Hurrying to meet a looming court deadline, the federal government has given Canadians two weeks to weigh in on how far to extend access to medical aid in dying. The Government of Canada has launched an online public consultation aimed at obtaining Canadian's views on amending the federal medical assistance in dying legislation. Canadians and interested stakeholders are invited to share their views online until January 27, 2020.

Who can provide medical assistance in dying and who can help
Those who can provide medical assistance in dying services are:

• physicians
• nurse practitioners (in provinces where this is allowed)

Those who can help provide medical assistance in dying include:

• pharmacists
• family members or other people that you ask to help
• health care providers who help physicians or nurse practitioners

These people can assist in the process without being charged under criminal law. However, physicians, nurse practitioners and other people who are directly involved must follow:

• the rules set out in the Criminal Code
• applicable provincial and territorial health-related laws, rules and policies

Protecting the right of providers to act according to their beliefs and values

Not all health care providers will be comfortable with medical assistance in dying. The federal practice may not be consistent with a provider's beliefs and values. The federal legislation does not force any person to provide or help to provide medical assistance in dying.
Provincial and territorial governments have the responsibility for determining how and where health care services are provided. They may also make policies around where medical assistance in dying can take place as long as they do not conflict with the Criminal Code.

There are 2 types of medical assistance in dying available to Canadians. They each must include a physician or nurse practitioner who:

• directly administers a substance that causes death, such as an injection of a drug
  • this is becoming known as clinician-administered medical assistance in dying
  • it was previously known as voluntary euthanasia

or

• provides or prescribes a drug that the eligible person takes themselves, in order to bring about their own death
  • this is becoming known as self-administered medical assistance in dying
  • it was previously known as medically assisted suicide or assisted suicide

The consultations will also ask Canadians whether assisted death should be expanded to give people in specific situations access to a doctor or nurse practitioner's help to die:

• So-called "mature minors" — people under age 18 considered by doctors to be capable of directing their own care.
• Cases involving "advance requests" — where a patient stipulates they would like their life to end at a later time when they are no longer competent to give consent.
• And people who wish to end their lives solely because of mental illness.

Process for requesting the service
The legislation contains safeguards to make sure those who ask for medical assistance in dying:

• request the service of their own free will
• are able to make health care decisions for themselves
• are eligible (this means they meet all of the listed criteria)
• can and do give informed consent, which includes being informed of all care options available to them to help relieve suffering

These safeguards will guide health care providers to carry out this service appropriately and in a way that protects people from abuse or misuse.

Talk to your physician or nurse practitioner about end-of-life care options in relation to your medical condition or circumstances.

To participate in the online public consultation: www.justice.gc.ca/eng/cons/ad-am/index.html
 

As of 2016: An estimated 564,000 Canadians are living with dementia. By 2031, this figure is expected to rise to 937,000, an increase of 66 per cent.1 The combined health-care system and out-of-pocket costs of dementia is estimated at $10.4 billion. By 2031, this figure is expected to increase by 60 per cent, to $16.6 billion.1
Footnotes: 1. Prevalence and Monetary Costs of Dementia in Canada, a report by the Alzheimer Society of Canada (2016)

Dementia is a term that generally refers to a variety of brain disorders. Different physical changes to the brain cause different dementias. Some are reversible, meaning that they can be treated and cured, while others are irreversible, meaning there is no cure. Symptoms worsen over time and include: loss of memory, changes in judgment and reasoning, difficulty performing familiar tasks, problems with language and changes in mood and behaviour. Alzheimer’s disease is irreversible and eventually fatal. Other dementias include vascular dementia, frontotemporal dementia (including Pick’s disease), Creutzfeldt-Jakob disease and Lewy body dementia. Dementia is not a normal part of aging, but age is the biggest risk factor.

Stigma is one of the biggest barriers for people with dementia to live fully with dignity and respect. That's why The Alzheimer Society is excited to kick off the second year of their awareness campaign--Yes. I live with dementia. Let me help you understand—to spark conversations and encourage Canadians to see dementia differently.

Once again this year, the experts are doing the talking: people with lived experience. Their vibrant ambassadors are openly and honestly sharing their stories to show Canadians a pathway to understanding. After all, who better to educate the public than those who face stigma every day?
By highlighting the humanity that is part of every single person living with dementia, the awareness campaign seeks to convert judgement into compassion and assumptions into understanding.
It's time to see dementia differently.

Check out ilivewithdementia.ca for useful information and resources to help you learn more and take action to end dementia stigma.

