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A Worker is a Worker, right WRONG

  • Posted on December 5, 2010 at 10:28 am

I am sure, that many out there, think I am a bit nuts, a bit obsessed with the idea of keeping the same regular worker visiting & helping Mom.  After all, one worker is the same as any other, so if they are all trained, capable, what does it matter if one shows up today, another tomorrow, and so on?

Basically, it has to do with PREVENTION.

I don’t check Mother’s body for new marks, bruises, etc. I mean I am a guy, she’s a she.  Sure, when I do the creams for her, or do a nightshirt change, I look, as best as I can, however I am not giving her a shower, like the regular workers do.  I am not seeing the whole picture, the under her arms, the upper back, or chest.

Old people bruise easy, when on Coumadin (blood thinner) they bruise even easier. However, when you also have Brittle Bones, bruising can be signs of something more.  In addition, she has skin that is losing its elasticity, so tears happen more easily.

These are things a worker can spot, but the rub is, if they’ve never seen her before, or its been months, they aren’t going to notice the small stuff.  Those things will go unnoticed, until suddenly they become major issues.   THAT COULD BE TOO LATE THEN.

Last Thursday, Mom was plugged (constipated) first thing. The fact that we had our regular worker, made mom less nervous, less apprehensive.  It eased her mind, solved the issue too, but later in the day, while trying to get up to go the bathroom, Mom had a spill.

She rested on a cart we use for her, which she shouldn’t have done. The cart leg buckled and down went mom, head first into a space heater, heavy wooden plant stand.

The sudden fear that pops into one’s head, is gut wrenching, to say the least. She hit hard, her head banged up against a solid wooden plant stand. Her whole back hit the floor hard,  her legs twisted, and you know what is running through your mind as you race to help her.

Fortunately, it seems nothing was broken, no damage that I could see. The Doctor checked her out Friday, didn’t notice anything either. Her blood pressure was up a bit, but then that’s normal, after you take a hard spill. 

We get over things like that, quickly. Old people DO NOT.  It lingers, it makes them more wary, nervous, which in Mom’s case isn’t a good thing. Isn’t for any elderly person, but with her conditions, it is a bit worse.

Now, the long of this whole story, is that for the next few days, one has to pay special attention, to bruising, to soreness, that may not show up immediately.  In Mom’s case, the day of the fall, and Friday, there was no sensitive areas, no hard bruising, or other tell tale signs.  Doesn’t mean there won’t be, as it can show up several days later.

Having regular workers, who know her, who see her regularly, means they WILL notice these subtle changes.  It means, they can spot something, before it manifests itself into something far more serious.   Things like cohesive thoughts, like slurred speech.  These can all show up later, but IF the worker is new, they won’t notice.

For VIHA & BCS, they don’t think of these things, or if they do, they simply don’t give a rat’s ass about it.  Their one and only concern is PROFITS.   VIHA wanting to keep within a budget, so they can afford the half million dollars salary for their CEO, and BCS so they can afford the quarter of a million dollar salary for their CEO.

The failure of BCS ( aside from hiring untrained, or incompetent workers )is that they simply can’t manage their employees, to insure that their patient load is properly staffed, by regular workers.  They need to get a map, so that workers are moving from one patient to another, in an efficient manner, instead of the Helter Skelter method they do now.

Bottom line is that BCS needs to spend money, to insure they hire trained & qualified home support workers, then assign them to a Patient, and not move them around at will. They need to have workers who are designated as Substitutes, so that when a regular worker is sick, is on vacation, they can fill in, without disrupting hundreds of other Patients, while BCS schedulers play some weird version of The Amazing Race ( reality show on television ).

Short term impact, is that it can be expensive to have the added staff, but long term, it means less extensive hospital & medial expenses for the Patients.  And given how we pay for Universal Health Care, that means a savings to the taxpayer.  IF we have less elderly patients, in need of hospital care, of additional medicines, treatments, then WE SAVE.

Course, aside from the money aspect, it also means we give our Elderly, SOME DIGNITY & RESPECT, after all, they are the one’s who built this city, this province, this country.

VIHA & BCS many not care, BUT SHOULDN’T WE?   I DO.

