Sunday 13 January 2019

Could New Brunswick adopt P.E.I. program that keeps 'frail seniors' at home longer?







https://www.cbc.ca/news/canada/new-brunswick/coach-program-pei-senior-care-overcrowded-hospitals-1.4975908


Could New Brunswick adopt P.E.I. program that keeps 'frail seniors' at home longer?

COACH Program aims to reduce emergency room visits, hospital admissions

P.E.I.'s COACH Program helps keep frail seniors at home longer and alleviates overcrowding in emergency rooms. (Credit: Getty Images/iStockphoto)


Faced with overcrowded hospitals and an aging demographic, health-care professionals on Prince Edward Island devised an award-winning program that helps "frail seniors" stay in their own home for longer.

And one of the founders of the Caring for Older Adults in Community and at Home (COACH) Program believes it could work in New Brunswick.

"Frail seniors do not do well in hospitals, and our hospital system is not designed to handle frail seniors," said Dr. Tim Stultz, who is also a consulting geriatrician.

With the provincial health department keen to improve health-care access for frail seniors — seniors with complex health needs — the idea for the community-based care program was hatched in partnership with home care, primary care and the provincial geriatric programs.
Frail seniors are identified by home care officials or primary care physicians, and a nurse practitioner will visit the patient, perform a geriatric assessment and discuss needs and goals with the patient and their family, Stultz said. From there, a team of health-care workers will provide patient care at home.

"It allows that senior to have more intensive care at home and trying to prevent going to the emergency room, going to the hospital, those kind of things," he said.

Pilot program success


A 2015 pilot program in Montague, P.E.I., studied 19 of the most frail seniors who were among the heaviest users of the health system. Over the course of a year, Stultz said, the number of emergency room visits decreased by 30 per cent, the number of primary care visits dropped by 40 per cent and admissions to hospital fell 70 per cent.

"Families now have a number that they can call," he said.

"A lot of the times, people go to the emergency room because they don't know what to do, they don't have an option."

Dr. Tim Stultz, a consulting geriatrician, helped found the COACH Program. (CBC)
 
 
Stultz said the program will soon launch an alert system for the patient's care team. If a client's medicare number is registered in a triage system, an email will be delivered to the team members, who can then intervene.

The program is also geared to avoid early nursing home admissions. He said the average nursing home stay in P.E.I. is 2.6 years, but it's 0.65 years for COACH clients.

"One gentleman we encountered who was headed for a nursing home … was on over 30 medications," Stultz said.

"And just the nurse practitioner and I sitting down and going through these pills, we were able to … get more than half of them taken away and he lived at home until he died. He was more active."

Good for New Brunswick?


The program has been recognized nationally, receiving the Canadian Frailty Network's innovation award last fall, and officials are packaging it so it can be used elsewhere.

He said the program could be of use to New Brunswick — with some tweaks.

The program is offered "tip to tip" on the island, which is about a two-hour drive, and that will be more of a challenge in New Brunswick, he said.

Stultz also suggested training more nurse practitioners — the backbone of the program — in geriatric care.

Overcrowded hospitals


New Brunswick hospitals continue to be plagued by overcrowding.

Last week, Horizon Health Network chief of staff Dr. John Dornan said about 24 per cent of hospital beds are occupied by people who need to be in nursing homes or their own houses.

The situation is the same for the Vitalité Health Network. Across the health network, 26 per cent of patients were waiting for nursing homes in the first quarter of last year.

Ken McGeorge co-chaired the province's Council on Aging. (Submitted)
 
"The problem that [they're] describing goes back to 1967, for heaven's sake," said Ken McGeorge, who co-chaired New Brunswick's Council on Aging.

"I'm embarrassed that we've been talking for how many decades about the very same issues, and I'm embarrassed that we have not had or supported the leadership that we needed to do to deal with those issues. … We can be a model in health care for the country; we're not anywhere close to that right now."

Speaking to CBC News earlier this week, McGeorge pointed to the success of the COACH Program while calling for change.