If you are concerned about a family member, loved one or friend experiencing signs of Alzheimer's-give us a call to see how we can help.  

​Photo by Huy Phan on Unsplash

By Amy Zellmer, Brain Injury Association of America Advisory Council member

With the holidays upon us, many brain injury survivors will find themselves facing more overstimulation than normal. This stimulation can cause additional brain fatigue and stress, and in some situations, both fear and panic set in.

Overstimulation is one of the most common consequences of concussion and traumatic brain injury (TBI), and it can be caused by any combination of sounds, images, light, smell, taste, and touch. Because overstimulation can’t be seen, it can be a mystery to those who have never experienced it and can also cause frustration for someone who is going through it and for his or her loved ones who don’t understand it.

I know about overstimulation from personal experience. I have a hard time dealing with a crowded restaurant or busy malls, especially during the holidays when there is too much noise, too many lights, and lots of scents. I have a hard time focusing when there is a lot of background noise, and I am unable to carry on a conversation or make sense of what I am trying to do. I will leave the mall feeling completely exhausted, and I often develop a headache to go with my exhaustion. I usually tire out before my 78-year-old mother, who can shop circles around me.

Here is my list of six simple things you can do to make the holidays easier on yourself or a loved one who is dealing with overstimulation.

1. Stay hydrated. 
The brain functions best when it is fully hydrated. When you are out shopping, it is easy to become dehydrated rather quickly. You can combat this by always having a water bottle with you and refilling it often. As tempting as it is, drinking alcohol and caffeine will cause you to become dehydrated, so it is best to avoid alcohol and caffeine when you know you are going to be faced with overstimulation.

2. Keep additional stimulation to a minimum. 
Decrease the amount of stimulation in places where you have control. If you know you’re headed to the mall or a crowded restaurant, don’t watch television before heading out or listen to the radio on the way there. If you’re going with friends or loved ones, explain to them that you might not be able to have a conversation while you’re there. Bring your sunglasses and earplugs along, and use them if necessary.

3. Get additional rest. 
While this one seems obvious, it is sometimes hard to do with the hustle and bustle of the holiday season. Rest is critical to help your brain recover from overstimulation. Take a nap before or after your outing, and do your best to get a good night’s sleep each night. Give yourself a designated bedtime, and stick with a schedule throughout the holidays.

4. Take shorter trips. 
If you have a lot to do, you may want to consider breaking it up into smaller trips. I find it easier to do one errand each day rather than trying to cram five things into one outing. It may take longer, but your brain will thank you.

5. Write lists. 
I am the queen of sticky notes and shopping lists. Why add additional stress to the situation by going shopping without a clear list of where you need to go and what you need to buy? Even with a list, it is easy to feel overwhelmed and out of sorts. Having a plan that details exactly where you need to go and what you need to purchase at each location will help keep your stress levels down and keep you organized.

6. Ask for help. 
It can be hard to do, but sometimes you need to ask for help – whether it’s asking for someone to drive you somewhere, carry your bags, or even run an errand for you. It’s best to know when you’ve reached your limit (preferably before you’ve reached your limit) and ask for help. If you are a friend or loved one of a person with a brain injury, offer to help before you are asked – or better yet, do something that’s on your loved one’s list before you see that he or she needs assistance.

If you are a caregiver, family member, or friend of a brain injury survivor, please understand that overstimulation is very real. Allow us to take the steps needed to ensure our health and sanity this holiday season and all year round.

To all my fellow brain injury survivors, I wish you a wonderful holiday season filled with peace, joy, and love. Take care of yourself, and give yourself grace when needed. It is easy to push ourselves because we feel like we have so much to do; however, it is important to know when to step back… and take a nap.

About the Author: 
Amy Zellmer is an award-winning author, speaker, and advocate of traumatic brain injury (TBI). She is a former member of the Brain Injury Association of America’s Advisory Council (BIAAAC) and travels the country with her Yorkie, Pixxie, to help raise awareness about this silent and invisible injury that affects over 2.5 million Americans each year. One of her books, Life With a Traumatic Brain Injury: Finding the Road Back to Normal, can be purchased from BIAA’s Online Marketplace.


