It’s “snowing” in BC – staff term for drugging of nursing home residents

So common is the inappropriate use of antipsychotic medications by nursing home staff in British Columbia that it now has a name – snowing.

SNOWING:  a colloquial term used by health care staff for sedating an individual so they are no longer intrusive or distracting in their behaviour or the sounds they make.

Source – B.C. nursing home staff, www.saobservernet/news/

On January 12, 2012 Jack Johnson of Salmon Arm, BC died at a nursing home run by B.C.’s Interior Health Authority. The Interior Health Authority is featured in other cases brought to our attention at Seniors at Risk.

Mr. Johnson’s family believes that the antipsychotic drug Seroquel (quetiapine) was responsible for the sudden onset of Mr. Johnson’s frightening and debilitating symptoms and that it was at least partly responsible for his death, as reported by the Salmon Arm Observer, July 11, 2012.

The family describes Mr. Johnson as “the most joyful man you could ever meet” until he was prescribed Seroquel, after which he became angry and agitated.

Instead of reducing or stopping the drug, the doctors and nursing home increased his dosage. Jack Johnson’s daughter Dina Loeb says “When he went in there, he was still walking, talking, dressing and feeding himself. Within 10 days, he wasn’t doing any of that.”

The first time Dina Loeb heard the term “snowing” a nursing home care aide told her ” ‘when they’re agitated, we give them more medication. Your dad peed in the corner so we snowed him.’ Dina says a nurse at the hospital confirmed the term and told her it is common practice.”

The family brought their concerns about the effect that Seroquel was having on Mr. Johnson to the nursing home and to B.C.’s Ministry of Health but they were given platitudes and misinformation.

“They said Dad was quite happy, moving around, scooting here and there, but in reality, he was stiff as a board, mouth gaping, eyes rolled back, not knowing anyone.” 

In a meeting with doctors, nurses and staff at the nursing home, the family specifically asked (more…)

Hospital “commissars” threaten to ban wife unless she agrees with doctors

 –––––––  Sep 13, 2012 | Related Article | Update of previously reported case – Ajax Pickering Hospital  Court affidavits and evidence reveal deception and intimidation by hospital, doctors and the Public Guardian and Trustee. –––––––

Another story of abuse by health care providers. Seniors at Risk has been working with this Ontario family for the past month, after it was brought to our attention by one of our website readers.

Marilyn Nelson and her spouse Arthur Hippe, both in their sixties, have shared the last 26 years together. Today though, the loving couple is prevented from seeing one another, except for two hours a day in a Toronto-area hospital, where they are not permitted a single moment of privacy.

Arthur Hippe suffered a stroke in late May 2010 and was admitted to Ajax Pickering Hospital east of Toronto. He is paralyzed on his left side and his speech has been affected. He remains in the same hospital today, apparently having received no post-stroke rehabilitation.

Arthur granted Marilyn his Power of Attorney for Personal Care on May 12, 2009, giving her the legal authority to make all his medical care consent decisions. However from the very beginning, the hospital disregarded Marilyn’s legal authority, refused to provide her with Arthur’s medical records, and made continual efforts to thwart her in making care consent decisions on Arthur’s behalf. Marilyn has asked on several occasions that Arthur be moved to a rehab or residential care facility, but the hospital continues to claim that there are no beds available.

Ajax Pickering Hospital is one of two hospitals operated by the Rouge Valley Health System, led by CEO Rik Ganderton (formerly an executive with IBM Canada). The hospital’s motto is “Patients First!”

One day, Marilyn came to visit Arthur and saw that he was staring vacantly, a marked difference. She asked hospital staff if he was on any new medications and was told he was on Zyprexa.

Marilyn Nelson researched the drug and found, to her horror, that, in addition to numerous toxic side effects,  Zyprexa and other antipsychotic drugs are well-known to increase the risk of strokes (cerebrovascular events). Asserting her legal right to provide consent (or not), she instructed the hospital physicians treating Arthur, including Dr. Romas Stas and Dr. Carman Price, to take Arthur off Zyprexa. That’s when the relationship with the hospital escalated further into bewildering hostility, says Marilyn.

