24/10/2007

Hon George Abbott

PO Box 9050, Stn Prov Govt

Victoria, BC V8W 9E2

Dear Minister,

The content of the recent programs on CBC radio and television which focused on the growing incidence of violence in Canadian Long Term Care Facilities has been extensively discussed by members of the Long-Term Care Medical Directors Association of Canada. The outcome of these discussions was a consensus view that violence in residential care facilities is a common occurrence in all parts of Canada and is part of the day-to-day clinical work of physicians practising in this field. Every member of our group can report numerous incidents in which facility residents, with behavioural complications accompanying dementia and other conditions, have caused physical harm to fellow residents or to staff.

We believe that this increase could be related to a number of factors which are new to Canada and which we believe will continue for many years to come.

These factors include but are not limited to;

1. The changing demographics in Canada and the increasing number of seniors who have dementia. (Age is the highest risk factor for developing this disease).

2. The increasing number of seniors diagnosed with dementia who develop behavioural problems as a complication of the disease.

3. The increasing number of seniors with other mental health illnesses such as bipolar disorder and schizophrenia.

4. The policy of integration of seniors with behavioural problems secondary to illness in non- specialized units where there is often a mix of cognitively well and cognitively impaired residents. ( It has certainly been shown that integration of the cognitively well and cognitively impaired residents can be beneficial where no behaviour issues exist)

5. The decrease in staff numbers (particularly RNs) in both Community and Residential Care. This has occurred through cut backs and the growing HR problem related to a shrinking work force pool.

6. The lack of physicians specializing in Psychogeriatrics and Geriatric Medicine.

As a group of concerned physicians we urge each Provincial Ministry of Health to review their policies regarding staff and resident safety in long-term care facilities and to openly discuss the concerns of all professionals working in residential and community care.

Many seniors live in communities which do not have specialized units where aggressive behaviours can be managed, and the existing units in centres of higher population are often inaccessible and filled to capacity. We believe that each community should have access to units which are designed and staffed appropriately to care for the very specific population in question. This care should be provided by trained staff, thus minimizing risk, and markedly reducing the inappropriate use of medication. We believe that in this environment the vast majority of aggressive behaviours could be managed, allowing the more specialized tertiary units to deal with the most violent and potentially dangerous patients.

The solutions to this growing problem can only be reached by consulting with front line staff and reviewing funding which might have to be allocated to provide appropriate and safe care. We accept and understand that violence will never be eradicated but it is our duty to our patients to advocate for safe care in the most suitable environment.

We urge you to meet with practising clinicians in your Province to discuss this issue, and to communicate with other jurisdictions and Provinces where changes are being made to address some of the concerns outlined above. The combined effort could lead to a universally accepted,AbbottGeorgePO Box 9050, Stn Prov GovtVictoriaBCV8W 9E2 adequately resourced standard of care, and allow for safe supervision and treatment of the hardworking citizens of this country who have had the misfortune of developing a devastating disease.

We recognize that the Provincial and Federal Governments are aware of the urgency of this and other health care issues, but as a group we respectfully request that due consideration be given to this growing problem.

The Long Term Care Medical Directors Association of Canada is willing to work with all levels of Government to find solutions to all care issues affecting the residents of facilities throughout Canada.

Yours sincerely

Dr Paddy Quail President LTCMDAC Calgary AB

 
Dr Len Aldridge Calgary AB 
Dr David Belcher Drayton Valley AB
Dr Chris Cox  Surrey BC
Dr. Nicholas Cristoveanu Kingston ON
Dr. Ken Dick   Abbotsford, BC
Dr Duncan Etches, Vancouver BC
Dr Doug Faulder Edmonton AB

Dr Serge Gingras Board Member LTCMDAC Montreal QC
Dr Alan Gow Salmon Arm BC
Dr Lyla Graham Ottawa ON
Dr Mary Hurlburt Edmonton AB
Dr Garey Mazowita Vancouver BC
Dr Kathleen McFadden Powell River BC 

Dr Boris A Nahornick Drumheller AB
Dr Gerald Nemanishen, Mission BC

Dr Iris Noland Colborne ON

Dr Murray Reimer Winkler MB

Dr Conrad Rusnak  Vancouver  BC 
Dr Richard Sebba Vancouver BC
Dr Pierre Soucie Ottawa ON
Dr David Strang VP LTCMDAC  Winnipeg MB 
Dr Merrick Tosefsky Coquitlam BC

Dr Diana Turner Calgary AB

Dr.Richard Wadge  Surrey BC

Dr. Arthur G Willms -   Surrey BC

24/10/2007

Hon Dave Hancock

Constituency Office

#203, 596 Riverbend Square

Edmonton, AB T6R 2E3

Dear Minister,

The content of the recent programs on CBC radio and television which focused on the growing incidence of violence in Canadian Long Term Care Facilities has been extensively discussed by members of the Long-Term Care Medical Directors Association of Canada. The outcome of these discussions was a consensus view that violence in residential care facilities is a common occurrence in all parts of Canada and is part of the day-to-day clinical work of physicians practising in this field. Every member of our group can report numerous incidents in which facility residents, with behavioural complications accompanying dementia and other conditions, have caused physical harm to fellow residents or to staff.

We believe that this increase could be related to a number of factors which are new to Canada and which we believe will continue for many years to come.

These factors include but are not limited to;

1. The changing demographics in Canada and the increasing number of seniors who have dementia. (Age is the highest risk factor for developing this disease).

2. The increasing number of seniors diagnosed with dementia who develop behavioural problems as a complication of the disease.

3. The increasing number of seniors with other mental health illnesses such as bipolar disorder and schizophrenia.

4. The policy of integration of seniors with behavioural problems secondary to illness in non- specialized units where there is often a mix of cognitively well and cognitively impaired residents. ( It has certainly been shown that integration of the cognitively well and cognitively impaired residents can be beneficial where no behaviour issues exist)

5. The decrease in staff numbers (particularly RNs) in both Community and Residential Care. This has occurred through cut backs and the growing HR problem related to a shrinking work force pool.

6. The lack of physicians specializing in Psychogeriatrics and Geriatric Medicine.

As a group of concerned physicians we urge each Provincial Ministry of Health to review their policies regarding staff and resident safety in long-term care facilities and to openly discuss the concerns of all professionals working in residential and community care.

Many seniors live in communities which do not have specialized units where aggressive behaviours can be managed, and the existing units in centres of higher population are often inaccessible and filled to capacity. We believe that each community should have access to units which are designed and staffed appropriately to care for the very specific population in question. This care should be provided by trained staff, thus minimizing risk, and markedly reducing the inappropriate use of medication. We believe that in this environment the vast majority of aggressive behaviours could be managed, allowing the more specialized tertiary units to deal with the most violent and potentially dangerous patients.

