Violations spark demand for Seniors Village takeover

Violations spark demand for Seniors Village takeover

George Le Masurier photo

Violations spark demand for Seniors Village takeover

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After three residents died as an indirect result of a norovirus outbreak at Comox Valley Seniors Village earlier this year, a group of family members of the facility’s residents demanded an investigation and better oversight of the facility by Island Health.

Now, two months later, and with no evidence of corrective action by the Chinese corporation that owns the facility, the same Comox Valley family members have asked Island Health to assume its full operational responsibility.

“It is our strong belief that the prolonged, ongoing challenges to bring this facility within compliance are indicative of a larger endemic problem … regarding this facility,” the family members said in a May 20 letter to Tim Orr, the director of residential services for Island Health.

The family members say there have been seven new contraventions of compliance to Residential Care Regulations between March 7 and May 3, all of which occurred since an investigation by Island Health licensing agents in March that resulted in a ‘high risk’ rating for the facility.

That review was triggered by a March 13 letter to Orr from the family members alleging that Seniors Village mishandled containment of the virus and that it may have been caused by food handling and a failure to ensure staff had required immunizations.

And there are currently 12 current contraventions, according to the Island Health Licensing Officer’s May 3 report. And there have been 22 incidents of regulatory non-compliance recorded since 2018.

The family members believe the most serious regulatory non-compliance occurred during the norovirus outbreak, while the top senior management positions remained vacant. A failure to clean the facility violated health and safety regulations, which was compounded by allegedly falsifying records to show the cleaning had been done.

The Comox Valley Seniors Village opened in 2009 by the Canadian company Retirement Concepts, but the problems began to surface in 2017 after it was sold to Anbang, a Chinese insurance company. Anbang purchased 31 Canadian long-term care facilities through its Canadian holding company, Cedar Tree, including seven on Vancouver Island and 24 others in BC, AB and QC.

Cedar Tree, in turn, contracts out management of Comox Valley Seniors Village, and other Anbang holdings, to a management company called Pacific Reach, owned by the former owner of Retirement Concepts.

What’s gone wrong

Problems identified or alleged by family members include unauthorized restraint, falsified records, building filth left uncleaned, incorrect feeding and failing to meet the contracted number of hours of care per resident among their complaints.

The family members believe that Seniors Village receives full payment from Island Health based on 3.11 hours of care per resident, but actually provides only 2.63 hours.

Island Health told Decafnation that “licensees are held accountable to meet all contractual obligations, including resident care hours.” And that Seniors Village has developed a corrective action plan, which Island Health “is monitoring weekly, including the licensee’s compliance to the Act and the Residential Care Regulations.”

Adequate staffing has been an consistent problem at the Seniors Village. The facility operated for six months without any senior management, neither a general manager or a director of care.

The facility has a difficult time keeping staff partly because it pays about $2 to $4 per hour less than other Valley facilities, such as Glacier View Lodge and The Views at St. Joseph. Seniors Village staff went on strike last fall for better working conditions and compensations.

But there are other problems that have caused many workers to quit.

Recently, the facility introduced unpopular shift changes. It essentially fired all its employees and made them reapply for their shifts, although workers were allowed to keep their seniority.

One concept in the shift reorganization, which the company has since reconsidered, would have required workers to rotate among the various wards every five weeks. But that was unacceptable to family members of residents in the dementia ward, where consistency and specialized training is necessary.

Deadly norovirus outbreak

Between Jan. 28 and Feb. 25, the norovirus spread rampantly throughout the facility. The family members believe the outbreak lasted longer than necessary because Seniors Village personnel — without a manager, dietician or care director — did not follow Island Health’s rigorous cleaning procedure.

“Past contraventions show the facility has a history of not having policies and procedures in place and the properly trained staff to executive them,” the family members wrote to Orr on March 13.

Two residents of the dementia wing died from pneumonia after noro infection and another died after refusing food after contracting the virus. Residents with “mobile dementia” often touch floors because they see things there.

According to the Public Health Agency of Canada, people become infected with norovirus through direct contact with infected people, touching surfaces contaminated with norovirus or by drinking water or eating food that has been contaminated, usually by food handlers who have the virus and don’t wash their hands properly.

“Further evidence supporting our concerns that the facility did not follow the required cleaning procedure is that we have determined that the only carpet cleaning during the 29-day outbreak was not steam cleaning as required, but vacuuming, which is specifically contraindicated in Island Health’s procedure,” the family members wrote to Orr on March 13.

The family of one dementia resident who died during the outbreak was permitted access to collect his personal belongings unaware that the required cleaning protocol had not been followed.

