Opinion

A tale not of world class health care

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The most dysfunctional branches of the provincial government must surely be the regional health boards, which are touted to deliver world class health care but fail miserably to live up to that lofty goal.

For instance, the qualifications for assisted living sound reasonable, until that accommodation is actually required, then everything gets complicated and unreasonable.

An elderly diabetic woman recently arrived via ambulance at Ridge Meadows Hospital suffering from pneumonia, life-threateningly high blood sugar readings and high cholesterol levels. She was admitted to the emergency ward, where she was seen by a hospital resident, who orders the woman to remain in the emergency ward while attempts are made to reduce her blood sugar levels and to treat the pneumonia.

So far everything is fine, but two days pass and her blood sugar levels stubbornly remain too high and the pneumonia also seems resistant to early treatment. So the woman was transferred from emergency to another ward in the hospital and this is where the situation turned almost completely stupid.

The woman was switched from oral medication to insulin injections for her diabetes and the blood sugar readings  began to slowly recede to safer levels. The pneumonia symptoms also improved.

Based on a report from the hospital’s physiotherapists and, seemingly convinced that she could look after herself at home, the hospital resident was prepared to discharge the woman,

A family member interjected and informed the doctor of the woman’s long-term history of exceedingly poor memory, which could potentially threaten the efficacy of the insulin injections if not taken in accordance with a strict timetable.

This was coupled with her physical instability, which had resulted in serious falls and the woman’s total inability to adhere to a diabetic diet.

Upon being apprised of these issues, the hospital resident transferred the woman  for further assessment and discharge planning.

So far, so good. But this is the point where Fraser Health Authority’s confusing guidelines begin to frustrate any reasonable attempts to provide decent health care and safety for the woman.

The excellent first-class attitude, treatment and counseling provided by Gardenview Pavilion staff had resulted in further lowering the woman’s blood sugar levels and marked improvement of the other medical issues.

The remaining concern was the importance of the timing of the insulin injections and the woman’s dietary intake, none of which could be taken for granted because of her poor memory. Otherwise, the woman could be discharged and returned to her own home.

There are private programs that attend to patients in their own homes as often as required, but there is a fee of between $35 and $40 for each visit. With two visits per day, that would amount to in excess of $2,000 per month. But the cost is not covered and the woman would have to pay from her own meager pension.

Notwithstanding the silliness of having to pay for her own at home nursing, the woman does qualify for subsidized assisted living, in which her medication and diet would be strictly monitored.

The waiting list for this type of accommodation can be as long as four years.

In the meantime, she would be left to her own devices and would likely end up back in the hospital or possibly even the morgue.

Apparently the woman can remain at Gardenview until such time as staff are convinced that she can look after herself. That might be a few days or a few months.

At an estimated cost of up to $1,000 per patient day at Gardenview, it will cost $30,000 per month to house the woman in the hospital, at no cost to her.

But the estimated $2,400 per month to provide home nursing is not covered.

If the woman can’t be placed in an assisted living facility immediately, the least Fraser Health should do is pay for the cost of home nursing until such time as assisted living accommodation is available.

Anything less is not world class health care, just lunacy.

Sandy Macdougall is a retired journalist and former district councillor.

 

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