"You need a leadership team. Civil servants can't do it [alone]. Politicians can't do it," he said.
"Just as in P.E.I., a geriatrician with the encouragement of government has set up what they call the COACH program. And in two years they have done what we have only talked about."
With files from Harry Forestell, Hadeel Ibrahim, Elizabeth Fraser, CBC Prince Edward Island
CBC's Journalistic Standards and Practices


36 Comments





David R. Amos
David R. Amos
Could New Brunswick adopt P.E.I. program that keeps 'frail seniors' at home longer?

Methinks the obvious answer is WHY NOT? N'esy Pas?


Rosco holt
Rosco holt
@David R. Amos
"WHY NOT? "
There isn't enough money to be made by government friends.









 David R. Amos 
David R. Amos
I spoke to the all knowing Ken McGeorge before the last election and just shook my head at his efforts to play dumb on the phone about not understanding my emails.


Rosco holt
Rosco holt
@David R. Amos
Are you sure he was playing?
Maybe he's really dumb. LOL










Colin Seeley
mo bennett
it all boils down to who's payin'!


Colin Seeley
Colin Seeley
@mo bennett

So true.


David R. Amos
David R. Amos
@mo bennett "it all boils down to who's payin'!"

YO MO Methinks you know as well as I that it will be all of us who pays the piper except the Irving Clan and their cohorts N'esy Pas?

Shawn McShane
Shawn McShane
@mo bennett Right now we are paying , $524,000 per day for 28% of hospital beds that are held by seniors who don’t require medical treatment.

Dianne MacPherson
Dianne MacPherson
@mo bennett
WE are "paying" anyway; lets try and start getting
VALUE out of the use of our tax dollars !!!

Rosco holt
Rosco holt
@Dianne MacPherson
We won't get value has long has we keep electing the same bunch of crooked self-serving politicians in power.







  
Rosco holt
marie-pierre Leblanc
we could pay for it ourselves if trudeau hadnt devalued our dollar so much if you made minimum wage in the 60 it would be worth 100,000 a year in todays dollars indexed against gold thank pierre trudeau for changing the bank of canada act jt is to inept to pull a move like that but his dady was


marie-pierre Leblanc
marie-pierre Leblanc
@marie-pierre Leblanc now the gov steals our money under threat of violence to service the debt they created and continue to grow

David Peters
David Peters
@marie-pierre Leblanc

Centralized banking is the root of the problem. It favours these the gov't monopolies and gov't backed monopolies. They don't want ppl to be self sufficient, so they make it next to impossible for most to be so.

marie-pierre Leblanc
marie-pierre Leblanc
@David Peters we had a central bank that worked well we borrowed money from that bank at straight interest for gov spending the loan was paid back and the interest was to the central bank which was ouselves now we pay compound interest to private banks never being able to satisfy the debt we are currently insolvent as a country

David R. Amos
David R. Amos
@David Peters "Centralized banking is the root of the problem."

Methinks you should finally check my work N'esy Pas?

David Peters
David Peters
@David R. Amos

Would be glad to. Can you provide a link?



 https://www.cbc.ca/radio/nowornever/swimming-against-the-current-1.4968738/why-this-out-of-work-reporter-decided-to-start-her-own-small-town-print-newspaper-1.4969980https://www.cbc.ca/radio/nowornever/swimming-against-the-current-1.4968738/why-this-out-of-work-reporter-decided-to-start-her-own-small-town-print-newspaper-1.4969980?__vfz=profile_comment%3D8748300018403





Why this out-of-work reporter decided to start her own small town print newspaper

Melissa Schneider is self-funding a newspaper to serve her rural Ontario community

Melissa Schneider is the owner, publisher, editor, photographer of The Echo. (Paula Duhatschek/CBC)



