Category Archives: Articles

Crisis Behind Closed Doors

Data obtained through a Freedom of Information request shows nearly half of all seniors in long-term care in BC are being given antipsychotics like Risperdal, Zyprexa and Seroquel. That’s almost twice the average for the rest of Canada and amongst the highest rates found anywhere in the world. And even though Health Canada warns these drugs cause a doubling of death rates in the elderly, care workers admit they’re mainly being used as chemical restraints in the absence of adequate staffing and proper oversight.

“IT WILL RELAX YOU.” That’s the only explanation hospital staff gave when administering the antipsychotic medication to Carl. At least, that’s the only reason he recalls—soon he began experiencing “very strange cognitive feelings.”

“I’m a reasonably logical person,” he says, but suddenly he was in a “swimmy universe that didn’t make any sense.”

Carl (not his real name) became indifferent to his normal interests; inexplicably disengaged when friends visited: “like I was talking to them through a tunnel.” He felt as if he was in a “mind meld” with the Alzheimer’s patient next to him, losing his memory and connection to the world. Though he reportedly looked more docile, inwardly he was intensely disturbed. “I wasn’t relaxed at all.”

Carl didn’t understand what was happening and assumed the serious physical illness for which he was receiving treatment was the cause. Yet his experiences come straight out of the clinical drug literature.

A 2009 study of people’s subjective experiences with taking antipsychotics found many complained about “cognitive impairment” and “emotional flattening,” while few mentioned calmness or relaxation.

Antipsychotics are a class of tranquillizing drugs routinely used to help rein in the minds of people diagnosed with intense schizophrenia. In recent years, they’ve been used increasingly (albeit usually in smaller doses) to “calm” elderly people with dementia in hospitals and long-term care facilities.

Yet they’re hardly benign. Now widely described in medical literature as “chemical restraints,” common effects include foggy somnolence and disorientation, cognitive impairment, akathisia or “inner agitation,” extreme weight gain, diabetes, loss of muscle control, and muscle rigidity. Within a year of use, fully one-third of seniors will have Parkinson’s-like tremors from drug-induced brain damage. Within several months of use, death rates of seniors double—mainly from heart attacks.

Fortuitously for Carl, one long-time friend visiting him daily happened to be a nurse. She knew his illness could’ve precipitated some temporary psychological slippage, but nothing like what she was seeing.

“His personality was changing,” she says. “His cognitive level was changing in a downward spiral.”

But hospital staff barely knew Carl except in this irrational, helpless state, so they told her she should prepare for her 65-year-old, recently retired friend to spend the rest of his days in a nursing home.

After hearing of Carl’s story, I wondered: How many more like him are there?

 

Half of all residents are given antipsychotics

For two years, I tried to find out how many seniors in BC long-term care facilities were being given antipsychotics. Freedom of Information deadlines came and went. Not a single report, document, or email appeared.

It seemed unbelievable that this number wasn’t known. Since 2002, Health Canada has been repeatedly warning doctors against using antipsychotics in seniors with dementia because of the doubling of death rates. Nevertheless, antipsychotic use in Canadian nursing homes has continued rising inexorably, and alarm has been spreading through the medical literature and media. In 2006, BC spent $76 million on antipsychotics, making them our fifth most expensive class of drugs (for comparison, that’s double the arts and sports funding in our provincial budget). Yet no one in BC’s health ministry had the slightest interest?

Even my contact at the Office of the Information and Privacy Commissioner became frustrated with my persistence. “I can’t keep going back just telling them to search again,” he said. Repeatedly.

And then in March of this year, it magically appeared (see downloadable document below). A provincial-wide analysis using PharmaNet data had been completed months before I’d first asked to see one in 2009.

So now we know: Nearly half (47.3 percent) of seniors in long term care facilities in BC are taking antipsychotics. That’s close to double the US and Canadian average of 26 percent, and four times the rate of Hong Kong, which is at the low end of the spectrum.

“Do we have any answers…as to why BC has a higher use of antipsychotics in LTC [long-term care]?” wrote Darlene Therrien, a health ministry research and policy director who was wondering if a methodological error could be producing such huge BC numbers.

“I can’t see any issues in the data that would explain it,” emailed analyst Brett Wilmer. “I’m pretty sure it’s a health system phenomena…”

When I received these documents, I requested interviews. Ministry of Health spokesperson Ryan Jabs emailed back, “I can’t find a person from the program area who is comfortable speaking with media on this topic.”