This article originally appeared in Volume 10, Issue 4 of THE Challenge! published in 2016.
Photo by jesse orrico on Unsplash
 

Ontario's senior driver programs aim to keep seniors driving for as long as they can safely do so.
Once drivers reach 80 years of age, every two years they must:

• Take a vision test
• Undergo a driver record review
• Participate in a 45-minute Group Education Session (GES)
• During the GES, complete two, brief, non-computerized in-class screening assignments
• If necessary, take a road test

Encourage seniors to increase their safety on the road with these tips:

• Stay active to maintain flexibility and strength
• Make sure brakes, steering wheel, and seats function smoothly
• Drive at times of day with good visibility
• Keep up to date on vision and hearing checks
• Use adaptors like extra mirrors
• Leave extra space between vehicles and stay below the speed limit
• Ask doctors about medications and their effects on driving
(National Institute on Aging)

Changes influencing Seniors on the road given how experienced most of them are as drivers, it can be hard for seniors to accept there are safety concerns about their driving. It’s important for them to know this isn’t because they are “bad drivers.” Age-related changes that affect driving for seniors include:

• Limited vision or hearing
• Decreased reaction time, judgment, or attention due to health conditions
• Poor posture
• Weakness when operating a steering wheel, brakes, etc.
• Memory loss that leads to getting lost or confused
• Medications that impair judgment and reaction times

Night-time driving exacerbates the effects of these changes on senior safety as well. 

Conversation Starters for your Senior: 
 
Driving can be a sensitive topic for seniors. Use these questions to start conversations:

• Have you noticed any scratches or dents on your car recently?
• Have you experienced anything frightening on the road lately?
• Do any of your medications affect how you feel when driving?
• Are there any signs on your usual route that have been hard to spot?
• What’s the best route to get between (two points senior should be familiar with)?
• Would it be helpful to you if you didn’t have to drive all the time?
(National Highway Traffic Safety Administration)
 
If you have questions about the Ontario Seniors Driving program, please call 1-800-396-4233 or 
visit: www.mto.gov.on.ca/english/driver/senior-driver-licence-renewal-program.shtml

Dr. Anthony Levinson writes- do you wonder if your loved one with dementia is taking too many medications? This is a concern for many older adults, with or without cognitive impairment.

In this video recording, hear what Dr. Joanne Ho, Geriatrician, and co-founder of GeriMedRisk, has to say about how to begin the conversation with your healthcare team and what needs to be considered when trying to reducing the number of medications that a person is taking. Learn the answers to the following questions:

• How does aging impact how medications may work?
• How does smoking impact the effectiveness of a drug?
• What is ‘pill burden’? How can this be managed?

Get the information you need to confidently discuss this with your healthcare team which includes your pharmacist.

Antibiotic resistance is one of the most urgent health threats we face globally.

Why Think Twice, and Seek Advice?
Antibiotics don’t work against common cold and flu viruses and are often unnecessary for some bacterial infections. Despite these facts, inappropriate antibiotic prescription remains common in Canada–estimated at over 30% of all prescriptions, and 50% of prescriptions for respiratory infections.
As drug-resistant infections increase, it is clear that Canadians need to ‘rethink’ and learn about antibiotics. We must consider the risks alongside the benefits of antibiotics. We must ask questions to understand where we can reduce needless antibiotic use.  

What are antibiotics and antibiotic resistance?
Antibiotics are life-saving medications that we rely on to prevent and treat many infections caused by bacteria. But when bacteria are exposed to antibiotics, they adapt and develop characteristics that allow them to fend off or disable antibiotics. Greater exposure to antibiotics accelerates these changes. Bacteria that develop resistance are not killed and continue to multiply. Resistant bacteria are difficult, and sometimes impossible to treat.

What are the consequences of antibiotic resistance?
By 2050, if we continue using antibiotics as we are now, approximately 10 million people worldwide will die from resistant organisms each year--more than the number of deaths caused by cancer. 

In Canada, a growing number of infections are not responding to antibiotics. Tuberculosis, gonorrhea, and urinary tract infections are becoming harder, and sometimes impossible, to treat.  In some provinces, experts estimate that tens of thousands of illnesses per year result from resistant bacteria.
Without effective antibiotics, other treatments will also become risky. Patients requiring surgery and chemotherapy will be poorly protected from the risks of life-threatening infections.

What you can do!
One of the best ways to combat antibiotic resistance is to ask questions—will an antibiotic help? Patients, talk to your prescriber. Practitioners, consult guidelines and experts in optimal prescribing.  ​

Take the quiz below! 

Photo by Curology on Unsplash

You need soap, water and 20 seconds.The single most important thing you can do to keep from getting sick and to stop the spread of disease-causing germs is to wash your hands — often. All it takes is soap and water, 20 seconds of scrubbing hands and wrists, and then a good rinse.