“It is unconscionable to us that Island Health would not have immediately stepped into direct this facility’s handling of the outbreak and provide additional resources given the known issues with this facility,” the family members wrote on March 13.

The family members believe that an Island Health run facility would have done a post-incident investigation to identify the root causes of the norovirus outbreak and recommendations to prevent another occurence.

“Why would it not be a requirement for this facility, given its serious breach of a critical public health protocol?” the family members asked Orr in their most recent May 20 letter.

Can Island Health take over?

Island Health has the authority to take operational control of a facility through the Community Care and Assisted Living Act if they believe has endangered public health.

Island Health says they have appointed an administrator at facilities in the past. They have done so twice in the past 15 years at two separate facilities.

“We take the concerns and complaints from residents and families seriously,” an Island Health spokesperson told Decafnation. “There are a number of regulatory mechanisms to direct corrective action on the part of the operators to ensure the safety of residents.”

The family members think the situation at Seniors Village qualifies.

“Severe and irrevocable consequences are both appropriate and needed given this service provider’s continued critical failures to meet the terms of its contract and the regulatory standards,” they wrote on May 20.

The family members told Orr they have supported Island Health’s need to follow a remedial process, and think it’s now “time to take decisive action.”

“If Island Health is of the view that Comox Valley Seniors Village has not yet reached this point, it begs one of two questions: How much longer? Or How much worse does it need to be?”

Family members of Comox Valley Seniors Village residents or former residents who signed both letters referred to in this article are Delores Broten, Bev Foster, Greta Judd, Sharon Jackson and Doug Malcolm.

This article has been updated to remove a sentence saying Island Health had not responded. Island Health’s responses were included in the original article.

 

 

 

 

 

 

WHAT IS THE NOROVIRUS AND HOW DO YOU GET IT?

Norovirus is a very contagious virus that causes vomiting and diarrhea. People of all ages can get infected and sick with norovirus.

Norovirus is sometimes called the stomach flu or stomach bug. However, norovirus illness is not related to the flu which is caused by influenza virus.

People with norovirus illness can shed billions of norovirus particles. And only a few virus particles can make other people sick.

You can get norovirus from:

–Having direct contact with an infected person
–Consuming contaminated food or water
–Touching contaminated surfaces and then putting your unwashed hands in your mouth

The most commonly reported setting for norovirus outbreaks … is healthcare facilities, including long-term care facilities and hospitals. Over half of all norovirus outbreaks reported … occur in long-term care facilities.

The virus can be introduced into healthcare facilities by infected patients, staff, visitors, or contaminated foods. Outbreaks in these settings can sometimes last months. Norovirus illnesses can be more severe, occasionally even deadly, in patients in hospitals or long-term care facilities compared with healthy people.

— Centers for Disease Control and Prevention

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The buck (doesn’t) stop here

The key to maintaining the public’s confidence in its government departments and agencies, is the concept of public accountability. The gap between the serious nature of the issues presented by community representatives and the response provided by Island Health is staggering. Island Health acknowledges its accountability but does it, in fact, hold itself accountable?

Seniors groups criticize VIHA RFP as too little, too late

In presentations to the Island Health board of directors, three Comox Valley seniors advocacy groups criticized the recent residential care bed RFP, said Island Health doesn’t provide us with an equitable share of resources and exposed mistreatment of seniors and a new hospital that isn’t clean

The Island Health board meeting that wasn’t a board meeting

Without public notice, Island Health holds its March board meeting a day early in Victoria, doesn’t address Comox Valley Hospital issues at “public forum” in Courtenay. But seniors health care advocates make passionate pleas for more resources

Record 178 patients at CVH, VIHA board in Courtenay

The Island Health board will hear presentations from individuals and community groups tomorrow in Courtenay about health care issues in the Comox Valley and wider region. But little has been done so far to address concerns at the Comox Valley Hospital where a record high 178 admitted patients was recorded Friday.

120 complex care beds proposed for Comox Valley

The Vancouver Island Health Authority (Island Health) has reissued a Request for Proposals to add 120 new beds for patients requiring a complex level of care in the Comox Valley. Island Health says it hopes to award contracts for the new beds in early May and expects they will open for patients sometime in 2020.

Island Health board to meet in Courtenay on March 29

The Vancouver Island Health Authority (VIHA, or Island Health) board of directors will hold their March meeting in the Comox Valley. It’s an opportunity for Comox Valley and Campbell River residents flummoxed by the myriad errors in planning the new hospitals to ask questions or even make presentations to the directors and Island Health executives.