One of us has to go, and it’s going to be you!

The doctors did not agree with Marilyn that Zyprexa and other antipsychotic drugs were harmful to Arthur, and in a meeting with the doctors and other hospital personnel, Marilyn says the doctor told her “One of us has to go, and it’s going to be you!”

So, what’s going on, you ask? How is it that a hospital and doctors can ignore a legal document stipulating that another person has full authority and responsibility to make medical care consent decisions?

As Seniors at Risk has reported (more…)

A new twist – doctor banned from visiting mother by health facility autocrats

 

Cases of elder rights being stripped by health care providers and public agencies are coming to light from coast to coast across Canada.

A reader notified Seniors at Risk of this St. John’s, Newfoundland and Labrador story.

It’s a story with an interesting twist.

The daughters of an 88-year-old hospital patient say that Eastern Health authority cut their visiting rights to their mother because they raised concerns about the care their mother was being given.

The twist? One of the daughters is a medical doctor.

The story of Elsie King and her daughters Yvonne and Grace was exposed by CBC Radio, St. John’s. This is the kind of journalism that CBC excels at, and should be encouraged (and funded) to do more of.

Here are the transcripts from the CBC’s podcasts of the on air broadcasts last month. Read and judge for yourself. You can listen to the broadcast too. Links to the online audio podcasts are provided at the end of each transcript.

Learn how health care facility staff, doctors and administrators can easily separate and damage families with little apparent consideration for the difficult times that the patient and the family are encountering.

Knowledge. Compassion. Courage. Action.

Take a stand against institutional elder abuse.  

Elsie King’s daughters take Eastern Health to Court over hospital visitation

CBC On the Go – Tuesday June 12, 2012 ­– St. Johns, Newfoundland and Labrador

An 88-year old patient’s daughters say Eastern Health cut their visiting rights when they questioned the care she was receiving. Eastern Health says it cut visits because their behaviour toward staff was unreasonable and aggressive. Each is taking the other to court.

Host Ted Blades with Jessica Doria Brown

Transcript:

There’s a battle going on at Eastern Health (St. Johns, Newfoundland) and the family of an 88-year-old woman.

Yvonne and Grace King say their mother Elsie was getting inadequate care at the Health Sciences Centre and when they spoke up about it, the health authority punished them by cutting the amount of time they’re allowed to spend with her.

But Eastern Health says it restricted their time at the hospital because of their rude and aggressive behaviour towards the staff.

The situation has gotten so bad that the sisters are taking Eastern Health to court and one of the sisters, Grace, to court as well.

From the sisters’ perspective, they say their mother has been getting second-rate care because of her advanced age. Yvonne King says staff delayed giving their Mom antibiotics, and they wouldn’t use a safety belt consistently to transfer her from her bed to the chair. They say that the staff have referred to her as “nursing home material”.

They say the hospital staff really resented it when they asked about their mother’s care. Yvonne King says the nurses wouldn’t even follow the doctor’s orders when…  [MORE]

King family vs. Eastern Health

CBC On the Go – Tuesday June 13, 2012 ­– St. Johns, Newfoundland and Labrador

Update on the King family vs. Eastern Health story. Bob Buckingham, the lawyer for the Kings tells Ted that court proceedings have been postponed indefinitely because Eastern Health has relaxed the restrictions it placed on Elsie and Yvonne visiting their mother Elsie at the Escasoni Complex.

Host Ted Blades with King family lawyer, Bob Buckingham

Transcript:

Host:  Yesterday we reported on the story of Yvonne and Grace King. The King sisters told us that they were punished for speaking up for what they said was the inadequate care their mother Elsie was getting at Eastern Health Sciences Centre. Their punishment? The health authority had severely restricted the amount time the daughters could spend with their mother. But Eastern Health told us their time was cut because of their rude and aggressive behaviour towards staff.

