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Family pressured to move dying father

Palliative care: Few alternatives to an acute-care bed.

Roger Young knows that when his father John dies, he will remember him as a vibrant, humorous and caring father, husband and friend.

Unfortunately, he will also have memories of the struggles he and his family are undergoing in finding palliative care for the 88-year-old man who has been a resident of Salmon Arm since 1957 and has metastatic cancer in his liver and spine.

A nurse practitioner in Abbotsford, Young worked as an RN at Shuswap Lake General Hospital in the 1980s, a facility in which his father served as a nursing orderly from 1964 to 1976.

He says he is “appalled at the callous pressure tactics and emotional blackmail” he has had to endure over the past week, since his father was declared a palliative patient.

Interior Health expressed regrets to Young on Monday.

“We apologize if there’s been a misunderstanding, if he’s been uncomfortable with our communication,” says Kirstine Hill, Community Integration Health Services administrator.

Young’s father was diagnosed with cancer last summer and underwent chemotherapy and a five-week course of radiation. After collapsing at his home, he was admitted to Shuswap Lake General on Dec. 5, where he was deemed to be in need of palliative care.

“Upon this designation, I began receiving telephone calls from hospital liaison nurses at SLGH applying pressure to have him moved out of the acute-care hospital bed,” writes Young in a Dec. 11 email to the Observer.  “As all palliative beds are currently occupied at Bastion Place, I was asked if it was possible to move him to a private palliative bed at one of the private long-term care facilities in the community, at the family’s expense.”

Private palliative care, at $175 a day, is beyond the family’s means, he says.

An irate Young says that unbeknownst to him, as he was driving to the Coast on Sunday, the same hospital liaison nurse was pressuring his brother who is visiting from Texas – in front of his dying father.

“She was not just talking about it, but agitating about it,” he says, noting the continuing pressure to move his father was making him feel guilty for not taking on the cost of private care.

Following IH advice, Young sought assistance from Veteran’s Affairs for his dad, who served with the Medical Corps in Britain and France in the Second World War. They offered to pay for an ambulance to drive his father to a palliative care house in Mission, near where he works.

But Young points out that not only would the trip be arduous, his dad has “a multitude of friends, family and a frail wife who reside in Salmon Arm.”

“This practice of trying to play hardball with patients and their families should not exist,” he says, emphasizing frontline staff are wonderful. “I am appalled that our health-care system is failing those who have paid into it for their entire lives, and have to endure stress and anguish when they most need it.”

A few hours after the Observer began making inquiries, Young received a call from Interior Health at his Abbotsford home. He says the person he spoke with told him nurse liaisons are not allowed to discuss private-pay options with families and an investigation will be initiated.

Hill, meanwhile, says she does not know who called Young, but suggested because his email had been sent to concerns@interiorhealth.ca, a patient quality care officer might have followed up with him.

In the meantime, she says Community Integration Health Services might well ask families to pay for a private facility while waiting for a publicly funded bed.

 

“From my experience, we explore all options,” she says, noting staff are working with the Youngs to find suitable care. “Until we sort that out, he’ll remain in acute care. We’re not going to discharge him before things are sorted out.”