Fully fund N.I. health care, hold VIHA accountable

The independent analysis of the Vancouver Island Health Authority (VIHA, or Island Health) delivered by external consultants Ernst & Young two weeks ago concluded that an electronic health records system implemented at Nanaimo Regional General Hospital (NRGH) was “not properly planned or implemented.”

Lagging seniors health care affects CVH, distressed caregivers

With the Island's largest over-65 population percentage and one of the lowest number of residential care beds per capita, Comox Valley caregivers are in distress and hospital workers feel the brunt of overcapacity and understaffing. VIHA says more beds and support...

VIHA brought changes, not always an improvement

For long-time employees of St. Joseph’s General Hospital, the transition to the new Comox Valley Hospital has presented a triad of difficult changes, including a less flexible management style and some systems that are less efficient and effective.

Ministry continues Liberals’ privatization of health care

Ministry continues Liberals’ privatization of health care

George Le Masurier photo

Ministry continues Liberals’ privatization of health care

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I work for Island Health as a medical transcriptionist at the Comox Valley Hospital.
On Jan. 30, all the VIHA medical transcriptionists, in Victoria, Nanaimo, Courtenay and Campbell River were notified that all the transcription for Island Health would be done by NUANCE, a multinational based in Burlington, Massachusetts.

VIHA has a contract with NUANCE to provide transcription software and for the last several years NUANCE employees, who work from home, have been doing VIHA’s “extra work”. This “extra work” currently amounts to over 80 percent of all VIHA transcription.

What does a medical transcriptionist do?

When a patient is admitted to hospital, discharged, seen by a specialist, in an outpatient clinic, etc. the treating doctor, midwife or nurse practitioner must dictate a report. That report goes to the patient’s medical record and is a medical/legal document signed by the dictating doctor and the transcriptionist.

The medical transcriptionist receives a typed draft report on their computer screen, along with the recording of the doctor’s dictation. The transcriptionist listens to the dictation, verifies the information about the patient, the doctor, the date and time that the patient was seen, and edits the dictation to ensure that when the report is entered electronically onto the patient’s chart it is an accurate record.

The report is, obviously, highly confidential and critical to patient care, includes patient’s medical history, diagnoses, current medications and treatment, family history, etc.

The transcriptionists who work for VIHA are required to have “graduated from an approved program in medical transcription” and are paid an hourly wage. If we have questions about something that is difficult to hear, the dosage or name of a medication, the name of a doctor, etc. we have access to the patient’s electronic chart and other sources for verification.

Usually there is a co-worker nearby who can be a second set of ears to listen to something that is unclear. People working for NUANCE have no access to the patient’s chart and no access to a peer to consult. The NUANCE transcriptionist who is doing piece work, not paid an hourly wage, and required to “produce, produce, produce” is under pressure to produce as quickly as possible.

If it takes five minutes of research to ensure that the record is accurate the VIHA transcriptionist can take five minutes. Five minutes may be a luxury a NUANCE employee cannot afford. If there is a “blank” (something that cannot be heard), the report is “pended” for review and completion by a supervisor.

If there is more than one blank in a report, regardless of whether it is done by a VIHA or NUANCE employee, instead of the report being uploaded to the patient’s chart it is automatically “pended”. The vast majority of “pended” reports, not surprisingly, are those transcribed by NUANCE employees, thus increasing the work that has to be done by VIHA supervisors.

My objection to privatization of any aspect of health care is that profit and highest quality of care cannot coexist and the motivation of a private “service provider” is profit. Since the 1980’s has there been a steady increase in the privatization of services directly related to patient care (as opposed to construction, paper supplies and other products and services that must be contracted from the private sector).

The consequence of this privatization is that the public authority that is responsible for ensuring the quality of care and the protection of patients, including confidential patient records which are essential to care, no longer has control of this work.

We were told that the decision to contract out all transcription on Vancouver Island was made following “lots of discussion at the Ministry of Health level.”

The timing of this announcement is interesting. A new collective agreement, if approved by the union membership, will take effect April 1, 2019. In that new agreement there is a memorandum of agreement entitled “Contract Retendering and Repatriation (Bill 47 Working Group).”

Bill 47 was passed unanimously in December last year. It repeals Bills 29 and 94, the legislation that opened the door to wide-scale privatization. The memorandum states “The parties agree that Bill 47 demonstrates Government’s commitment to a better path forward, one that provides stability and equal respect for all health care workers, and continuity of care for patients” and establishes a process for the Ministry of Health, the Health Employers’ Association of British Columbia, Health Authorities and the Union to discuss contracted out services and to “develop guidelines and processes that will be used to identify the opportunities, assess the practicability, and support the orderly return of these services to the direct control of the Employer where Government and/or the Employer make the decision to return of contracted services to the bargaining unit.”