The situation had gotten so bad that each side was taking the other to court:  the sisters to get the visitation restrictions lifted; and Eastern Health to keep them in place.

They were supposed to be in court today, but things have changed.

Bob Buckingham is the King family lawyer and he… [MORE]

 

Top doctor’s claim – 130,000 elderly patients killed ‘prematurely’ every year; elderly woman starved to death in hospital

Readers of Seniors at Risk sent us two stories yesterday that will shock people who are not already aware that thousands of our elders’ fundamental human rights are being violated, and their lives put in danger, while supposedly in the ‘care’ of a modern and civilized health system.

In the first story below, one of Britain’s top doctors exposes the widespread practice in health care facilities of prematurely ending elderly people’s lives with morphine injection and withholding of food and water. The practice is based on a scheme known as the Liverpool Care Pathway, named for the U.K. city in which it was perfected.

Its unregulated, under-the-radar use extends far beyond the U.K. Evidence indicates its adoption (and abuse) here in B.C. Families are often told their loved one “died peacefully”, when in fact they died in the painful distress of dehydration, starvation and narcotic poisoning. By eye-witness accounts, this is an excruciating way to die.

The other story, equally horrifying, is from Canada. An elderly Winnipeg woman starved to death after not being given any food for 14 days during her 45-day stay in hospital. The hospital board said it was “sorry”.

Seniors at Risk is continually being made aware of these and similar cases of institutional elder abuse, almost daily. It is an epidemic, and a disgraceful atrocity.

When our existing laws, lax as they are, are not enforced, when no one is held personally accountable, when health organizations are not open and honest about their practices, and when there are no consequences for such reprehensible acts, then these crimes become inevitable and increasingly frequent.

Knowledge. Compassion. Courage. Action.

Take a stand against institutional elder abuse.  Start by reading these two stories:

Top doctor’s chilling claim: The NHS kills off 130,000 elderly patients every year

By STEVE DOUGHTY  – MAIL ONLINE  – PUBLISHED: 23:08 GMT, 19 June 2012 | UPDATED: 13:20 GMT, 21 June 2012

  • Professor says doctors use ‘death pathway’ to euthenasia of the elderly
  • Treatment on average brings a patient to death in 33 hours
  • Around 29 per cent of patients that die in hospital are on controversial ‘care pathway’…

NHS doctors are prematurely ending the lives of thousands of elderly hospital patients (more…)

Wife wins court order to see husband of 33 years in B.C. hospital

 

Another story has been sent to Seniors at Risk that exposes inhumane and autocratic behaviour by health care facility staff towards seniors and their family members.

The situation in British Columbia health care facilities has become so dysfunctional that families, in times of great distress, are forced to resort to the B.C. Supreme Court to compel our publicly-funded health care providers and authorities to use common sense and display considerate behaviour.

Although this couple was successful in obtaining a court order against the health authority and the health care facility, few families can afford the extraordinary legal bills (usually $250 – $350 per hour) to hire lawyers for this purpose.

It begs the question – Are human rights and justice available only to the weathy and well-positioned in British Columbia today?

Story below.

Wife wins right to see husband in hospital

Judge grants unsupervised visits; VIHA calls it ‘a good outcome’

By Cindy E. Harnett, Times Colonist June 3, 2012

 
A Victoria woman has won the right to unsupervised visits with her husband of 33 years in Victoria General Hospital after Vancouver Island Health Authority imposed a ban restricting her to 20-minute conversations, over a speakerphone, twice weekly.
 
Retired cancer researcher Dr. Carol Haines, in her mid-60s, can now see her husband, Fred Oster, 67, a retired Royal Roads University professor, in hospital after the couple petitioned the courts.
 
On Friday, B.C. Supreme Court Judge Bob Johnston immediately granted daily, unsupervised visits to Haines from 1 p.m. until 4: 30 p.m. effective until June 11. VIHA and the petitioners will meet again Friday in an effort to reach a permanent agreement on visitation at the hospital.
 
