens and here we are up in the North complaining about wait-lists, not enough General Practitioners, shortages with medications and such.

Speaking about medications: read this article re: clinical medication trials. From the article:

“You’ve said, “This project will make information about drug clinical trials easier for Canadians to find and use so that they can make informed decisions about their health.” But such a list, as we have learned in other countries, probably won’t empower patients. And it wouldn’t have saved the lives that have been lost because of a lack of transparency around clinical trials. Share your thoughts with me please.”

As social workers what do we do, or, say to a client re: medication shortages? How do we answer questions related to whether or not they should participate in drug trials? Many will want to ask us because we are much more approachable than the doctor and often we have a bit more time to spend with them. Again, our role is to assist with problem solving or help to answer their own questions. We cannot supply the answer. We can ask our clients the questions, “So, what do you think?” or “So, what do you want?”

*Initially posted on http://www.socialjusticesolutions.org/

*October 25, 2012

Healthcare

Recap on Personalized Medicine

by Victoria Brewster, MSW

The presentation was well worth the donation of $18 or chai. Dr. Ido Amit, Department of Immunology, Weizmann Institute of Science in Israel and Dr. Sarit Assouline, Department of Oncology and Hematology, Jewish General Hospital (JGH) discussed Personalized Medicine. Dr. Amit stated that within 5-10 years this area will grow and new treatments will focus on care, medications and what to avoid.
The words used were Genomics and Genome which has to do with each persons genetics and genes. “Imagine a book with all the information of who you are” a direct quote from Dr. Ido Amit. He also described the analogy of a radio and taking a hammer to it to describe diseases and chronic illnesses today and current treatments.
It appears that physicians do not always know what will work for a specific patient. Imagine someone with cancer (the radio) and taking a hammer (the treatment) to smash it to pieces hoping that will work for a patient. Now…..imagine a radio where a specific part or piece can be targeted for treatment.
Dr. Sarit Assouline discussed cancer treatment at the JGH where she is employed. Personalized Medicine is used for a group of individuals who have been tested and samples taken to define their gene mutation. She used the example of one with Leukemia. A Bio-marker is identified, (the mutated gene) and a specific treatment (medication) is given to these individuals.
Gleevec is an example of a medication prescribed for life for newly diagnosed adult and/or pediatric patient with Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML) in the chronic phase. Currently, this drug costs $3500 a month. Imagine spending that amount of money for the rest of your life and your insurance does not cover the whole cost of the medication……..
Other issues raised were ethics and regulatory bodies in government or insurance. Who decides who pays and who approves a treatment? Like neuroplasticity which was not accepted by the medical field for many years, the feeling was Personalized Medicine will also meet resistance.
*October 29, 2012