Why would a government and employer with this intent move with such haste to complete the privatization of a service that is not yet completely privatized? In order to beat the April 1 date and present the union with a fait accompli and then say, sorry, not interested in repatriation?

What effort has VIHA made to hire more transcriptionists? There are jobs that have not been posted. Work that could be done by casuals is not offered to them. Several years ago the Health Authority claimed that it could not fill evening and night shifts that had been posted but most of the work done by NUANCE employees is done in the daytime so those jobs could have been re-posted as dayshifts.

The medical transcription certificate program is offered by BC colleges. An employer concerned about recruitment could actually partner with a college to encourage employees to take the training (which can be done on-line without time off work). An employer interested in solving the recruitment problem, if there is one, would work with the union to do so.

If there was a genuine commitment to highest quality care the decision would have been to find ways to repatriate all of medical transcription, not privatize all of it.

Barbara Biley lives in Courtenay

 

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Comox Valley seniors group says new beds fall short

Comox Valley seniors group says new beds fall short

George Le Masurier photo

Comox Valley seniors group says new beds fall short

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Decafnation reported last week that the announcement of new long-term care beds did not please everyone in the Comox Valley. We quoted health care workers still employed by Island Health and Seniors Voices advocated Delores Broten.

This week, Seniors Voices Comox Valley has issued an advisory for caregivers in response to the announcement by Health Minister Adrian Dix.

Dix announced the province awarded Golden Life Management Corporation a contract for 120 new residential care beds and two new hospice beds (for a total of six with the four existing beds). He also gave Providence Residential Care Community Society permanent funding for the 21 temporary beds it currently operates at the former St. Joe’s General Hospital under the name Mountain Views, and 10 new beds, currently funded at another facility, and four respite beds.

Here is Seniors Voices Comox Valley analysis of the announcement.

“Our data (and personal experience) indicates that the Comox Valley needed about 150 beds in 2017 to meet the need at that time. We estimate that about 25 to 30 new beds are needed every year. This means that by the time the “120 new beds”, the Golden Life beds, come on line at the end of 2020, the Valley will require at a minimum another 100 beds. The beds awarded to Providence already exist and are already full.

“The new Comox Valley hospital is bursting at the seams, constantly at over 100 percent capacity, a situation leading to stress and problems for staff and patients. On any given day over one third of the admitted patients in the hospital are deemed to require “Alternative Level of Care,” not an expensive hospital bed. This is not new but has worsened this winter. Many of these people are waiting for residential care. The new beds will not help the hospital over-crowding due to the ever-increasing need.

“The decision to award this contract to a private company is inexplicable to us. The contract could easily have been awarded to Glacierview Lodge, the experienced, qualified and community-supported not-for-profit already operating in the Valley. Minister Dix appeared to be unaware of the raison d’etre of private enterprise, which is to generate a profit to satisfy the interests of shareholders/investors, saying that Golden Life is a “good company.”

“Good company or not, private corporate interests could result in the sale to a “maybe not so good company” (as in the sale of Retirement Concepts to Anbang). As well, wages are lower than in nonprofit facilities, which will lead to on-going staffing issues. We do not agree that private profit should be realized from the public funds the government will provide Golden Life for the care of our seniors.

“For caregivers, the greatest relief in this announcement will come from the addition of four more respite beds at Mountain View (Providence). Too many caregivers lose control of their lives to look after their loved ones. These respite beds will provide caregivers with a week or two of welcome and needed time to look after themselves.

“If you share our concern about the seniors’ care crisis in the Comox Valley, please contact your MLA to request work begin immediately on developing an expanded care plan. After all, based on history, it will take years.”

You can get more information about Senior Voices by contacting Delores Broten at delores@watershedsentinel.ca

 

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Providence, Golden Life get new Comox Valley long-term beds

Providence, Golden Life get new Comox Valley long-term beds

Golden Life’s Garden View Village in Kimberley  / Photo by the Kimberley Bulletin

Providence, Golden Life get new Comox Valley long-term beds

By

This article will be updated with additional location reactions to the news as it comes in

Golden Life Management Corporation and Providence Residential Care Community society will share the Comox Valley’s 151 long-awaited additional residential care beds.

Minister of Health Adrian Dix made the announcement at the Florence Filberg Centre in Courtenay this morning. Local MLA Ronna-Rae Leonard also attended.

Golden Life, a Cranbrook-based company, will build 120 residential care beds and six hospice beds on property in Courtenay. The hospice beds include two new beds and the four existing beds that will move from The Views at St. Joseph.