Haines had been banned because of questions from VIHA about her psychiatric health, her impact on her husband’s health and the stress she placed on staff, the court heard. …
 
Oster suffered a severe traumatic brain injury in September 2011 that left him unable to live independently. Vancouver-based lawyer Joe Arvay, representing the couple, told the court Oster had been “involuntarily detained at Victoria General Hospital” since March 6. 
 
Restrictions on Haines’ visits have varied from daily, hourly supervised visits to two calls of 20 minutes twice weekly, over a speakerphone. The petitioners (more…)

B.C. health care facilities ban families, intimidate visitors with police presence

Two more incidents this week reveal a disturbing and growing trend by health care facilities and health care authorities in British Columbia to intimidate and bully visitors.

Examples of health care facility staff banning family members and using police to intimidate visitors also feature prominently in the story of Jean Wilder of Invermere, B.C., first reported by Seniors at Risk on April 26, 2012 (see update at end of this posting).

 

Victoria General Hospital bans mother from seeing son

May 31, 2012:  Times-Colonist, Victoria, BC

A 73-year-old mother who traveled to Victoria from South Africa to care for her seriously ill son has been banned from Victoria General Hospital after she says she tapped a nurse on the head to get her attention.
 
Shirley Spence, originally from England, has been (more…)

Ombudsperson replies to letters from public – are you “personally aggrieved” ?

 

Seniors at Risk has received feedback from members of the public who sent letters to government officials to express their concerns about Jean Wilder, a 60-year-old woman recovering from surgical complications, who is being held unlawfully by B.C.’s Interior Health Authority in an Invermere, B.C. care facility.

People say their letters and requests for action are being ignored or dismissed by officials and politicians. Some feel they are being actively discouraged from raising concerns.

The response from the Ombudsperson’s Office suggests that only Jean Wilder herself can complain. Requests for assistance from human rights and legal aid groups were denied, saying they are either too busy or not interested in (more…)

Healthcare Thrives on Conflicts of Interest

Corrupt Medical Research Only the Tip of the Iceberg

Alan Cassels, University of Victoria

WE TRUST strongly in our medical system because, metaphorically speaking, we largely don’t mix church and state. For the most part, the medical care we receive from our hospitals and doctors is supported by public funds and delivered on the basis of human goodness, charity and justice. Examples that show how strenuous we are in ensuring that commerce doesn’t taint our medical care include:

  • We don’t let doctors sell drugs; pharmacists do that.
  • We don’t let drug companies run medical schools; universities do that.
  • We don’t let drug manufacturers write prescribing guidelines for physicians; independent experts do that.
  • And we don’t let people selling drugs or medical devices write medical journal articles; academic physicians do that.

Or, at least, that’s what I thought.

April was a particularly hard month for rude awakenings. Cracks in the crumbling edifice between commerce and medicine were revealed and new research unveiled gross, sometimes shocking, levels of conflicts of interest in our medical system. We are finding evidence of academic doctors selling themselves to the highest bidders, medical journals allowing themselves to be prostituted by drug companies and medical schools allowing doctors in residence to be bribed with drug company trinkets. I would argue that of all the factors threatening to undermine our trust in medicine, financial conflicts of interest top the list.

Don’t believe me? Then believe the data: In April, four separate research studies published in four diverse areas showed the widespread and rampant nature of conflicts of interest in medicine. One derives from the world of cancer research. One is from psychiatry. One is from medical education and the last is from the world of medical journals. As you absorb these examples, try to decide for yourself if we are doing enough as a society to eliminate the conflicts of interest infecting medicine.

What do I mean by conflict of interest? Wikipedia generally defines it as “any situation in which an individual or corporation (either private or governmental) is in a position to exploit a professional or official capacity in some way for their personal or corporate benefit.”

