Friday, 25 May 2007

PPAO, Elder Abuse ... & getting you a bloody Will already!!

Last month I finished my most recent tenure with the Patient Advocate Office of Ontario's Ministry of Health & Long Term Care. Among other things, the PPAO works to:

- provide advocacy & rights advice services to patients;
- address hospital/facility-based or provincial systemic issues impacting on patients' rights;
- public and health care professional education through speaking engagements, publishing reports and engaging with the media.

Since my first contract with them, a decent share of my job involved policy research into things like the rights of mental health consumers; the impact of patient advocacy services on health outcomes; as well as elder abuse issues in our province's Long Term Care facilities and policies that have been identified to counter these problems. As one might imagine they weren't the most uplifting of files - but I was glad to have had it as this experience taught me a great deal about some of the most vulnerable members of society, and the limits of our health & social services in being able to meet their needs.

If there is one lesson above all others that I can take with me and shout out to all uh yall - it is that everybody should consider making a living will or power of attorney, even if you're one who thinks you have nothing to lose. While planning how to and who can distribute one's finances are what most people think of (definitely important) - it is only one aspect of why such documents exist. What's also at stake is who can make your medical decisions should you ever be diagnosed with a condition or have suferred a trauma which has left you incapable of making your own treatment decisions. Do you want to be kept alive at all costs? Do you want to be given a controversial or unproven experimental new therapy that might make you worse off for that chance to be a little better? The truth of the matter is that many of us (esp us younger cats) haven't even considered these types of things well enough to know how we really feel - but if we don't make these decisions and leave it to chance - by default these decisions are going to our closest relatives or worse perhaps, a public appointed guardian whose never met you. The Toronto Start reports that a whopping 80% of North Americans have not signed any sort of living will.

Yet while family might seem the logical choice in such unfortunate scenarios - even in the case of relatives who we don't doubt love us unconditionally, we may still disagree on many many things, let alone something as personal as this. Heck - when it comes to treatment decisions love may even be a weakness, as some people have great difficulty letting go or making the difficult decisions the patient might have wanted in favour of their own self interests or ideologies. While health facilities have a great deal to work on themselves - the reality is that the lion's share of abusive decisions or one's against what a patient wants or would have wanted are taken by the relatives they know and love who have been empowered with the legal voice of consent. Once you know what you want it's not hard to control your fate here - it's about finding someone you trust to act out your wishes, putting it down on paper, and then putting copies of it in the rights hands or an easy to find place should it ever be needed.

Ok so I've rambled way beyond the realm of Elder Abuse here as the whole issue of consent is important for all situtations were one's ability to manage their financial or treatment decisions is in question. Nevertheless it was the issue of Elder Abuse (both financial and physical/mental) that started me down this path and which I continue to remain interested in. I'm working on a longer piece about the past and present situation in Long Term Care facilities. I know a number of you have a wealth of knowledge in this area from either work or personal experience with friends/family ... if you care to share your stories/ideas/anything with me I'd love to hear it - feel free to email me at bryan.heal@learnlink.mcmaster.ca
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