Golden Life currently operates 13 seniors facilities; 10 in the British Columbia Kootenay region and three in Alberta. A fourth Alberta location will open soon.

Construction of the new Comox Valley facility will begin this summer and is expected to complete before the end of 2020.

The newly-created Providence Residential Care Community Society, which assumes ownership April 1 of The Views and the 17-acre St. Joseph’s property at the top of Comox Hill, will receive 31 beds, plus four respite beds.

They consist of the 21 temporary beds that Island Health opened at the former acute care hospital, which now become permanent, and an additional 10 new beds. The Views will convert the existing four hospice beds to respite beds.

“In addition to the RFP process, Providence Residential and Community Care Society … has an agreement to work with Island Health on a potential campus of care redevelopment plan,” according a Ministry of Health news release this morning.

The Views currently operates 116 residential care beds, which will be redeveloped to current standards as part of the agreement.

PRCC Vice-Chair Chris Kelsey, of Comox, could not say when redevelopment of the St. Joe’s property will begin.

Celeste Mullin, vice-president, Golden Life Management Corp. said, “We are grateful for the opportunity to work with the Minister of Health, Island Health and Comox Valley Hospice Society to bring exemplary housing, care and services to the Comox Valley. Our villages are more than bricks and mortar. They are vibrant and dynamic communities that support each person’s unique beliefs, values and wishes affording them the opportunity to direct and live their best quality of life.”

Chris Kelsey, chair of the St. Joseph’s board of directors, gave this statement to Decafnation.

“This announcement is a watershed moment for St. Joseph’s and our community. Over the past five or more years, we have been working hard planning a future role for the St. Joseph’s site that best serves the needs of our community. Our Board, management team, and staff are extremely grateful for this opportunity. This announcement allows PRCC and us, in partnership with Island Health, to take very concrete steps to implement our ambitious plans and to revolutionize the care that we provide to our most vulnerable citizens. We have always considered it to be an amazing privilege to serve our community, and we look forward to the hard work ahead and to the continuation of our mission.”

 

Who is Golden Life?

Golden Life’s founding history makes it an interesting choice to build the Comox Valley much-needed and twice-delayed long-term care beds.

In the 1990s, Cranbrook construction company owner, Endre Lillejord, tried to find housing for his mother that “supported independence and dignity,” but such facilities were not common then.

So Lillejord directed his Golden Life Construction company to build the facility he envisioned for his mother. He called it Joseph Creek Village, and his mother moved in with the first wave of residents in 1998.

The Comox Valley announcement is part of the Health Ministry’s $240 million three-year plan “to increase the direct care seniors receive in residential care homes in communities and across the province.”

Dix has set a target of 3.36 care hours per-resident-day, on average across health authorities, by 2021.

 

Good news for caregivers, nurses

Today’s announcement brings some good news for Comox Valley Hospital workers.

Island Health opened the temporary beds at St. Joe’s, called Mountain View, to ease serious overcapacity issues at the Comox Valley Hospital. Recently, there were more than 200 admitted patients in the hospital, which was designed for a maximum of 153 patients. That has stressed hospital staff.

Most of the extra patients no longer need acute care, but due to the current shortage of long-term care beds, they have nowhere to go.

The announcement is also good news for some family caregivers.

The shortage of long-term care and respite beds has caused problems for at-home caregivers, many of whom are exhausted and in crisis. The lack of available, publicly-funded beds has forced many family members to care for their loved ones beyond their capacity to do so.

Island Health issued a Request for Proposal for 70 new long-term care beds three years ago, but cancelled it a year later, and issued a new RFP last year.

 

Not everyone pleased

Today’s announcement hasn’t quelled the concerns of several caregiver groups in the Comox Valley, who fear the new beds won’t be enough.

“Very pleased to see the government finally take action on the crying need of two years ago,” caregiver Delores Broten told Decafnation.”But the need continues to grow and by the time these beds are ready, we will ned as many again.

Caregivers also fear a private operator will run a low-budget operation and eventually sell to an even larger private corporation with negative consequences for patients and their families.

They point to Retirement Concepts, a Canadian-owned company purchased by the Chinese insurance company Anbang in 2017, and later seized by the Chinese government over allegations of fraud.

Retirement Concepts ran 21 facilities from Quebec to BC, including the Comox Valley Seniors Village and Casa Loma, an independent living facility, where workers have been on strike.

Another source told Decafnation this morning that Comox Valley Seniors Village has been running without a Director of Care or a General Manager since September, and that there have been at least five complaints to the provincial licensing officer about the lack of supervision.