​Viruses that cause colds and the flu most often are transmitted on the hands. People commonly catch colds when they rub their nose or their eyes after their hands have been contaminated with the cold virus. By washing your hands frequently, you wash away germs that you may have picked up from other people or from contaminated surfaces.

Parents can encourage their children by setting an example. Wash hands often in front of children to teach them that hand washing with soap and water is more than a chore — it's an important way to prevent colds, sore throats and other infections. Also, because dirty hands often can carry germs, teaching children to keep their hands away from their eyes, nose and mouth also will help prevent illness. Make hand washing fun for kids by singing “Happy Birthday” twice while they rub their hands together with soap and water. This way, you’ll be sure they washed for a good 20 seconds.

Hand washing takes on an especially important role during the winter months, when infectious diseases such as the flu are in season. (If you haven’t already, consider getting a flu shot.) You also can protect your health during cold and flu season by getting plenty of sleep, exercising, eating nutritious foods and drinking plenty of fluids. Also, remember to cover your mouth when coughing or sneezing and avoid rubbing your eyes and nose. Stay away from crowds when possible, and don't share food or drinks.

The Centers for Disease Control and Prevention recommends that you cover your mouth and nose with a tissue when you cough or sneeze, and then wash your hands for 20 seconds with soap and water or an alcohol-based hand cleaner. This practice will help avoid spreading germs to others. If you don’t have a tissue, cough or sneeze into your elbow or shoulder instead of your hands.

​The bottom line is that hand washing is easy and effective. This season, with proper hand washing, you can protect your health and help prevent the spread of colds and flu to others.

Source: my.clevelandclinic.org/health/treatments/17474-a-simple-secret-for-staying-well-wash-your-hands

Photo Credit: City of Burlington

As November 11th quickly approaches, below is a list of Ceremonies and Events happening across Hamilton & Burlington. We would like to Thank our Veterans for their Service to our Country- Lest We Forget. 

Hamilton Remembrance Garrison Service & Parade
Sunday, November 10, 2019
10:45 am to 11:45 am
Veterans’ Place at Gore Park, 64 King Street East, Hamilton
Join us for a Remembrance Day parade at the cenotaph in Veterans’ Place at Gore Park as we honour Hamilton’s veterans and service men and women.
View event
 
Ancaster Remembrance Day Service
Monday, November 11, 2019
10:30 am to 11:15 am
Ancaster Old Town Hall, 310 Wilson Street East, Ancaster
View event
 
Dundas Remembrance Day Parade and Service
Monday, November 11, 2019
10:30 am to 11:15 am
Dundas Cenotaph at the Dundas Lions Memorial Community Centre, 10 Market Street South, Hamilton
View event
 
Lynden Remembrance Day Service
Monday, November 11, 2019
10:30 am to 11:15 am
Royal Canadian Legion - Beverly Branch 500, 206 Lynden Road, Lynden
View event
 
Mount Hope Remembrance Day Service
Monday, November 11, 2019
10:30 am to 11:15 am
Canadian Warplane Heritage Museum, 9280 Airport Road, Mount Hope
View event
 
Royal Canadian Legion Branch 163 Remembrance Day Service
Monday, November 11, 2019
10:30 am to 11:15 am
Royal Canadian Legion - Branch 163, 435 Limeridge Road East, Hamilton
View event
 
Stoney Creek Remembrance Day Parade and Service
Monday, November 11, 2019
10:30 am to 11:15 am
Stoney Creek Cenotaph, King Street & Highway 8, Hamilton
View event
 
Hamilton Remembrance Day Service
Monday, November 11, 2019
10:45 am to 11:30 am
Veterans’ Place at Gore Park, 64 King Street East, Hamilton
View event
 
Waterdown Remembrance Day Service
​Monday, November 11, 2019
10:45 am to 11:30 am
Royal Canadian Legion - Waterdown Branch 55, 79 Hamilton Street North, Waterdown
View event
 
For information about roads impacted by Remembrance Day services, visit
hamilton.ca/roadclosures to find the list of temporary road closures for special events.

Burlington:
9 a.m.
Sunrise Remembrance Day Service
This 30-minute ceremony takes place at the Naval Ships Memorial Monument in Spencer Smith Park. For more information, contact the Burl-Oak Veterans at 905-632-3118.
-Spencer Smith Park

10:15 a.m.
Remembrance Day Parade
-The parade starts at Central Public School.
Brant to Elgin Street, Elgin to Locust Street, Locust to Ontario Street, Ontario to Brant, returning to Central Public School after the Service.