The solutions to this growing problem can only be reached by consulting with front line staff and reviewing funding which might have to be allocated to provide appropriate and safe care. We accept and understand that violence will never be eradicated but it is our duty to our patients to advocate for safe care in the most suitable environment.

We urge you to meet with practising clinicians in your Province to discuss this issue, and to communicate with other jurisdictions and Provinces where changes are being made to address some of the concerns outlined above. The combined effort could lead to a universally accepted,HancockDaveConstituency Office#203, 596 Riverbend SquareEdmontonABT6R 2E3 adequately resourced standard of care, and allow for safe supervision and treatment of the hardworking citizens of this country who have had the misfortune of developing a devastating disease.

We recognize that the Provincial and Federal Governments are aware of the urgency of this and other health care issues, but as a group we respectfully request that due consideration be given to this growing problem.

The Long Term Care Medical Directors Association of Canada is willing to work with all levels of Government to find solutions to all care issues affecting the residents of facilities throughout Canada.

Yours sincerely

Dr Paddy Quail President LTCMDAC Calgary AB

 
Dr Len Aldridge Calgary AB 
Dr David Belcher Drayton Valley AB
Dr Chris Cox  Surrey BC
Dr. Nicholas Cristoveanu Kingston ON
Dr. Ken Dick   Abbotsford, BC
Dr Duncan Etches, Vancouver BC
Dr Doug Faulder Edmonton AB

Dr Serge Gingras Board Member LTCMDAC Montreal QC
Dr Alan Gow Salmon Arm BC
Dr Lyla Graham Ottawa ON
Dr Mary Hurlburt Edmonton AB
Dr Garey Mazowita Vancouver BC
Dr Kathleen McFadden Powell River BC 

Dr Boris A Nahornick Drumheller AB
Dr Gerald Nemanishen, Mission BC

Dr Iris Noland Colborne ON

Dr Murray Reimer Winkler MB

Dr Conrad Rusnak  Vancouver  BC 
Dr Richard Sebba Vancouver BC
Dr Pierre Soucie Ottawa ON
Dr David Strang VP LTCMDAC  Winnipeg MB 
Dr Merrick Tosefsky Coquitlam BC

Dr Diana Turner Calgary AB

Dr.Richard Wadge  Surrey BC

Dr. Arthur G Willms -   Surrey BC

24/10/2007

Hon Len Taylor

Room 346, Legislative Building

2405, Legislative Drive

Regina, SK S4S 0B3

Dear Minister,

The content of the recent programs on CBC radio and television which focused on the growing incidence of violence in Canadian Long Term Care Facilities has been extensively discussed by members of the Long-Term Care Medical Directors Association of Canada. The outcome of these discussions was a consensus view that violence in residential care facilities is a common occurrence in all parts of Canada and is part of the day-to-day clinical work of physicians practising in this field. Every member of our group can report numerous incidents in which facility residents, with behavioural complications accompanying dementia and other conditions, have caused physical harm to fellow residents or to staff.

We believe that this increase could be related to a number of factors which are new to Canada and which we believe will continue for many years to come.

These factors include but are not limited to;

1. The changing demographics in Canada and the increasing number of seniors who have dementia. (Age is the highest risk factor for developing this disease).

2. The increasing number of seniors diagnosed with dementia who develop behavioural problems as a complication of the disease.

3. The increasing number of seniors with other mental health illnesses such as bipolar disorder and schizophrenia.

4. The policy of integration of seniors with behavioural problems secondary to illness in non- specialized units where there is often a mix of cognitively well and cognitively impaired residents. ( It has certainly been shown that integration of the cognitively well and cognitively impaired residents can be beneficial where no behaviour issues exist)

5. The decrease in staff numbers (particularly RNs) in both Community and Residential Care. This has occurred through cut backs and the growing HR problem related to a shrinking work force pool.

6. The lack of physicians specializing in Psychogeriatrics and Geriatric Medicine.

As a group of concerned physicians we urge each Provincial Ministry of Health to review their policies regarding staff and resident safety in long-term care facilities and to openly discuss the concerns of all professionals working in residential and community care.

Many seniors live in communities which do not have specialized units where aggressive behaviours can be managed, and the existing units in centres of higher population are often inaccessible and filled to capacity. We believe that each community should have access to units which are designed and staffed appropriately to care for the very specific population in question. This care should be provided by trained staff, thus minimizing risk, and markedly reducing the inappropriate use of medication. We believe that in this environment the vast majority of aggressive behaviours could be managed, allowing the more specialized tertiary units to deal with the most violent and potentially dangerous patients.

The solutions to this growing problem can only be reached by consulting with front line staff and reviewing funding which might have to be allocated to provide appropriate and safe care. We accept and understand that violence will never be eradicated but it is our duty to our patients to advocate for safe care in the most suitable environment.

We urge you to meet with practising clinicians in your Province to discuss this issue, and to communicate with other jurisdictions and Provinces where changes are being made to address some of the concerns outlined above. The combined effort could lead to a universally accepted,TaylorLenRoom 346, Legislative Building2405, Legislative DriveReginaSKS4S 0B3 adequately resourced standard of care, and allow for safe supervision and treatment of the hardworking citizens of this country who have had the misfortune of developing a devastating disease.

We recognize that the Provincial and Federal Governments are aware of the urgency of this and other health care issues, but as a group we respectfully request that due consideration be given to this growing problem.

The Long Term Care Medical Directors Association of Canada is willing to work with all levels of Government to find solutions to all care issues affecting the residents of facilities throughout Canada.

Yours sincerely

Dr Paddy Quail President LTCMDAC Calgary AB

 
Dr Len Aldridge Calgary AB 
Dr David Belcher Drayton Valley AB
Dr Chris Cox  Surrey BC
Dr. Nicholas Cristoveanu Kingston ON
Dr. Ken Dick   Abbotsford, BC
Dr Duncan Etches, Vancouver BC
Dr Doug Faulder Edmonton AB

Dr Serge Gingras Board Member LTCMDAC Montreal QC
Dr Alan Gow Salmon Arm BC
Dr Lyla Graham Ottawa ON
Dr Mary Hurlburt Edmonton AB
Dr Garey Mazowita Vancouver BC
Dr Kathleen McFadden Powell River BC 

Dr Boris A Nahornick Drumheller AB
Dr Gerald Nemanishen, Mission BC

Dr Iris Noland Colborne ON

Dr Murray Reimer Winkler MB

Dr Conrad Rusnak  Vancouver  BC 
Dr Richard Sebba Vancouver BC
Dr Pierre Soucie Ottawa ON
Dr David Strang VP LTCMDAC  Winnipeg MB 
Dr Merrick Tosefsky Coquitlam BC

Dr Diana Turner Calgary AB

Dr.Richard Wadge  Surrey BC

Dr. Arthur G Willms -   Surrey BC

24/10/2007

Hon Theresa Oswald

302 Legislative Building

450 Broadway

Winnipeg, Manitoba R3C 0V8

Dear Minister,

The content of the recent programs on CBC radio and television which focused on the growing incidence of violence in Canadian Long Term Care Facilities has been extensively discussed by members of the Long-Term Care Medical Directors Association of Canada. The outcome of these discussions was a consensus view that violence in residential care facilities is a common occurrence in all parts of Canada and is part of the day-to-day clinical work of physicians practising in this field. Every member of our group can report numerous incidents in which facility residents, with behavioural complications accompanying dementia and other conditions, have caused physical harm to fellow residents or to staff.