The source also said Seniors Village is literally rationing the jam for residents.

Golden Life employees gave the company mixed reviews on the Indeed Canada website. Most unfavorable reviews mentioned understaffing and wage issues. But the company got better reviews from five people who commented on another employee-review site called glassdoor.ca.

 

 

 

QUICK FACTS FROM BC HEALTH MINISTRY

— Residential care homes offer seniors 24-hour professional supervision and care in a safe and secure environment.
— Through the $240-million investment over three years, the average direct care hours in
Contact:B.C. will increase from 3.11 per-resident day in 2016, to 3.24 by 2019, reaching 3.36 by
2021.
— Progress has been made with almost 270,000 more care hours being provided throughout the province by converting part-time and casual staff to full time.
— New funding of $48.4 million in 2018 will add more than one million hours of direct care.

For more information on increasing staffing in residential care homes, visit here

 

GOLDEN LIFE’S
SENIORS FACILITIES

 

Castle Wood Village
Castlegar, BC

Columbia Garden Village
Invermere, BC

Crest View Village
Creston, BC

Garden View Village
Kimberley, BC

Joseph Creek Village
Cranbrook, BC

Lake View Village
Nelson, BC

Mountain Side Village
Fruitvale, BC

Rocky Mountain Village
Fernie, BC

Rose Wood Village
Trail, BC

Whispering Winds Village
Pincher Creek, AB

Silver Kettle Village
Grand Forks, BC

Evanston Grand Village
Calgary, AB

Grande Avenue Village
Cochrane, AB

Coming Soon
Seton, AB

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Bishop gifts St. Joe’s Comox site to Providence Health Care

Bishop gifts St. Joe’s Comox site to Providence Health Care

George Le Masurier photo

Bishop gifts St. Joe’s Comox site to Providence Health Care

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The Views at St. Joe’s has been gifted to a new entity called the Providence Residential & Community Care Services Society (PRCC).

Chair of the St. Joe’s Board of Trustees Chris Kelsey told Decafnation last night the Bishop of Victoria has given St. Joe’s, including its 17 acres of property at the top of Comox Hill to the nonprofit company.

Providence Health Care is a British Columbia Catholic health care organization that operates St. Paul’s Hospital and seven community care facilities in the Lower Mainland. The Bishop of Victoria sits on the board of a society that owns Providence.

The Views at St. Joe’s is Providence’s first acquisition outside the Lower Mainland and is, at the moment, the sole operating facility of the newly-formed PRCC. It’s expected that Providence’s other community care facilities will eventually be moved in the new company.

The acquisition means that, at the closing date of April 1, the current St. Joe’s board will be dissolved. But Kelsey has been appointed Vice Chair of PRCC, and he said there will always be representation on its board.

“What this means is, we’re not going anywhere,” Kelsey said.

Kelsey said the St. Joe’s board starting working on its future role four years ago, when it became clear that Island Health was closing down its acute care hospital. And, he said, Providence shares their vision of a campus of care dedicated for seniors.

“With Providence, we’re building an organization focused solely on seniors care,” he said. “A dementia village concept is part of that plan.”

Running an acute care hospital requires “90 percent of your attention and your budget,” leaving less flexibility to make seniors care better.

“Now we can focus just on that,” he said.

The Views staff will become PRCC employees and medical staff will receive their privileges through the new company.

FURTHER READING: Providence Residential & Community Care

To get out from under the financial restrictions of the Hospital Act, it’s the intent to eventually make PRCC an independent entity, and distance itself from Providence hospitals. That would allow PRCC to borrow funds for capital project, which it cannot do under the Hospital Act.

That’s important for The Views, which needs to be modernized, as do several of Providence’s existing and aging seniors facilities the Lower Mainland.

Providence assisted St. Joe’s in preparing its proposal for the new Comox Valley long-term care beds.

But Kelsey said he does not believe St. Joe’s is the leading proponent for the news beds.

“If that were the case, we would be talking by now. And we’re not,” he said.

But that won’t delay PRCC from moving ahead with a new vision for the St. Joe’s site.

“Whether or not we receive any of the new long-term care beds from Island Health, we will move ahead with a redevelopment of The Views,” Kelsey said. “Either through a competitive process or direct negotiation.”

Kelsey said St. Joe’s and Providence have been working with Island Health and the Ministry of Health through the transfer of ownership process, and both have supported the change.

The Views Administrative Officer Michael Aikins said the change in ownership actually accelerates the redevelopment plans.

“With PPRC as owner, we’re going to build a community with various levels of housing and care options that support seniors, and their spouses and partners, to age in place on a single campus — ranging from independent living, long-term care and specialized dementia care and neighbourhoods,” he said in a news release.