Melissa Schneider was wearing pyjamas when she found out she'd lost her job.
It was November 2017, and Schneider was working as a freelance reporter with the St. Thomas/Elgin Weekly News, one of several papers shut down after a major swap between Torstar and Postmedia.
Schneider had just wrapped up her fourth story of the week, and called her editor to let him know it was on the way.
"He picked up the phone and told me that we were all fired," said Schneider.
"We just disappeared into the night."
For Schneider, the phone call was unwelcome but not unprecedented.  She'd been in the new business for over a decade and it was the third time she'd been laid off.
Still, Schneider said she felt blindsided.
"It felt like there are no more chances to get into this industry, no more chances to get kicked out of this industry," said Schneider.
"There just are no more opportunities, because they'd consolidated now to the point where there's nothing left, there's nothing left to consolidate. There's nobody left to fire. There's nothing left to shut down, so where are you supposed to go from here?"
The Echo relies on advertisers to generate money, and hasn't yet become financially sustainable. (Paula Duhatschek/CBC)
 
 
Although some might have taken the layoff as a sign to hang up their tape recorder and move on, Schneider had a different thought.

"If I'm going to do something, if I'm going to really do something and I'm really going to put my wherewithal behind it and make something spectacular, then I'm going to make something that's my own," she said.

So, she decided to create her own print newspaper: The Echo.

Doing things the old-fashioned way


Today, Melissa Schneider is the owner, publisher, reporter, and main financial backer of The Echo, a print newspaper covering a pocket of Elgin County, Ont. where Schneider grew up.

It's an old-fashioned business model, but Schneider said it makes sense for the coverage area, which has many seniors and where internet connections can be spotty.

"I always joke that when the power goes out here, which it does quite often, you can still sit with a flashlight and read your hard copy of The Echo," said Schneider.

Schneider's grade eight yearbook lists her career goal as 'author or journalist.' (Paula Duhatschek/CBC)
 
 
There's another reason behind her dedication to the old-fashioned newspaper.

As a child, Schneider made the news herself while figure skating at a nearby arena. She was warming up when a local reporter-photographer snapped her picture as part of a photo feature.

The day the paper came out, Schneider was captivated over breakfast by a picture of herself in newsprint.

"It was laying there on my plate and I thought, 'That's it for me, that's exactly what I want to do,'" said Schneider.

A baby and a newspaper


Still, The Echo isn't immune to the financial challenges of the media industry, and although Schneider is living her childhood dreams, dreams on their own won't pay the bills.

For now, Schneider keeps the paper afloat using her savings, but only has enough in her Echo fund to keep the paper going until the end of the year.
I always joke that when the power goes out here, which it does quite often, you can still sit with a flashlight and read your hard copy of The Echo.- Melissa Schneider
The paper's precarious financial situation was made doubly complicated when, just two months into publication, Schneider found out she was pregnant.

"Which was another kind of, 'So now what are we supposed to do?'" said Schneider.

"Because I literally just started this venture and it seemed to be going OK. And I didn't really know what that meant for the future, for us, for the paper, for life really in general."

But Schneider is optimistic about the future. She jokes about taking a three-day maternity leave, and then setting up a crib in her home office and diving right back into her work.

"All I'm doing is bringing one more reporter into the universe," she said. "The baby's going to get into the industry and take over from its mom, that's my plan B here."

For Schneider, showing up is important. She wants her neighbours to know that when news happens, they can count on her to be there and to write about it.

And whether The Echo lasts one more edition, or is around for another 30 years, Schneider said she can be at peace with herself knowing that she gave it her all.

"I would rather have dreamed a dream and made it come true," she said, "than to only ever have thought of it and never been able to live it."



14 Comments



  
David Peters
David Peters
Canadian journalism needs more free market competition like this.


David R. Amos
David R. Amos
@David Peters "Would be glad to. Can you provide a link?"

https://www.cbc.ca/news/canada/new-brunswick/coach-program-pei-senior-care-overcrowded-hospitals-1.4975908

"Centralized banking is the root of the problem. It favours these the gov't monopolies and gov't backed monopolies. They don't want ppl to be self sufficient, so they make it next to impossible for most to be so."

BTW you got this link and many documents after we talked before the last election

https://www.scribd.com/document/2619437/CROSS-BORDER

David Peters
David Peters
@David R. Amos

You are either crazy, or up to something.