We believe that this increase could be related to a number of factors which are new to Canada and which we believe will continue for many years to come.

These factors include but are not limited to;

1. The changing demographics in Canada and the increasing number of seniors who have dementia. (Age is the highest risk factor for developing this disease).

2. The increasing number of seniors diagnosed with dementia who develop behavioural problems as a complication of the disease.

3. The increasing number of seniors with other mental health illnesses such as bipolar disorder and schizophrenia.

4. The policy of integration of seniors with behavioural problems secondary to illness in non- specialized units where there is often a mix of cognitively well and cognitively impaired residents. ( It has certainly been shown that integration of the cognitively well and cognitively impaired residents can be beneficial where no behaviour issues exist)

5. The decrease in staff numbers (particularly RNs) in both Community and Residential Care. This has occurred through cut backs and the growing HR problem related to a shrinking work force pool.

6. The lack of physicians specializing in Psychogeriatrics and Geriatric Medicine.

As a group of concerned physicians we urge each Provincial Ministry of Health to review their policies regarding staff and resident safety in long-term care facilities and to openly discuss the concerns of all professionals working in residential and community care.

Many seniors live in communities which do not have specialized units where aggressive behaviours can be managed, and the existing units in centres of higher population are often inaccessible and filled to capacity. We believe that each community should have access to units which are designed and staffed appropriately to care for the very specific population in question. This care should be provided by trained staff, thus minimizing risk, and markedly reducing the inappropriate use of medication. We believe that in this environment the vast majority of aggressive behaviours could be managed, allowing the more specialized tertiary units to deal with the most violent and potentially dangerous patients.

The solutions to this growing problem can only be reached by consulting with front line staff and reviewing funding which might have to be allocated to provide appropriate and safe care. We accept and understand that violence will never be eradicated but it is our duty to our patients to advocate for safe care in the most suitable environment.

We urge you to meet with practising clinicians in your Province to discuss this issue, and to communicate with other jurisdictions and Provinces where changes are being made to address some of the concerns outlined above. The combined effort could lead to a universally accepted,OswaldTheresa302 Legislative Building450 BroadwayWinnipegManitobaR3C 0V8 adequately resourced standard of care, and allow for safe supervision and treatment of the hardworking citizens of this country who have had the misfortune of developing a devastating disease.

We recognize that the Provincial and Federal Governments are aware of the urgency of this and other health care issues, but as a group we respectfully request that due consideration be given to this growing problem.

The Long Term Care Medical Directors Association of Canada is willing to work with all levels of Government to find solutions to all care issues affecting the residents of facilities throughout Canada.

Yours sincerely

Dr Paddy Quail President LTCMDAC Calgary AB

 
Dr Len Aldridge Calgary AB 
Dr David Belcher Drayton Valley AB
Dr Chris Cox  Surrey BC
Dr. Nicholas Cristoveanu Kingston ON
Dr. Ken Dick   Abbotsford, BC
Dr Duncan Etches, Vancouver BC
Dr Doug Faulder Edmonton AB

Dr Serge Gingras Board Member LTCMDAC Montreal QC
Dr Alan Gow Salmon Arm BC
Dr Lyla Graham Ottawa ON
Dr Mary Hurlburt Edmonton AB
Dr Garey Mazowita Vancouver BC
Dr Kathleen McFadden Powell River BC 

Dr Boris A Nahornick Drumheller AB
Dr Gerald Nemanishen, Mission BC

Dr Iris Noland Colborne ON

Dr Murray Reimer Winkler MB

Dr Conrad Rusnak  Vancouver  BC 
Dr Richard Sebba Vancouver BC
Dr Pierre Soucie Ottawa ON
Dr David Strang VP LTCMDAC  Winnipeg MB 
Dr Merrick Tosefsky Coquitlam BC

Dr Diana Turner Calgary AB

Dr.Richard Wadge  Surrey BC

Dr. Arthur G Willms -   Surrey BC

24/10/2007

Hon George Smitherman

Hepburn Block

10th Floor, 80 Grosvenor St

Toronto, ON M7A 2C4

Dear Minister,

The content of the recent programs on CBC radio and television which focused on the growing incidence of violence in Canadian Long Term Care Facilities has been extensively discussed by members of the Long-Term Care Medical Directors Association of Canada. The outcome of these discussions was a consensus view that violence in residential care facilities is a common occurrence in all parts of Canada and is part of the day-to-day clinical work of physicians practising in this field. Every member of our group can report numerous incidents in which facility residents, with behavioural complications accompanying dementia and other conditions, have caused physical harm to fellow residents or to staff.

We believe that this increase could be related to a number of factors which are new to Canada and which we believe will continue for many years to come.

These factors include but are not limited to;

1. The changing demographics in Canada and the increasing number of seniors who have dementia. (Age is the highest risk factor for developing this disease).

2. The increasing number of seniors diagnosed with dementia who develop behavioural problems as a complication of the disease.

3. The increasing number of seniors with other mental health illnesses such as bipolar disorder and schizophrenia.

4. The policy of integration of seniors with behavioural problems secondary to illness in non- specialized units where there is often a mix of cognitively well and cognitively impaired residents. ( It has certainly been shown that integration of the cognitively well and cognitively impaired residents can be beneficial where no behaviour issues exist)

5. The decrease in staff numbers (particularly RNs) in both Community and Residential Care. This has occurred through cut backs and the growing HR problem related to a shrinking work force pool.

6. The lack of physicians specializing in Psychogeriatrics and Geriatric Medicine.

As a group of concerned physicians we urge each Provincial Ministry of Health to review their policies regarding staff and resident safety in long-term care facilities and to openly discuss the concerns of all professionals working in residential and community care.

Many seniors live in communities which do not have specialized units where aggressive behaviours can be managed, and the existing units in centres of higher population are often inaccessible and filled to capacity. We believe that each community should have access to units which are designed and staffed appropriately to care for the very specific population in question. This care should be provided by trained staff, thus minimizing risk, and markedly reducing the inappropriate use of medication. We believe that in this environment the vast majority of aggressive behaviours could be managed, allowing the more specialized tertiary units to deal with the most violent and potentially dangerous patients.