So we’re left on our own to figure out what those BC health system “phenomena” are—and how dangerous they might be.

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Making Our Circles Bigger

A plethora of young groups are bringing extremely diverse people together to share knowledge, ideas and perspectives. Can getting us out of our silos lead to new types of collaboration, community building and social solutions?

I arrive at the Victoria Event Centre not knowing exactly what to expect at a “PechaKucha.” I leave a couple hours later having had a great time—but still not knowing exactly what I’ve experienced. However, I’m becoming increasingly sure it’s part of a growing local and international social movement of immense vitality, astonishing creative breadth, and intriguing political possibilities.

PechaKucha nights, I’ve discovered, are just one of a growing number of unusual ways that diverse Victorians are being brought together to share ideas and explore collaborative possibilities through relaxed, open processes. Some are even trying to generate new approaches to tackling serious social problems.

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Captains of Local Government Plotting New Course?

A recent conference of municipal planners and politicians in Victoria revealed a suprising undercurrent of sustainability radicalism

 

 

Fifteen minutes in, the discussion on “Engaging Your Community in Sustainability Initiatives” turned unexpectedly—and suddenly, everyone became much more engaged. The Capital Regional District, currently trying to engage politicians and the public in its own Regional Sustainability Strategy, would do well to take note.

It wasn’t that the first speaker that February morning in the Victoria Conference Centre had been boring. In fact, the delegates to the Federation of Canadian Municipalities’ “Sustainable Communities Conference” attending this forum—about two hundred of them—had seemed quite attentive. Satya Rhodes-Conway, an alderperson from Wisconsin, had spoken with thoughtful bubbliness about local governments taking the lead on making buildings energy efficient, handing out cameras to schoolkids to document a city’s most unappealing areas to walk, and giving mini-grants to non-profits to do education and outreach. “If you engage the people,” she’d said, “they will make it happen.”

Then Sevag Pogharian started talking. Immediately, bursts of raucous laughter and spontaneous applauding were ripping off the veneer of polite optimism we’d all evidently been holding onto. Continue reading

Forget Chickens; Invest in Eggs

Our general belief that jobs are created by businesses needs a little refinement

 

When Mayor Dean Fortin began proposing a gradual reduction of the business tax rate in Victoria relative to the residential rate, he argued it would help protect and create jobs. In resounding endorsement, the Canadian Federation of Independent Business agreed it would help companies “hire more staff”. A feature in the Greater Victoria Chamber of Commerce’s “Business Matters” magazine, “Local Government’s Role in Business Prosperity”, similarly endorsed this idea.

When federal finance minister Jim Flaherty announced the Conservatives’ latest corporate tax cuts, he explained that this would allow Canadian businesses to “create jobs”.

When the Smart Tax Alliance coalition of BC businesses came out swinging in defence of the Harmonized Sales Tax, chairman John Winter’s primary argument was that the eased tax burden on businesses would help them “create jobs”.

When discussing the Wisconsin state government’s now infamous efforts to squash public sector workers’ rights while giving tax breaks to corporations, Kevin Gaudet, national director of the Canadian Taxpayers Federation, explained on CBC radio that even in times of public financial crisis we should be cutting taxes for businesses because “they’re the ones that put in place the jobs that people get paid for”.

It’s a statement that constantly re-emerges in federal proclamations and provincial debates, local community discussions and dinner-table arguments: Businesses create jobs. The phrase has spread throughout our culture like a viral “meme”, the term evolutionary biologist Richard Dawkins coined to describe ideas, beliefs, symbols and other cultural information being passed around like genes between breeding rabbits. Continue reading

“They Put Me in this Dark, Little Room”

Métissage creates a stirring view of our shared oppression.

 

It was a very unusual way of discussing power and discrimination. And it left me thinking we should be doing it more.

After lunch in a lounge for about a hundred people during the University of Victoria’s recent Diversity Conference, we prepared to hear actors recount true experiences of an anonymous UVic female custodian, Aboriginal technical worker, black office worker and student, and female sessional instructor.

During introductory remarks, the co-directors, theatre PhD candidate Will Weigler and educational psychology instructor Catherine Etmanski, explained that the project had hatched out of a growing awareness that UVic’s own challenges in achieving a healthy, diverse workplace for its non-faculty staff are rarely openly discussed.

“Their experiences of what happens is, as they say, where the rubber meets the road,” Weigler observed. “So we thought, how can we create an opportunity for their voices to be heard?”

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