David R. Amos
David R. Amos
@David Peters You know exactly who I am correct?

David Peters
David Peters
@David R. Amos

Apart from your recent spamming, I've never heard of you. You must be mistaking me for someone else.

David R. Amos
David R. Amos
@David Peters @David Peters "You are either crazy, or up to something."

This is the first Mr Peters i crossed paths with

https://www.cbc.ca/news/canada/new-brunswick/saint-john-black-community-won-t-get-gg-apology-1.907265

David R. Amos
David R. Amos
@David Peters And this was the second Peters dude (I am betting you are the former because of your snobby replies)

https://globalnews.ca/news/4403323/new-brunswick-election-kings-centre/








Eric Duhatschek 
Eric Duhatschek
great piece! Those of us who spent 40-plus years in the newspaper business fervently hope Melissa succeeds.


Cindy Fordyce
Cindy Fordyce
@Eric Duhatschek

Might be a good time for other reporters to reach out to her - might be able to help with content :)

Charles Waggon
Charles Waggon
@Cindy Fordyce That and support from business in the form of advertising

David Peters
David Peters
@Cindy Fordyce

Look into gov't mismanagement and outright corruption...there'll be tons and tons of content.

David R. Amos
David R. Amos
@David Peters For the record I agreed with you over the years but now I no longer care about your opinions.. Remember this spit and chew?

https://www.cbc.ca/news/canada/new-brunswick/ernest-drapeau-david-smith-bill-21-1.3650540

Methinks you should have Googled David Amos Federal Court long ago N'esy Pas?









2 chief justices appear at odds over judge-moving bill

Terse letter exchange between David Smith and Ernest Drapeau sheds light on debate about Bill 21

Court of Appeal Chief Justice Ernest Drapeau, left, cancelled a Feb. 29 meeting about Bill 29 after Court of Queen's Bench Chief Justice David Smith, right, said he could not attend on short notice. (CBC)


The province's two top judges sparred earlier this year over the timing of a meeting to discuss the controversial Bill 21, according to confidential letters obtained by CBC News.

Chief Justice Ernest Drapeau of the New Brunswick Court of Appeal cancelled a Feb. 29 meeting to discuss the legislation after Chief Justice David Smith of the Court of Queen's Bench said he would not take part.

Smith told Drapeau in a Feb. 26 letter he couldn't attend because he was out of the country "and a four-day notice period prevents adequate preparation for and personal attendance at this meeting."
Later the same day, Drapeau wrote back that, "I deeply regret your decision to not participate in the meeting."

Drapeau's terse letter adds that even if Smith was away, participation was "an option that was available by way of telephone."

The rare glimpse at the private interactions of the two senior judges sheds more light on the debate over Bill 21.

Judicial disagreement

 

The chief justices of the New Brunswick Court of Appeal and the Court of Queen's Bench appear to have different options about a proposed bill that would give the minister of justice the power to veto the movement of judges within the province. (CBC)
 
 
 
Drapeau and Smith appear to disagree about the bill, introduced by the Liberals on Feb. 5.

The bill will amend the Judicature Act to take away Smith's unilateral power to transfer Court of Queen's Bench justices and would let the justice minister veto any move.

Smith calls the bill a potential violation of the court's independence.

After failing to persuade the Liberal government to change the bill, he's now warning that he is looking at "further options." The bill is expected to pass the legislature next week.

The Liberals have said they consulted Drapeau about the bill and he approved it.

They also say Justice Judy Clendening was filling in for Smith on administrative issues while he was vacationing in Florida and she gave her approval to the bill the day before it was introduced.

Michael Bray, Smith's lawyer, disputes that interpretation of events.
 
Bray said Clendening told Smith that she got a call from a government official that didn't mention the coming bill and that she said the general idea of a veto would be "constitutionally suspect."

Drapeau has not spoken publicly about his view of bill and his office did not respond to an interview request on Thursday.