The solutions to this growing problem can only be reached by consulting with front line staff and reviewing funding which might have to be allocated to provide appropriate and safe care. We accept and understand that violence will never be eradicated but it is our duty to our patients to advocate for safe care in the most suitable environment.

We urge you to meet with practising clinicians in your Province to discuss this issue, and to communicate with other jurisdictions and Provinces where changes are being made to address some of the concerns outlined above. The combined effort could lead to a universally accepted,SmithermanGeorgeHepburn Block10th Floor, 80 Grosvenor StTorontoONM7A 2C4 adequately resourced standard of care, and allow for safe supervision and treatment of the hardworking citizens of this country who have had the misfortune of developing a devastating disease.

We recognize that the Provincial and Federal Governments are aware of the urgency of this and other health care issues, but as a group we respectfully request that due consideration be given to this growing problem.

The Long Term Care Medical Directors Association of Canada is willing to work with all levels of Government to find solutions to all care issues affecting the residents of facilities throughout Canada.

Yours sincerely

Dr Paddy Quail President LTCMDAC Calgary AB

 
Dr Len Aldridge Calgary AB 
Dr David Belcher Drayton Valley AB
Dr Chris Cox  Surrey BC
Dr. Nicholas Cristoveanu Kingston ON
Dr. Ken Dick   Abbotsford, BC
Dr Duncan Etches, Vancouver BC
Dr Doug Faulder Edmonton AB

Dr Serge Gingras Board Member LTCMDAC Montreal QC
Dr Alan Gow Salmon Arm BC
Dr Lyla Graham Ottawa ON
Dr Mary Hurlburt Edmonton AB
Dr Garey Mazowita Vancouver BC
Dr Kathleen McFadden Powell River BC 

Dr Boris A Nahornick Drumheller AB
Dr Gerald Nemanishen, Mission BC

Dr Iris Noland Colborne ON

Dr Murray Reimer Winkler MB

Dr Conrad Rusnak  Vancouver  BC 
Dr Richard Sebba Vancouver BC
Dr Pierre Soucie Ottawa ON
Dr David Strang VP LTCMDAC  Winnipeg MB 
Dr Merrick Tosefsky Coquitlam BC

Dr Diana Turner Calgary AB

Dr.Richard Wadge  Surrey BC

Dr. Arthur G Willms -   Surrey BC

24/10/2007

Hon Philippe Couillard

Edifice Catherine-De-Longpre

1075, Chemin Sainte Foy, 15e Etage

Quebec, Quebec G1S 2M1

Dear Minister,

The content of the recent programs on CBC radio and television which focused on the growing incidence of violence in Canadian Long Term Care Facilities has been extensively discussed by members of the Long-Term Care Medical Directors Association of Canada. The outcome of these discussions was a consensus view that violence in residential care facilities is a common occurrence in all parts of Canada and is part of the day-to-day clinical work of physicians practising in this field. Every member of our group can report numerous incidents in which facility residents, with behavioural complications accompanying dementia and other conditions, have caused physical harm to fellow residents or to staff.

We believe that this increase could be related to a number of factors which are new to Canada and which we believe will continue for many years to come.

These factors include but are not limited to;

1. The changing demographics in Canada and the increasing number of seniors who have dementia. (Age is the highest risk factor for developing this disease).

2. The increasing number of seniors diagnosed with dementia who develop behavioural problems as a complication of the disease.

3. The increasing number of seniors with other mental health illnesses such as bipolar disorder and schizophrenia.

4. The policy of integration of seniors with behavioural problems secondary to illness in non- specialized units where there is often a mix of cognitively well and cognitively impaired residents. ( It has certainly been shown that integration of the cognitively well and cognitively impaired residents can be beneficial where no behaviour issues exist)

5. The decrease in staff numbers (particularly RNs) in both Community and Residential Care. This has occurred through cut backs and the growing HR problem related to a shrinking work force pool.

6. The lack of physicians specializing in Psychogeriatrics and Geriatric Medicine.

As a group of concerned physicians we urge each Provincial Ministry of Health to review their policies regarding staff and resident safety in long-term care facilities and to openly discuss the concerns of all professionals working in residential and community care.

Many seniors live in communities which do not have specialized units where aggressive behaviours can be managed, and the existing units in centres of higher population are often inaccessible and filled to capacity. We believe that each community should have access to units which are designed and staffed appropriately to care for the very specific population in question. This care should be provided by trained staff, thus minimizing risk, and markedly reducing the inappropriate use of medication. We believe that in this environment the vast majority of aggressive behaviours could be managed, allowing the more specialized tertiary units to deal with the most violent and potentially dangerous patients.

The solutions to this growing problem can only be reached by consulting with front line staff and reviewing funding which might have to be allocated to provide appropriate and safe care. We accept and understand that violence will never be eradicated but it is our duty to our patients to advocate for safe care in the most suitable environment.

We urge you to meet with practising clinicians in your Province to discuss this issue, and to communicate with other jurisdictions and Provinces where changes are being made to address some of the concerns outlined above. The combined effort could lead to a universally accepted,CouillardPhilippeEdifice Catherine-De-Longpre1075, Chemin Sainte Foy, 15e EtageQuebecQuebecG1S 2M1 adequately resourced standard of care, and allow for safe supervision and treatment of the hardworking citizens of this country who have had the misfortune of developing a devastating disease.

We recognize that the Provincial and Federal Governments are aware of the urgency of this and other health care issues, but as a group we respectfully request that due consideration be given to this growing problem.

The Long Term Care Medical Directors Association of Canada is willing to work with all levels of Government to find solutions to all care issues affecting the residents of facilities throughout Canada.

Yours sincerely

Dr Paddy Quail President LTCMDAC Calgary AB

 
Dr Len Aldridge Calgary AB 
Dr David Belcher Drayton Valley AB
Dr Chris Cox  Surrey BC
Dr. Nicholas Cristoveanu Kingston ON
Dr. Ken Dick   Abbotsford, BC
Dr Duncan Etches, Vancouver BC
Dr Doug Faulder Edmonton AB

Dr Serge Gingras Board Member LTCMDAC Montreal QC
Dr Alan Gow Salmon Arm BC
Dr Lyla Graham Ottawa ON
Dr Mary Hurlburt Edmonton AB
Dr Garey Mazowita Vancouver BC
Dr Kathleen McFadden Powell River BC 

Dr Boris A Nahornick Drumheller AB
Dr Gerald Nemanishen, Mission BC

Dr Iris Noland Colborne ON

Dr Murray Reimer Winkler MB

Dr Conrad Rusnak  Vancouver  BC 
Dr Richard Sebba Vancouver BC
Dr Pierre Soucie Ottawa ON
Dr David Strang VP LTCMDAC  Winnipeg MB 
Dr Merrick Tosefsky Coquitlam BC

Dr Diana Turner Calgary AB

Dr.Richard Wadge  Surrey BC

Dr. Arthur G Willms -   Surrey BC

24/10/2007

Hon Michael Murphy

Legislative Building, Centre Block

PO Box 6000

Fredericton, NB E3B 5H1

Dear Minister,

The content of the recent programs on CBC radio and television which focused on the growing incidence of violence in Canadian Long Term Care Facilities has been extensively discussed by members of the Long-Term Care Medical Directors Association of Canada. The outcome of these discussions was a consensus view that violence in residential care facilities is a common occurrence in all parts of Canada and is part of the day-to-day clinical work of physicians practising in this field. Every member of our group can report numerous incidents in which facility residents, with behavioural complications accompanying dementia and other conditions, have caused physical harm to fellow residents or to staff.