Ten Minute Service

  • Posted on April 20, 2010 at 9:57 am

I don’t get it. Why do substitute workers seem to think that they have been here before, when the fact is, they haven’t been?  I mean is it that all patients they tend to, look alike? Or What?

Today’s substitute worker, Nancy, insists she has been here before, but in the afternoon. Which would mean that this goes back about a year, and that could be true.

I suppose that it is possible, that before Mom broke her wrist, that today’s substitute was one of her workers. I do vaguely recall one, that would come on Friday’s, to help her with her twice weekly shower.

And yet, while she may have been the worker then, a lot has changed since then. People of Mom’s age have issues, yet once again Beacon Community Services sends in people ill informed.

This is one of my major issues with how both the Government [ VIHA ] and the outsourced agencies [ Beacon Community Services ] treat the elderly.  They may have staff that is trained, however if one is unaware of conditions, or changes in situations, how can they properly attend to the needs of the Patient?

You can’t expect to come in cold, and ASSUME things are no different, than when you were last here.  AND to be honest, if you were here a year back, can you really remember all the details?

Sure, you may remember a face, the house, the generalities, but do you remember she has brittle bones?  I doubt it, because the diagnosis wasn’t confirmed until after you were here, so once more, trained or not, you are not up to speed.   Even the so called ‘YELLOW BOOK’ that these workers are supposed to check, is not up to date.  NOR do they use it for what it is intended for, which is to alert other workers of conditions.

All that gets written into the book, is bathed, changed, all a-okay.   Like that helps, and despite having an infection, no mention is in the infamous yellow book.   No mention that the groin area is tender, and needs a very soft touch.

So who is at fault for this?

Is it me, the Primary Caregiver, or is it the Agency who is sending these people to my home? Is it VIHA for not following up on the service they are paying for?

My job is hard enough, and for many, too hard. I question myself often enough, and that is with a bond to the Patient. She is my Mother, after all.  These workers have no bond, no incentive buy wages & benefits, or so it seems.  Workers to our home, get an hour to perform some pretty basic stuff, a wash, dressing, and that is about it.  Yet the good workers, take their time, always get out in time to go to the next assignment, but Mom doesn’t feel rushed.   THAT IS WHAT A TRAINED WORKER CAN DO.

On the flip side, those who are HOUSEKEEPERS INSTEAD OF BEING HEALTH CARE PROVIDERS, don’t provide that kind of service.  Mom winds up feeling rushed, the job is not done carefully or properly.  I’ve had to redo the washing several times, or if I miss out on noticing, the result is the infection returns.  The discomfort returns, which means I wind up doing more to ease her, have to get the Doctor in to tend to the result.

Yet it is to prevent that, which is why we first started with this type of in home care. I couldn’t help Mom properly clean her private regions.  After all,  I am a guy.  Yet it seems many of these woman, don’t care enough to insure that what they are there to do, is done right & completely.

To get Mom ready for bed, it takes me on the average 20 minutes. And that doesn’t take into account washing her or anything but getting her changed, and comfortable. Applying the necessary cream to her groin for the night & setting the towels, etc. to insure her legs stay spread open, to allow for air.

SO HOW CAN A WORKER GIVING HER A SPONGE BATH TAKE TEN MINUTES ONLY TO WASH, CLEAN, AND COAT WITH MOISTURIZE LOTION OVER HER ENTIRE BODY?

The answer is :   THEY CAN’T !

If they tell you, they have been here, my mistake was in assuming that meant they knew most of the drill.  I SHOULD HAVE been very specific, as to what was required, but somehow, I just don’t think it would have mattered.

No lotion for her aging skin was applied.  Her legs weren’t washed or feet. The Private Area (the whole reason we have these women come in) was not fully cleaned.  A damp cloth glossed over, is good enough, for Nancy.

My day just become more complicated.  No added laundry but now I have to make sure that Mom sits, with the depends open, and more than likely will need to do the sponge bath operation over again, tonight or when she goes to lay down for the afternoon.   That is more time being spent, added to an already full schedule.

I don’t mind doing the added stuff, when necessary. I DO OBJECT TO HAVING TO DO ADDED STUFF WHEN IT ISN’T NECESSARY.

