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Ontario hospitals plan off-site care for seniors if second wave of COVID-19 hits hard – The Globe and Mail

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Reta, 95, is a patient at Southlake Regional Health Centre, which has been lauded for its program helping seniors be discharged quickly so they may return home with health care support.

Southlake Hospital

Hospitals in Ontario are planning to provide health care services to more seniors in their own homes and house patients who no longer need acute care in retirement residences and hotels, as they brace for a potential second wave of the coronavirus.

The pandemic has highlighted an urgent need for alternative care for seniors, say health care experts. The elderly can’t languish in acute-care hospital beds or be transferred to unsafe nursing homes.

The experts say more hospitals should copy an innovative home-care program at Southlake Regional Health Care in Newmarket, north of Toronto. The program is at once a window into how one hospital has helped seniors be discharged quickly and return home with health care support, and a stark reminder of the uneven pace of progress elsewhere.

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Reta, 95, was one of the first patients to participate in the Southlake@home program at Southlake Regional Health Centre in Newmarket, Ontario, north of Toronto.

Southlake Hospital

During the first wave of the coronavirus, hospitals cancelled most elective surgeries to clear space for a surge of critically ill COVID-19 patients that never came. Hospitals also emptied beds by discharging many patients to retirement and long-term care homes.

This time around, they have less flexibility for dealing with patients who no longer need the acute care services of a traditional hospital but are unable to live independently.

“This is about transitioning from crisis management, which we did in the spring, to living with COVID,” said David Pichora, chief executive officer of Kingston Health Sciences Centre and member of a government committee planning for the next wave of the pandemic. “Nobody wants to go back to what we were doing in April.”

Care-homes crisis pushes Toronto-area hospitals to near capacity

Patients who no longer need acute care are filling up hospital beds once again, primarily because hospitals can no longer discharge many of them to long-term care homes, where more than 1,800 residents in Ontario died from COVID-19.

These patients, known as alternate-level-of-care (ALC), occupy just over 5,100 hospital beds, about the same number as before the pandemic when overcrowding was a chronic problem.

The homecare program at Southlake hospital in Newmarket, Ontario, pictured here on July 20, 2020, has helped the hospital dramatically reduce the number of days patients wait for appropriate services.

Galit Rodan/The Globe and Mail

The province’s Chief Medical Officer of Health, David Williams, issued a directive last month preventing long-term care homes from accepting new residents or readmitting previous residents to wards, where up to four individuals share a room. The order does not affect existing residents who live in ward rooms. Slightly less than one-third of Ontario’s 78,443 long-term care beds are in older homes with wards.

The Kingston region in southeastern Ontario is losing 300 of its 4,000 long-term care beds as a result of the new admission restrictions, Dr. Pichora said. His hospital admitted 78 patients to long-term care in June, about a third of the normal volume.

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Hospitals also will do everything possible to avoid cancelling surgeries again, said Dr. Pichora. There are no data in Canada linking cancelled surgeries to mortality rates. In the U.S., the National Cancer Institute predicts that tens of thousands of excess cancer deaths will occur over the next decade as a result of delays in treatment caused by COVID-19.

Patients like Reta, who have participated in the Southlake@home program, wait less than a day to return to their own homes once they no longer need acute care.

Southlake Hospital

Kingston Health Sciences is one of several hospitals that have found alternatives for ALC patients by leasing empty space in other buildings. It has installed 30 beds in a retirement home and is looking for more space. Queensway Carleton Hospital in Ottawa has retrofitted a floor in a hotel with 32 beds. North York General Hospital in Toronto has 20 beds in a retirement home, and is working with community groups to care for these patients.

“This close partnership between sectors has to continue after COVID,” said Joshua Tepper, CEO of North York General.

The Ontario Hospital Association is urging the government to earmark additional funding for home care and for more hospitals to lease space in hotels and retirement homes.

Administrators at Southlake hospital, picured here on July 20, 2020, are exploring the use of neighbouring retirement homes for some patients.

Galit Rodan/The Globe and Mail

A Ministry of Health spokeswoman said the government is working on a plan to help hospitals manage capacity, including looking at using hotels and other alternative sites beyond Sept. 30.

Samir Sinha, the director of geriatrics at the Mount Sinai and University Health Network hospitals in Toronto, said the pandemic is an opportunity for government to expand home care, a less expensive option. The province spends $103 a day on home care services, compared with $182 a day for residents of long-term care, government figures show.

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“If you ask anybody,” Dr. Sinha said, “they will say I want to stay in my home as long as possible.”

Several hospitals, including Kingston Health Sciences and North York General, have introduced home-care programs similar to the one at Southlake, the first of its kind in Ontario.

Patients who have participated in the 16-month-old Southlake@home program wait less than a day to return to their own homes, once they no longer need acute care, said Arden Krystal, chief executive officer of the hospital.

Judy Smith’s 95-year-old mother-in-law, Reta, was one of the first patients to participate in the Southlake program. Twelve days after Reta was rushed to hospital in March, 2019, after she fell in the dining room at her retirement home, fracturing both ankles, she was back in her own apartment.

A team of nurses, occupational therapists and personal support workers provided care to Reta for 14 weeks, until she could go to the dining room for meals on her own, using her walker.

“I had high standards for care,” said Ms. Smith, a retired geriatric nurse. “This program met those standards.”

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The program initially helped Southlake reduce the number of ALC patients, but these beds are once again filling up. Today, ALC patients occupy roughly 20 per cent of the hospital’s 525 beds. As a result, Southlake is also exploring using neighbouring retirement homes for some of these patients, Ms. Krystal said.

“Because of what happened in long-term care many families are somewhat reluctant to jump to that now,” she said. “They don’t want their loved ones to become endangered.”

Editor’s note: An earlier version of this article had an incorrect age for Judy Smith’s mother-in-law, Reta.

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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