We believe that this increase could be related to a number of factors which are new to Canada and which we believe will continue for many years to come.

These factors include but are not limited to;

1. The changing demographics in Canada and the increasing number of seniors who have dementia. (Age is the highest risk factor for developing this disease).

2. The increasing number of seniors diagnosed with dementia who develop behavioural problems as a complication of the disease.

3. The increasing number of seniors with other mental health illnesses such as bipolar disorder and schizophrenia.

4. The policy of integration of seniors with behavioural problems secondary to illness in non- specialized units where there is often a mix of cognitively well and cognitively impaired residents. ( It has certainly been shown that integration of the cognitively well and cognitively impaired residents can be beneficial where no behaviour issues exist)

5. The decrease in staff numbers (particularly RNs) in both Community and Residential Care. This has occurred through cut backs and the growing HR problem related to a shrinking work force pool.

6. The lack of physicians specializing in Psychogeriatrics and Geriatric Medicine.

As a group of concerned physicians we urge each Provincial Ministry of Health to review their policies regarding staff and resident safety in long-term care facilities and to openly discuss the concerns of all professionals working in residential and community care.

Many seniors live in communities which do not have specialized units where aggressive behaviours can be managed, and the existing units in centres of higher population are often inaccessible and filled to capacity. We believe that each community should have access to units which are designed and staffed appropriately to care for the very specific population in question. This care should be provided by trained staff, thus minimizing risk, and markedly reducing the inappropriate use of medication. We believe that in this environment the vast majority of aggressive behaviours could be managed, allowing the more specialized tertiary units to deal with the most violent and potentially dangerous patients.

The solutions to this growing problem can only be reached by consulting with front line staff and reviewing funding which might have to be allocated to provide appropriate and safe care. We accept and understand that violence will never be eradicated but it is our duty to our patients to advocate for safe care in the most suitable environment.

We urge you to meet with practising clinicians in your Province to discuss this issue, and to communicate with other jurisdictions and Provinces where changes are being made to address some of the concerns outlined above. The combined effort could lead to a universally accepted,MurphyMichaelLegislative Building, Centre BlockPO Box 6000FrederictonNBE3B 5H1 adequately resourced standard of care, and allow for safe supervision and treatment of the hardworking citizens of this country who have had the misfortune of developing a devastating disease.

We recognize that the Provincial and Federal Governments are aware of the urgency of this and other health care issues, but as a group we respectfully request that due consideration be given to this growing problem.

The Long Term Care Medical Directors Association of Canada is willing to work with all levels of Government to find solutions to all care issues affecting the residents of facilities throughout Canada.

Yours sincerely

Dr Paddy Quail President LTCMDAC Calgary AB

 
Dr Len Aldridge Calgary AB 
Dr David Belcher Drayton Valley AB
Dr Chris Cox  Surrey BC
Dr. Nicholas Cristoveanu Kingston ON
Dr. Ken Dick   Abbotsford, BC
Dr Duncan Etches, Vancouver BC
Dr Doug Faulder Edmonton AB

Dr Serge Gingras Board Member LTCMDAC Montreal QC
Dr Alan Gow Salmon Arm BC
Dr Lyla Graham Ottawa ON
Dr Mary Hurlburt Edmonton AB
Dr Garey Mazowita Vancouver BC
Dr Kathleen McFadden Powell River BC 

Dr Boris A Nahornick Drumheller AB
Dr Gerald Nemanishen, Mission BC

Dr Iris Noland Colborne ON

Dr Murray Reimer Winkler MB

Dr Conrad Rusnak  Vancouver  BC 
Dr Richard Sebba Vancouver BC
Dr Pierre Soucie Ottawa ON
Dr David Strang VP LTCMDAC  Winnipeg MB 
Dr Merrick Tosefsky Coquitlam BC

Dr Diana Turner Calgary AB

Dr.Richard Wadge  Surrey BC

Dr. Arthur G Willms -   Surrey BC

24/10/2007

Hon Chris d'Entremont

PO Box 488

Halifax, NS B3J 2R8

Dear Minister,

The content of the recent programs on CBC radio and television which focused on the growing incidence of violence in Canadian Long Term Care Facilities has been extensively discussed by members of the Long-Term Care Medical Directors Association of Canada. The outcome of these discussions was a consensus view that violence in residential care facilities is a common occurrence in all parts of Canada and is part of the day-to-day clinical work of physicians practising in this field. Every member of our group can report numerous incidents in which facility residents, with behavioural complications accompanying dementia and other conditions, have caused physical harm to fellow residents or to staff.

We believe that this increase could be related to a number of factors which are new to Canada and which we believe will continue for many years to come.

These factors include but are not limited to;

1. The changing demographics in Canada and the increasing number of seniors who have dementia. (Age is the highest risk factor for developing this disease).

2. The increasing number of seniors diagnosed with dementia who develop behavioural problems as a complication of the disease.

3. The increasing number of seniors with other mental health illnesses such as bipolar disorder and schizophrenia.

4. The policy of integration of seniors with behavioural problems secondary to illness in non- specialized units where there is often a mix of cognitively well and cognitively impaired residents. ( It has certainly been shown that integration of the cognitively well and cognitively impaired residents can be beneficial where no behaviour issues exist)

5. The decrease in staff numbers (particularly RNs) in both Community and Residential Care. This has occurred through cut backs and the growing HR problem related to a shrinking work force pool.

6. The lack of physicians specializing in Psychogeriatrics and Geriatric Medicine.

As a group of concerned physicians we urge each Provincial Ministry of Health to review their policies regarding staff and resident safety in long-term care facilities and to openly discuss the concerns of all professionals working in residential and community care.

Many seniors live in communities which do not have specialized units where aggressive behaviours can be managed, and the existing units in centres of higher population are often inaccessible and filled to capacity. We believe that each community should have access to units which are designed and staffed appropriately to care for the very specific population in question. This care should be provided by trained staff, thus minimizing risk, and markedly reducing the inappropriate use of medication. We believe that in this environment the vast majority of aggressive behaviours could be managed, allowing the more specialized tertiary units to deal with the most violent and potentially dangerous patients.