Drapeau, Smith and the chief justice of the provincial court, Pierre Arseneault, sit on a committee that discusses court administration issues with provincial officials.

Letters written 3 weeks after bill


The exchange of letters obtained by CBC News began three weeks after the bill was introduced, after it began to generate political controversy and after Smith went public with his objections.

Bray said Smith was only told about the bill "after the fact" of its introduction in the legislature on Feb. 5.
Bray said Smith was still in Florida when Drapeau asked for the Feb. 29 meeting and didn't want to discuss the bill by conference call because on a previous conference call he'd been "frustrated because of the poor quality" of the call.
I see no useful purpose in going ahead, and the meeting is therefore cancelled.- Ernest Drapeau , chief justice New Brunswick Court of Appeal
"He felt this was important enough that he wanted a face-to-face meeting, either with a representative of his there, or when he returned," Bray said.

Smith said in his letter to Drapeau that he had asked Justice Fred Ferguson to attend on his behalf.
But Drapeau responded that given Smith's decision to not participate, "I see no useful purpose in going ahead and the meeting is therefore cancelled."

Smith wrote back Feb. 29, offering to meet Drapeau in Fredericton on March 14 or at a judicial event in Moncton on March 18.

Courts have different perspectives


Asked if the exchange between Drapeau and Smith was a sign of a healthy administration of the justice system, Bray said that, "I don't think anything that's happened on Bill 21 has been terribly healthy for the administration of justice."

Ann Whiteway-Brown, the president of the Canadian Bar Association's New Brunswick branch, said the apparent disagreement between the chief justices makes it "difficult" to fix the bill "because the two courts certainly have a different perspective on it."

She said she finds it odd the province consulted Drapeau on a bill that doesn't affect his court while not consulting Smith, whose court the bill does affect.

Justice Minister Denis Landry refused to comment on Thursday.

About the Author

 

Jacques Poitras
Provincial Affairs reporter
Jacques Poitras has been CBC's provincial affairs reporter in New Brunswick since 2000. Raised in Moncton, he also produces the CBC political podcast Spin Reduxit. 





21 Comments


  


David Peters
David Peters
Elections and term limits for Judges, Crown Prosecutors and Police Chiefs. Lets give the voter more say in how government works.


Nick Carver
Nick Carver
@David Peters Horrible idea. Just look to the US for innumerable examples of bad judges being elected by pandering to voters with suspect decision. The legal system must be insulated as much as possible from politics.

David Peters
David Peters
@Nik Carrier

At least with the US system you can see who the good and bad ones are....then have a say on the matter.

By not having a vote or term limits simply protects the bad actors, IMO.

Nick Carver
Nick Carver
@David Peters For the rare instance that there are bad actors, there are mechanisms in place to deal with them. Opening up our entire justice system to the whims of a flaky electorate is a recipe for disaster. Every other day I hear a story about some judge in the states violating the law on the books to make some part of his/her electorate happy. Usually its the evangelicals, but not always.

David Peters
David Peters
@Nik Carrier

Not opening the whole justice system to elections, just the most powerful, lead positions.... that affect could also corruption going on under them as well.

Wont argue the merrits of elections with you. I just don't share your contempt for the electorate.

Frank O'Phil
Frank O'Phil
@David Peters; beware of the tyranny of the majority. - Alexis de Tocqueville

Jay Boucher-Langlais
Jay Boucher-Langlais
@David Peters;
“A democracy is nothing more than mob rule, where fifty-one percent of the people may take away the rights of the other forty-nine. -” Thomas Jefferson.

David Peters
David Peters
@Jay Boucher-Langlais

Democracy with a constitution and laws where no one is above the law would be preferable. Obviously these laws are in place to protect minorities.

My concern is that we have a massive government bureaucracy that seems to be getting more and more insulated from accountability or transparency. A very weak vague constitution is part of the problem.

Jay Boucher-Langlais
Jay Boucher-Langlais
@David Peters; the judges (appointed and "independent" by the way) did a very good job at interpreting the Constitution.

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