11 a.m.
Remembrance Day Service
This 45 to 60 minute ceremony is held at the Cenotaph, on the north side of City Hall. For more information, contact the Royal Canadian Legion Branch 60 at 905-639-6400.
-Cenotaph, City Hall
(426 Brant St.)

 

Photo by Srikanta H. U on Unsplash
Article Written By Tim and Gina Murray - Aging Matters

Even in the closest families, aging parents and changes of a new life season can create discord.
For some families struggling years before a parent needs help, dysfunction escalates issues and even affects the senior’s care.

Defining dysfunction — The weight of caring for an aging loved one can bring challenging family dynamics. Some deal with power struggles around health decisions and finances, and others deal with dishonesty or fractured relationships.

When family issues affect a senior’s care — A spouse may not be ready to relinquish every day duties or may not feel their partner requires the level of care the rest of the family does. Perhaps siblings will communicate only with their parent and not each other, putting Mom in a high-pressure place when she needs to be focused on her own well-being.
These tensions can affect the day-to-day lives of seniors and their care teams, here are a few tips to combat them:

• Set rules and stick to them — Providing compassionate care for seniors is like following a sheet of music; we want everyone singing in unison. It’s important to narrow down and map out the family’s top two or three goals – not 10 or 20 – and share them with the client and their family. You won’t be able to accommodate everyone’s opinion, and sometimes family members will try to undermine what’s happening. Stand your ground; prioritize and stick to the agreed-upon plan.
• Find a spot for everyone — Bringing in help can shake up a family’s roles, and that’s often unsettling for adult children and seniors alike. We recommend finding a “job” for everyone, whether that’s playing a favourite game or music with a parent, bringing out old photographs or discussing cherished memories. When everyone feels like a part of the team, they’re more likely to cooperate and support the care plan.
• Recognize when people are doing their best — A common issue is the fight to have each child contribute equally in time, finances and support.

Whether someone truly cannot or just doesn’t want to be hands-on, encourage the family members to recognize that people can only give what they can. How else could they contribute? Twice-monthly phone calls? Increased financial support? Showing that you care is pivotal, but recognizing when others are doing the same can turn a strained situation.

If we can’t meet everyone’s goals, we step back and figure out what else we can do for a family as. often, dysfunction is a result of a new and unfamiliar situation.

Link for Original Article:
​www.urbanacitizen.com/opinion/columns/72793/when-family-dysfunction-disrupts-in-home-care?fbclid=IwAR2-VG_oXhPL392UNiMN-_lR87-_dNakI5t6kab7dA2WsP9QfKc5KJWOx1E
 

Photo by David Menidrey on Unsplash

Halloween is just around the corner yet as fun as it is, it increases safety concerns for the elderly- especially those with mental and/or physical complications, such as Dementia and increased risk of falls.
Some factors that contribute to these concerns include:

• Decorations
• Costumes
• Wet pavements
• Falling leaves
• Less daylight hours
• Changing weather conditions

Consider the following tips to help alleviate these concerns for your elderly loved one, friend or neighbour:

• Keep all floors, entry ways and porches free of decorations.
• Add night lights to hallways, walkways and rooms, and keep well lit.
• Avoid window decorations that block light or view of front or side doors.
• Use only safe pumpkin carving tools, light pumpkin with flame-less votive.
• Place carved pumpkins outside to keep decaying smell and bugs outside.
• Spend the evening with them, be available to help answer door, keep them safe.
• When done with candy, or at dusk: Put a sign on door, “Sorry No More Candy”.
• There is debate on turning off porch light, which can increase security risk

Don’t leave an elder with Dementia or physical limitations home alone on Halloween…

• Take them to a community event or family home, and return home after dusk.
• Send a companion to be with them from 4:00pm-10:00pm or overnight if needed.
• Help them answer the door and hand out candy if they wish.
• Watch a movie or listen to music in another room away from front door if possible.
• Be prepared; books, albums, crafts, favourite foods, etc. to enjoy and distract.
• Follow dietary instructions; avoid over indulgence of chocolate or sugar.
• Remember Halloween may not be a happy time for our elderly with Dementia and they may be scared from the added stimulation of doorbell, knocks, noise outside. Be sensitive to what they can tolerate and do your best to keep them safe and enjoy the evening with you.