The solutions to this growing problem can only be reached by consulting with front line staff and reviewing funding which might have to be allocated to provide appropriate and safe care. We accept and understand that violence will never be eradicated but it is our duty to our patients to advocate for safe care in the most suitable environment.

We urge you to meet with practising clinicians in your Province to discuss this issue, and to communicate with other jurisdictions and Provinces where changes are being made to address some of the concerns outlined above. The combined effort could lead to a universally accepted,d'EntremontChrisPO Box 488HalifaxNSB3J 2R8 adequately resourced standard of care, and allow for safe supervision and treatment of the hardworking citizens of this country who have had the misfortune of developing a devastating disease.

We recognize that the Provincial and Federal Governments are aware of the urgency of this and other health care issues, but as a group we respectfully request that due consideration be given to this growing problem.

The Long Term Care Medical Directors Association of Canada is willing to work with all levels of Government to find solutions to all care issues affecting the residents of facilities throughout Canada.

Yours sincerely

Dr Paddy Quail President LTCMDAC Calgary AB

 
Dr Len Aldridge Calgary AB 
Dr David Belcher Drayton Valley AB
Dr Chris Cox  Surrey BC
Dr. Nicholas Cristoveanu Kingston ON
Dr. Ken Dick   Abbotsford, BC
Dr Duncan Etches, Vancouver BC
Dr Doug Faulder Edmonton AB

Dr Serge Gingras Board Member LTCMDAC Montreal QC
Dr Alan Gow Salmon Arm BC
Dr Lyla Graham Ottawa ON
Dr Mary Hurlburt Edmonton AB
Dr Garey Mazowita Vancouver BC
Dr Kathleen McFadden Powell River BC 

Dr Boris A Nahornick Drumheller AB
Dr Gerald Nemanishen, Mission BC

Dr Iris Noland Colborne ON

Dr Murray Reimer Winkler MB

Dr Conrad Rusnak  Vancouver  BC 
Dr Richard Sebba Vancouver BC
Dr Pierre Soucie Ottawa ON
Dr David Strang VP LTCMDAC  Winnipeg MB 
Dr Merrick Tosefsky Coquitlam BC

Dr Diana Turner Calgary AB

Dr.Richard Wadge  Surrey BC

Dr. Arthur G Willms -   Surrey BC

24/10/2007

Hon Doug W Currie

Second Floor, Jones Building

11 Kent Street, PO Box 2000

Charlottetown, PE C1A 7N8

Dear Minister,

The content of the recent programs on CBC radio and television which focused on the growing incidence of violence in Canadian Long Term Care Facilities has been extensively discussed by members of the Long-Term Care Medical Directors Association of Canada. The outcome of these discussions was a consensus view that violence in residential care facilities is a common occurrence in all parts of Canada and is part of the day-to-day clinical work of physicians practising in this field. Every member of our group can report numerous incidents in which facility residents, with behavioural complications accompanying dementia and other conditions, have caused physical harm to fellow residents or to staff.

We believe that this increase could be related to a number of factors which are new to Canada and which we believe will continue for many years to come.

These factors include but are not limited to;

1. The changing demographics in Canada and the increasing number of seniors who have dementia. (Age is the highest risk factor for developing this disease).

2. The increasing number of seniors diagnosed with dementia who develop behavioural problems as a complication of the disease.

3. The increasing number of seniors with other mental health illnesses such as bipolar disorder and schizophrenia.

4. The policy of integration of seniors with behavioural problems secondary to illness in non- specialized units where there is often a mix of cognitively well and cognitively impaired residents. ( It has certainly been shown that integration of the cognitively well and cognitively impaired residents can be beneficial where no behaviour issues exist)

5. The decrease in staff numbers (particularly RNs) in both Community and Residential Care. This has occurred through cut backs and the growing HR problem related to a shrinking work force pool.

6. The lack of physicians specializing in Psychogeriatrics and Geriatric Medicine.

As a group of concerned physicians we urge each Provincial Ministry of Health to review their policies regarding staff and resident safety in long-term care facilities and to openly discuss the concerns of all professionals working in residential and community care.

Many seniors live in communities which do not have specialized units where aggressive behaviours can be managed, and the existing units in centres of higher population are often inaccessible and filled to capacity. We believe that each community should have access to units which are designed and staffed appropriately to care for the very specific population in question. This care should be provided by trained staff, thus minimizing risk, and markedly reducing the inappropriate use of medication. We believe that in this environment the vast majority of aggressive behaviours could be managed, allowing the more specialized tertiary units to deal with the most violent and potentially dangerous patients.

The solutions to this growing problem can only be reached by consulting with front line staff and reviewing funding which might have to be allocated to provide appropriate and safe care. We accept and understand that violence will never be eradicated but it is our duty to our patients to advocate for safe care in the most suitable environment.

We urge you to meet with practising clinicians in your Province to discuss this issue, and to communicate with other jurisdictions and Provinces where changes are being made to address some of the concerns outlined above. The combined effort could lead to a universally accepted,CurrieDoug WSecond Floor, Jones Building11 Kent Street, PO Box 2000CharlottetownPEC1A 7N8 adequately resourced standard of care, and allow for safe supervision and treatment of the hardworking citizens of this country who have had the misfortune of developing a devastating disease.

We recognize that the Provincial and Federal Governments are aware of the urgency of this and other health care issues, but as a group we respectfully request that due consideration be given to this growing problem.

The Long Term Care Medical Directors Association of Canada is willing to work with all levels of Government to find solutions to all care issues affecting the residents of facilities throughout Canada.

Yours sincerely

Dr Paddy Quail President LTCMDAC Calgary AB

 
Dr Len Aldridge Calgary AB 
Dr David Belcher Drayton Valley AB
Dr Chris Cox  Surrey BC
Dr. Nicholas Cristoveanu Kingston ON
Dr. Ken Dick   Abbotsford, BC
Dr Duncan Etches, Vancouver BC
Dr Doug Faulder Edmonton AB

Dr Serge Gingras Board Member LTCMDAC Montreal QC
Dr Alan Gow Salmon Arm BC
Dr Lyla Graham Ottawa ON
Dr Mary Hurlburt Edmonton AB
Dr Garey Mazowita Vancouver BC
Dr Kathleen McFadden Powell River BC 

Dr Boris A Nahornick Drumheller AB
Dr Gerald Nemanishen, Mission BC

Dr Iris Noland Colborne ON

Dr Murray Reimer Winkler MB

Dr Conrad Rusnak  Vancouver  BC 
Dr Richard Sebba Vancouver BC
Dr Pierre Soucie Ottawa ON
Dr David Strang VP LTCMDAC  Winnipeg MB 
Dr Merrick Tosefsky Coquitlam BC

Dr Diana Turner Calgary AB

Dr.Richard Wadge  Surrey BC

Dr. Arthur G Willms -   Surrey BC

24/10/2007

Hon Leona Aglukkag

Igaluit, NU

Dear Minister,

The content of the recent programs on CBC radio and television which focused on the growing incidence of violence in Canadian Long Term Care Facilities has been extensively discussed by members of the Long-Term Care Medical Directors Association of Canada. The outcome of these discussions was a consensus view that violence in residential care facilities is a common occurrence in all parts of Canada and is part of the day-to-day clinical work of physicians practising in this field. Every member of our group can report numerous incidents in which facility residents, with behavioural complications accompanying dementia and other conditions, have caused physical harm to fellow residents or to staff.