THE ISSUE IS SIMPLE, WITHOUT ANY OVERSIGHT AS TO HOW CONTRACTED AGENCIES ARE STAFFED, ELDERLY PEOPLE ARE NOT RECEIVING THE CARE THAT THEY SHOULD. 

WITHOUT AN ACTIVE OVERSIGHT PROGRAM, THAT COMES INTO THE HOME, THAT CHECKS ON EACH WORKER QUALIFICATION, ELDERLY PEOPLE ARE BEING MIS-TREATED THROUGH NEGLIGENCE & INDIFFERENCE.

Substitute Workers

  • Posted on March 2, 2010 at 11:51 am

It happens, a home support worker is off, for whatever reason, and a substitute worker is sent in her place. Nothing unusual about that, and common in the industry, and other professions as well.

I can remember having many substitute teachers when I went to school, and sure, we managed to pull a few fast one’s over them, but not too many. After all, they had been briefed and knew the lesson plan so it wasn’t easy to fool them, too much. Still, they did ALWAYS have the basics, which brings me to substitutes for Home Support Workers.

Last week, this week, and next week, we shall be inundated with replacement workers, substitutes.  And now the worry commences, thanks to the lack of professionalism, not just from Beacon Community Services, but from VIHA itself.

The level of confidence, that a qualified worker will show up, is minimal, at best.

Under normal circumstances, one can muddle through, but when there is a situation, that has to be monitored, or watched closely, the stress levels become greatly increased. I think that VIHA fails to understand the ramifications of their inability to insure that ONLY QUALIFIED PERSONNEL are sent into people’s homes.

Mom has developed a few skin tears, in the groin region, right where the depends lay. The band, has caused some abrasion along the line, making the skin raw, at best. Extra care needs to be taken, to insure comfort as well as protection.  I’ve contacted our Doctor, but tomorrow we get a substitute.  And so the worry has begun.

Maybe it will be needless, but given the past history, I tend to doubt that. AND THAT is why VIHA needs to be protecting the patients. THEY need to actually check on the staff being sent out, on the qualifications of these people, not just accept the word of the agency they have contracted to do the job. THEY NEED to verify that EACH & EVERY PERSON SENT TO A PATIENT IS QUALIFIED TO DO THE JOB.

Yet, despite my own constant complaints to them, to Beacon, the answers are exactly the same. Oh don’t worry, we know they are qualified, yet we have proof, that this is a lie. No way can someone who can’t understand or speak English, can effectively have gone through any local training, to attest to their qualifications.  It is impossible to pass any test, if you can’t understand the language.

By far, this is not an easy job, just as teaching isn’t. Yet no substitute is hired to teach our children, if they don’t have government certified credentials, that are verified, before they can accept a teaching assignment.  Yet we allow UNVERIFIED PERSONNEL to go into people’s home, and administer care to them, without knowing if they are properly trained or not.

THIS IS WRONG & DANGEROUS !

There is no doubt, that it is more costly to do things the right way, than not, in overall costs. However, I would say, it actually is far more costly doing things the wrong way, doing things on the cheap, when it comes to Health Care, than doing them right. And yes, that includes allowing only qualified personnel to care for patients, in their homes.

The problem is, we don’t seem to care about that anymore. Old people are expendable, at the end of their productive cycle, so why spend money on them, when it can be allocated to other areas, to the more vibrant. Truth of the matter is, one day we are going to be those older people, and we sure as hell won’t enjoy being tossed aside, for some younger person. We ignore that reality, that becoming old is inevitable, and that it is actually cheaper, to provide proper care now, than to wait for a crisis to arise.

Cheaper to insure a person’s infections are treated now with over the counter cremes, than having to run high potency drugs through an IV later on.  Cheaper now to insure a patient is dry, before dressing, than having to deal with skin breakdowns later, to deal with infections, all because we sent someone who doesn’t know how to clean an older person properly.

These hidden costs can break our entire system, by skimping on the quality of people we send into homes, to care for our elderly. You can’t do this, and save money, because the reality is, it is going to cost a lot more.

Not enough old people will die quickly from this half assed in home care. So the costs will indeed grow, and that is a mathematical certainty.  Better to have old people stay as healthy as possible, instead of creating crisis situations, that take up the valuable resources of emergency personnel.

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