 

 

WHO IS PROVIDENCE
HEALTH CARE?

 

Compassionate care for over a century
Providence Health Care’s commitment to serving those most in need began more than 120 years ago when the Sisters of Providence
came to Vancouver and opened St. Paul’s Hospital, a 25-bed “cottage” on the path to English Bay. Now operating 17 sites, Providence
Health Care is a health and wellness resource for families, patients and residents from all parts of British Columbia.

Providence Health Care was formed in 2000 through the consolidation of CHARA Health Care Society, Holy Family Hospital and St.
Paul’s Hospital, and is now one of the largest Catholic health care organizations in Canada. Providence sites include two acute care
hospitals, five residential care homes, an assisted living residence, a rehabilitation centre, seven community dialysis units, a hospice,
an addictions clinic and a youth health clinic.

Living our values
To this day, Providence continues the mission of the five founding congregations of sisters by meeting the physical, emotional, social
and spiritual needs of patients through compassionate care, teaching and research. Providence welcomes the challenge of caring for
some of society’s most vulnerable populations. 

Global leader in health care excellence and innovation
Providence is home to St. Paul’s Hospital. St. Paul’s serves 174,000 unique patients who account for over 500,000 visits annually.
As one of two adult academic health sciences centres in B.C. (affiliated with the University of British Columbia and other postsecondary institutions), St. Paul’s is a renowned acute care hospital recognized provincially, nationally and internationally for its
work, including its several centres of excellence and affiliated research programs. In coordination with its health partners – including
the Ministry of Health, Vancouver Coastal Health and the Provincial Health Services Authority – the Providence Health Care Research
Institute leads research in more than 30 clinical specialties. This research continues to advance the lives of British Columbians
every day.

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MAiD: A passing … but not gently into that good night

MAiD: A passing … but not gently into that good night

Lorraine “Lani” Hudelson | Born March 13, 1941, Died December 13, 2018 | Arriving Honolulu International Airport June 1961

MAiD: A passing … but not gently into that good night

By

I still don’t know why she wants me present at her passing. I’m not a particular friend nor even a steady acquaintance.

When I asked her, “why me?” Lorraine — Lani to those who know her best — says, “You’ve always been honest with me.”

So, honest at her end, I can say:

She’s angry.
She’s difficult.
She’s needy.
She rages.

She’s insistent.
She’s determined.
She’s intelligent.
She’s driven.

Her life’s been difficult from the beginning and, at her end of days, even more so.

The kindnesses of caregivers can’t help. The absence of close family doesn’t matter to her.

No home care, no hospice care, no drugs, can alleviate it.

Only the pain, the terrible, terrible pain.

Her brain injury affects all the primitive areas of her brain.

She suffers from:

Insistent fatigue.
Unbearable headaches.
Visual challenges.
Personality flux and confusion.
Lack of coordination.

She can’t:

Concentrate.
Remember.
Sleep consistently or well.
Process information.
Control impulsivity.

She has difficulty with:

Loud noises.
Controlling her emotions.

But the worst of the pain comes from her inoperable spinal stenosis that is progressively damaging her nerves.

Affected are her:

Gait.
Balance.
Dexterity.
Grip.
Bladder and bowel functions.

She believes her earliest doctors were not thorough enough with their investigations into her symptoms, but she feels cared for and comforted by her later ones.

***

Today, a rainy, windy, stormy December 13, she is dying with the help of those doctors and with the support of a few witnesses.

One of those witnesses, my partner, Megan, has truly befriended Lani in her darkest hours. She has run errands to the grocery store and the pharmacy and she has sat patiently with Lani and absorbed her angry outbursts for hours at a time.

She and I arrive at Lani’s home at 1 o’clock. We are greeted at the door by her sister, Pat, who flew into Comox a few days ago and has helped Lani get her house in order. They’ve talked with her lawyer, and her banker, retrieved her will from a safety deposit box, gone to the post office and filled out a change of address card.

When I hear this, I smile a bit, wondering what forwarding address they used for Lani.

Lani is sitting in her recliner eating Poppycock, a Christmas sweet made with nuts and popcorn all covered in caramel.

“Why not?” she says. “I don’t have to worry about diabetes anymore. I should have a treat before I die.”

Gallows humour, so typical of Lani.

Next to arrive is Lani’s primary physician, Dr. Usmani. He brings with him a silver case, the size of a small piece of luggage.

Ah, the instruments of death, I speculate.

I know Dr. Usmani has completed whatever course work is required to be certified to assist a patient who wants to die, but this is the first time he’s actually completing the procedure himself.