We believe that this increase could be related to a number of factors which are new to Canada and which we believe will continue for many years to come.

These factors include but are not limited to;

1. The changing demographics in Canada and the increasing number of seniors who have dementia. (Age is the highest risk factor for developing this disease).

2. The increasing number of seniors diagnosed with dementia who develop behavioural problems as a complication of the disease.

3. The increasing number of seniors with other mental health illnesses such as bipolar disorder and schizophrenia.

4. The policy of integration of seniors with behavioural problems secondary to illness in non- specialized units where there is often a mix of cognitively well and cognitively impaired residents. ( It has certainly been shown that integration of the cognitively well and cognitively impaired residents can be beneficial where no behaviour issues exist)

5. The decrease in staff numbers (particularly RNs) in both Community and Residential Care. This has occurred through cut backs and the growing HR problem related to a shrinking work force pool.

6. The lack of physicians specializing in Psychogeriatrics and Geriatric Medicine.

As a group of concerned physicians we urge each Provincial Ministry of Health to review their policies regarding staff and resident safety in long-term care facilities and to openly discuss the concerns of all professionals working in residential and community care.

Many seniors live in communities which do not have specialized units where aggressive behaviours can be managed, and the existing units in centres of higher population are often inaccessible and filled to capacity. We believe that each community should have access to units which are designed and staffed appropriately to care for the very specific population in question. This care should be provided by trained staff, thus minimizing risk, and markedly reducing the inappropriate use of medication. We believe that in this environment the vast majority of aggressive behaviours could be managed, allowing the more specialized tertiary units to deal with the most violent and potentially dangerous patients.

The solutions to this growing problem can only be reached by consulting with front line staff and reviewing funding which might have to be allocated to provide appropriate and safe care. We accept and understand that violence will never be eradicated but it is our duty to our patients to advocate for safe care in the most suitable environment.

We urge you to meet with practising clinicians in your Province to discuss this issue, and to communicate with other jurisdictions and Provinces where changes are being made to address some of the concerns outlined above. The combined effort could lead to a universally accepted,AglukkagLeonaIgaluitNU adequately resourced standard of care, and allow for safe supervision and treatment of the hardworking citizens of this country who have had the misfortune of developing a devastating disease.

We recognize that the Provincial and Federal Governments are aware of the urgency of this and other health care issues, but as a group we respectfully request that due consideration be given to this growing problem.

The Long Term Care Medical Directors Association of Canada is willing to work with all levels of Government to find solutions to all care issues affecting the residents of facilities throughout Canada.

Yours sincerely

Dr Paddy Quail President LTCMDAC Calgary AB

 
Dr Len Aldridge Calgary AB 
Dr David Belcher Drayton Valley AB
Dr Chris Cox  Surrey BC
Dr. Nicholas Cristoveanu Kingston ON
Dr. Ken Dick   Abbotsford, BC
Dr Duncan Etches, Vancouver BC
Dr Doug Faulder Edmonton AB

Dr Serge Gingras Board Member LTCMDAC Montreal QC
Dr Alan Gow Salmon Arm BC
Dr Lyla Graham Ottawa ON
Dr Mary Hurlburt Edmonton AB
Dr Garey Mazowita Vancouver BC
Dr Kathleen McFadden Powell River BC 

Dr Boris A Nahornick Drumheller AB
Dr Gerald Nemanishen, Mission BC

Dr Iris Noland Colborne ON

Dr Murray Reimer Winkler MB

Dr Conrad Rusnak  Vancouver  BC 
Dr Richard Sebba Vancouver BC
Dr Pierre Soucie Ottawa ON
Dr David Strang VP LTCMDAC  Winnipeg MB 
Dr Merrick Tosefsky Coquitlam BC

Dr Diana Turner Calgary AB

Dr.Richard Wadge  Surrey BC

Dr. Arthur G Willms -   Surrey BC

24/10/2007

Hon Brad Cathers

Yukon Legislative Assembly

Box 2703

Whitehorse, Yukon Y1A 2C6

Dear Minister,

The content of the recent programs on CBC radio and television which focused on the growing incidence of violence in Canadian Long Term Care Facilities has been extensively discussed by members of the Long-Term Care Medical Directors Association of Canada. The outcome of these discussions was a consensus view that violence in residential care facilities is a common occurrence in all parts of Canada and is part of the day-to-day clinical work of physicians practising in this field. Every member of our group can report numerous incidents in which facility residents, with behavioural complications accompanying dementia and other conditions, have caused physical harm to fellow residents or to staff.

We believe that this increase could be related to a number of factors which are new to Canada and which we believe will continue for many years to come.

These factors include but are not limited to;

1. The changing demographics in Canada and the increasing number of seniors who have dementia. (Age is the highest risk factor for developing this disease).

2. The increasing number of seniors diagnosed with dementia who develop behavioural problems as a complication of the disease.

3. The increasing number of seniors with other mental health illnesses such as bipolar disorder and schizophrenia.

4. The policy of integration of seniors with behavioural problems secondary to illness in non- specialized units where there is often a mix of cognitively well and cognitively impaired residents. ( It has certainly been shown that integration of the cognitively well and cognitively impaired residents can be beneficial where no behaviour issues exist)

5. The decrease in staff numbers (particularly RNs) in both Community and Residential Care. This has occurred through cut backs and the growing HR problem related to a shrinking work force pool.

6. The lack of physicians specializing in Psychogeriatrics and Geriatric Medicine.

As a group of concerned physicians we urge each Provincial Ministry of Health to review their policies regarding staff and resident safety in long-term care facilities and to openly discuss the concerns of all professionals working in residential and community care.

Many seniors live in communities which do not have specialized units where aggressive behaviours can be managed, and the existing units in centres of higher population are often inaccessible and filled to capacity. We believe that each community should have access to units which are designed and staffed appropriately to care for the very specific population in question. This care should be provided by trained staff, thus minimizing risk, and markedly reducing the inappropriate use of medication. We believe that in this environment the vast majority of aggressive behaviours could be managed, allowing the more specialized tertiary units to deal with the most violent and potentially dangerous patients.