One study from the cancer world examined the frequency and impact of conflicts of interest as they related to high-impact, published, clinical cancer research. It basically asked the question: “Are researchers who publish in cancer journals conflicted?” (For instance, do they own shares or have stock in or otherwise benefit financially from their association with a drug manufacturer or do they work for the drug company whose drug they are studying?) The reviewers looked at cancer research published in eight major journals in 2006 to see if conflicts of interest were reported and, if so, who funded the research? They also wanted to discern if there is a real association between the research funders and what the research concludes (i.e. do the industry-sponsored researchers have more positive things to say about their sponsor’s drug than the researchers not on industry’s payroll?)

Their results? Out of 1,534 original oncology studies, almost a third (29 percent) of the researchers had a conflict of interest, including industry funding, yet only 17 percent declared they had received such funding. Studies paid for by industry funding were twice as likely to focus on treatments (as opposed to other aspects of cancer care) and randomized trials that assessed survival were more likely to report positive survival outcomes when there was an obvious conflict of interest. In other words, the drug is shown to “work” better if there is company money involved.

The authors concluded there are indeed conflicts of interest in the clinical cancer research published in high-impact journals; often, those conflicts are not disclosed and the conflicts result in a more positive spin being put on the results of the trial.

The next example comes from the world of mental illness. A report by Boston researchers found that 90 percent of the authors of three American Psychiatric Association (APA) clinical practice guidelines in psychiatry had financial ties to companies that manufacture drugs mentioned in those guidelines. Worse yet, the authors had financial connections, including owning equity in the companies that made the recommended medications, being a consultant or corporate board member, or receiving honoraria. None of these conflicts were disclosed in the guideline.

Translation: The academics who wrote the major guidelines for American physicians on treating serious mental illness – schizophrenia, bipolar disorder and major depression – were basically all funded by the drug companies. If you thought only well meaning psychiatrists, interested in the welfare of patients, provided the guidelines, you’d be wrong. The picture looks even darker when you narrow in on the conflicts of interest of the authors of the guidelines for only bipolar disorder and schizophrenia: Here, 100 percent of the authors had such conflicts. Most people would consider these findings very worrisome, including Tufts University professor Sheldon Krimsky, one of the co-authors of this report. Tufts published a 2006 study examining conflicts of interest of the creators of psychiatry’s “Bible,” the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders).

In a telephone interview with Krimsky from his office in Boston, he told me we should be worried about conflicts of interest because they can lead to a “distortion of the scientific record” and that industry-funded activities may lead to an “interpretation of the science in a direction that may not be defensible.”

While he’d like to see these guidelines do a much better job of disclosing conflicts of interests among the authors, such disclosure is only an intermediate step towards erecting a solid firewall between drug companies and guidelines for physicians. “The innovators must be separate from the evaluators,” he notes. That’s right, a separation of church and state.

No doubt guideline committees, such as those sponsored by the APA, need to come clean about their financial conflicts, but they must go further to avoid them in the first place. At the very least, groups like the APA should admit they’ve got a huge potential PR liability on their hands, and if they don’t prevent drug companies from putting their own people on guideline committees, the APA shouldn’t be surprised when our doctors scorn or ignore their guidance.

What about smaller things than prescribing guidelines? What about trinkets – do they influence what our physicians think about drug companies? A recent study conducted in two medical schools in the US found that exposure to even small pharmaceutical items affected a doctor’s treatment preferences.

You might find this hard to believe. Most physicians I know scorn the idea that they could be “bought” with trinkets. (We’re talking drug company pens, free drug samples and other logo-laden paraphernalia.) Most physicians are adamant that these small, promotional items are unlikely to influence prescribing behaviour. Yet, in this study, the researchers measured whether exposure to these items result in doctors looking more favourably on drug companies and whether or not the medical schools with more restrictive policies towards pharmaceutical marketing produce doctors with different attitudes.

Researchers conducted a randomized, controlled experiment with more than 300 senior level medical students at two US medical schools. One of the schools (University of Miami) allowed the students to be exposed to small, branded promotional items for the cholesterol-lowering drug Lipitor (atorvastatin). The control group was comprised of students at the University of Pennsylvania School of Medicine where restrictive policies are in place to limit pharmaceutical marketing.