That’s why Dr. Reggler, the next person to come through the front door, is with us. He’ll make sure that everything goes as it should this day, that no steps are inadvertently forgotten.

A sort of certification process, that thought jumps to my mind, as the doorbell rings again and an intern, whose name I never did catch, walks into the living room. He immediately goes to Lani and shakes her hand.

“Thanks for letting me observe.”

Seems uncomfortable, I observe, but what else is there to say?

The final person to arrive is Wendy. At first, I think she’s a friend of Lani’s and I’m a little relieved that Lani has more people in her life than just doctors.

But no. Wendy’s the nurse who’ll assist Dr. Usmani.

What has happened to Lani’s friends? Where is the rest of her family? I’m disconsolate, but understand more fully why I am here, a mere acquaintance.

Her pain has hollowed out her life, has reduced it to the bare essentials, to the doctors who can alleviate her pain.

We’re all here now. Dr. Usmani asks Lani to sign some documents.

“I’ve practiced my signature,” she says.

Spinal stenosis affects fine motor function, I recall.

With that done, Lani gets up from her recliner, not without trouble, and says, “Let’s get on with it, then.” She reaches for her crutches, her crucking futches according to Lani, and moves slowly, but independently, down the hall to her bedroom.

Once there, she climbs into her hospital bed, a relatively new purchase. It can be raised and lowered at the head and knees.

I note the impressions in the carpet that mark the foot of her original bed, and ponder, A memory not quite disappeared.

As Lani lies back on a stack of pillows and raises the head of the bed a bit, her sister climbs into the bed with her, sits next to her, and holds her hand.

We are finally all settled and Dr. Usmani explains the procedure. “There will be four injections,” he says. “The first one will put Lani to sleep; the second will eliminate any pain that the other injections may cause; the third will deepen Lani’s sleep; the final one will paralyze her muscles.”

Stop her heart muscle, I think.

Lani doesn’t seem disturbed by this list at all. She’s heard it many times by now.

Dr. Usmani asks for her verbal consent to proceed. He does this three times. Each time she responds in the affirmative.

The last time she says, “Yes,” and turns to her sister and says, “I’m scared.”

This is the first crack I’ve seen in Lani’s resolve.

“Of course, you are,” her sister says. “But this is what you want.”

“Yes, it is, “Lani visibly swallows, her teeth grit, her face settles determinately. “It’s way past time for this.”

Dr. Usmani begins the series of injections. Megan walks to the foot of Lani’s bed and holds onto Lani’s legs, supporting Lani one last time as she leaves us. Lani falls asleep.

Fifteen minutes later, after listening to her heart through his stethoscope, Dr. Usmani says, “She’s gone.”

Pat, a religious person, tells us how she justified witnessing Lani’s death. “God would want us to help her come home to Him.”

I think how this comforts Pat, though it’s a perspective I’m sure Lani doesn’t share.

For me, the years-ago Catholic, I silently repeat the beginning of Psalm 23:

Yea, though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me, thy rod and thy staff they comfort me.

Later, Dr. Reggler straightens out Lani’s legs, Wendy lifts Lani’s head and removes the pillows propped behind her. They both straighten the comforter covering Lani.

The doctors and nurse leave soon after. “Stay with me,” Pat asks, “until the funeral home comes?”

We agree. We reminisce about Lani.

I remember what Lani said, “I am not choosing to die…I am dying anyway. What I’m choosing is how and when and where to die.”

The funeral attendants arrive bringing a stretcher with them. I’m startled: They’re both women. Why do I think that unusual?

Moments later, they wheel Lani out of the bedroom and down the outside ramp Lani had built when she could no longer manage the porch steps.

Lani’s favourite plaid blanket drapes her body.

Salut to you, you most uncompromising woman. You have not gone gentle into that good night.

Pat Carl is a writer and a participant in the Comox Valley Civic Journalism Project. She may be reached at pat.carl0808@gmail.com

 

 

 

 

 

 

ABOUT MAiD

Patients and their families have many decisions to make when faced with end-of-life care or intolerable suffering.

Legislation governing Medical Assistance in Dying (MAiD) was passed by the Federal Parliament on June 17, 2016. This means medical assistance in dying is now legal in Canada when provided within the purview of the legislation. 

Under the new law, doctors may provide medical assistance in dying to capable, consenting adults who have a grievous and irremediable medical condition that causes enduring, intolerable suffering and who are at a point where natural death is reasonably foreseeable.

British Columbians seeking medical assistance in dying should speak with their physician or other primary care provider or their local health authority.

For more information, click here

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