The solutions to this growing problem can only be reached by consulting with front line staff and reviewing funding which might have to be allocated to provide appropriate and safe care. We accept and understand that violence will never be eradicated but it is our duty to our patients to advocate for safe care in the most suitable environment.

We urge you to meet with practising clinicians in your Province to discuss this issue, and to communicate with other jurisdictions and Provinces where changes are being made to address some of the concerns outlined above. The combined effort could lead to a universally accepted,CathersBradYukon Legislative AssemblyBox 2703WhitehorseYukonY1A 2C6 adequately resourced standard of care, and allow for safe supervision and treatment of the hardworking citizens of this country who have had the misfortune of developing a devastating disease.

We recognize that the Provincial and Federal Governments are aware of the urgency of this and other health care issues, but as a group we respectfully request that due consideration be given to this growing problem.

The Long Term Care Medical Directors Association of Canada is willing to work with all levels of Government to find solutions to all care issues affecting the residents of facilities throughout Canada.

Yours sincerely

Dr Paddy Quail President LTCMDAC Calgary AB

 
Dr Len Aldridge Calgary AB 
Dr David Belcher Drayton Valley AB
Dr Chris Cox  Surrey BC
Dr. Nicholas Cristoveanu Kingston ON
Dr. Ken Dick   Abbotsford, BC
Dr Duncan Etches, Vancouver BC
Dr Doug Faulder Edmonton AB

Dr Serge Gingras Board Member LTCMDAC Montreal QC
Dr Alan Gow Salmon Arm BC
Dr Lyla Graham Ottawa ON
Dr Mary Hurlburt Edmonton AB
Dr Garey Mazowita Vancouver BC
Dr Kathleen McFadden Powell River BC 

Dr Boris A Nahornick Drumheller AB
Dr Gerald Nemanishen, Mission BC

Dr Iris Noland Colborne ON

Dr Murray Reimer Winkler MB

Dr Conrad Rusnak  Vancouver  BC 
Dr Richard Sebba Vancouver BC
Dr Pierre Soucie Ottawa ON
Dr David Strang VP LTCMDAC  Winnipeg MB 
Dr Merrick Tosefsky Coquitlam BC

Dr Diana Turner Calgary AB

Dr.Richard Wadge  Surrey BC

Dr. Arthur G Willms -   Surrey BC

24/10/2007

Hon Ross Wiseman

Confederation Building , 1st Floor West Block

Box 8700

St John's, NL A1B 4J6

Dear Minister,

The content of the recent programs on CBC radio and television which focused on the growing incidence of violence in Canadian Long Term Care Facilities has been extensively discussed by members of the Long-Term Care Medical Directors Association of Canada. The outcome of these discussions was a consensus view that violence in residential care facilities is a common occurrence in all parts of Canada and is part of the day-to-day clinical work of physicians practising in this field. Every member of our group can report numerous incidents in which facility residents, with behavioural complications accompanying dementia and other conditions, have caused physical harm to fellow residents or to staff.

We believe that this increase could be related to a number of factors which are new to Canada and which we believe will continue for many years to come.

These factors include but are not limited to;

1. The changing demographics in Canada and the increasing number of seniors who have dementia. (Age is the highest risk factor for developing this disease).

2. The increasing number of seniors diagnosed with dementia who develop behavioural problems as a complication of the disease.

3. The increasing number of seniors with other mental health illnesses such as bipolar disorder and schizophrenia.

4. The policy of integration of seniors with behavioural problems secondary to illness in non- specialized units where there is often a mix of cognitively well and cognitively impaired residents. ( It has certainly been shown that integration of the cognitively well and cognitively impaired residents can be beneficial where no behaviour issues exist)

5. The decrease in staff numbers (particularly RNs) in both Community and Residential Care. This has occurred through cut backs and the growing HR problem related to a shrinking work force pool.

6. The lack of physicians specializing in Psychogeriatrics and Geriatric Medicine.

As a group of concerned physicians we urge each Provincial Ministry of Health to review their policies regarding staff and resident safety in long-term care facilities and to openly discuss the concerns of all professionals working in residential and community care.

Many seniors live in communities which do not have specialized units where aggressive behaviours can be managed, and the existing units in centres of higher population are often inaccessible and filled to capacity. We believe that each community should have access to units which are designed and staffed appropriately to care for the very specific population in question. This care should be provided by trained staff, thus minimizing risk, and markedly reducing the inappropriate use of medication. We believe that in this environment the vast majority of aggressive behaviours could be managed, allowing the more specialized tertiary units to deal with the most violent and potentially dangerous patients.

The solutions to this growing problem can only be reached by consulting with front line staff and reviewing funding which might have to be allocated to provide appropriate and safe care. We accept and understand that violence will never be eradicated but it is our duty to our patients to advocate for safe care in the most suitable environment.

We urge you to meet with practising clinicians in your Province to discuss this issue, and to communicate with other jurisdictions and Provinces where changes are being made to address some of the concerns outlined above. The combined effort could lead to a universally accepted,WisemanRossConfederation Building , 1st Floor West BlockBox 8700St John'sNLA1B 4J6 adequately resourced standard of care, and allow for safe supervision and treatment of the hardworking citizens of this country who have had the misfortune of developing a devastating disease.

We recognize that the Provincial and Federal Governments are aware of the urgency of this and other health care issues, but as a group we respectfully request that due consideration be given to this growing problem.

The Long Term Care Medical Directors Association of Canada is willing to work with all levels of Government to find solutions to all care issues affecting the residents of facilities throughout Canada.

Yours sincerely

Dr Paddy Quail President LTCMDAC Calgary AB

 
Dr Len Aldridge Calgary AB 
Dr David Belcher Drayton Valley AB
Dr Chris Cox  Surrey BC
Dr. Nicholas Cristoveanu Kingston ON
Dr. Ken Dick   Abbotsford, BC
Dr Duncan Etches, Vancouver BC
Dr Doug Faulder Edmonton AB

Dr Serge Gingras Board Member LTCMDAC Montreal QC
Dr Alan Gow Salmon Arm BC
Dr Lyla Graham Ottawa ON
Dr Mary Hurlburt Edmonton AB
Dr Garey Mazowita Vancouver BC
Dr Kathleen McFadden Powell River BC 

Dr Boris A Nahornick Drumheller AB
Dr Gerald Nemanishen, Mission BC

Dr Iris Noland Colborne ON

Dr Murray Reimer Winkler MB

Dr Conrad Rusnak  Vancouver  BC 
Dr Richard Sebba Vancouver BC
Dr Pierre Soucie Ottawa ON
Dr David Strang VP LTCMDAC  Winnipeg MB 
Dr Merrick Tosefsky Coquitlam BC

Dr Diana Turner Calgary AB

Dr.Richard Wadge  Surrey BC

Dr. Arthur G Willms -   Surrey BC