What did they find? The Miami students exposed to the Lipitor swag were obviously more enamoured with the drug compared to the control group in Pennsylvania. On a “skepticism” scale, the Miami students held more favourable attitudes toward pharmaceutical marketing compared with the other group of students where the opposite effect was observed. Basically, those students not marinating in drug company promotion were less swayed by promotional items related to the drug.

The authors concluded “subtle exposure to small, pharmaceutical, promotional items influences implicit attitudes toward marketed products among medical students.”

A study published in April by Sergio Sismondo at Queens University in Kingston looked at the relationship between drug companies and medical journals and asked, “Are medical researchers and medical journals too close to the pharmaceutical industry for comfort – or patient safety?”

We’ve all heard of the phenomenon of “ghostwriting” where big, important names in medical academia are asked to put their names to papers written by others (often drug company hacks). But Sismondo pushes the concept a bit further referring to the “ghost management” of pharmaceutical research and publication where cradle-to-grave medical publishing is “managed” every step of the way by pharma funders. He notes there has always been a problem with plagiarism and the misallocation of credit (like the prof who puts his own name on the hard work of his graduate students), but those scenarios are only the tip of the iceberg.

A more serious problem in medical publishing is the pharmaceutical industry using “willing participants” in the form of researchers seeking fame, glory and money associated with huge, multimillion-dollar studies. These people, known in the marketing world as KOLs (Key Opinion Leaders), are luminaries who put their names to the body of academic published research and serve as speakers and de facto promoters of the company’s products. They put their names to studies that are published according to the objectives of the funders (usually the drug companies). The published studies are then reprinted and distributed to the offices of physicians and anyone else who influences drug formularies.

As Sismondo says, “Those articles may look like independent confirmation of the reps’ pitches [and] plagiarizing KOLs lend their good names to the pitches.”

If you were to ask me if conflicts of interest are a problem in medicine, I’d say, “Ask the data and then decide for yourself.”

Alan Cassels is a drug policy researcher at the University of Victoria, British Columbia and the co-author of the bestselling Selling Sickness. He does not work for the pharmaceutical industry.

cassels@uivic.ca www.alancassels.com

Request for Public Inquiry – Alberta, Canada

From: http://elderadvocates.ca/request-for-public-inquiry/

HAND DELIVERED

The Honourable Mr. Ron Stevens, QC
Minister of Justice and Attorney General
Room # 208, Legislature Building
10800 – 97 Avenue, Edmonton, AB T5K 2B6

Dear Mr. Minister:

Request for a Public Inquiry to Address the Following:

A physician, has a powerful quasi-judicial position in society by virtue of the reliance on his assessments by the judicial system, in that his assessment can lead to the detaining of lawful citizens behind locked doors, and removal of property and human rights.

The current standards required for a physician in the performance of his assessment are not well defined. We believe that if the judiciary is to rely on a physician’s assessment, specific standards and criteria must be developed for the exercise and documentation of a physician’s assessment. These should include cross examination of the physician or documentation/ affidavit testimony which outlines the process which was followed as well as practical avenues for the appeal and review of that assessment.

Many seniors are being abused through the process that declares them incompetent to look after their finances and personal decisions.

Therefore we ask your government to hold a Public Inquiry to:

  1. allow hearings across the province of persons who have been victimized by a process that has no safe, definitive guidelines to ensure a fair, ethical assessment. The hearings should include those Alberta citizens who are detained behind locked doors who wish to be heard
  2. establish legislated criteria and standards to govern the assessment protocol, that recognizes constitutional rights and the Charter of Rights and Freedoms
  3. establish practical avenues of accessible, appeal protocol.
  4. establish penalties for those who are in breach of legislation.
  5. a definitive time line in regard to these undertakings.

Thank you.
Respectfully submitted,
Elder Advocates of Alberta Society

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