health care – Jewish Independent

CHW tickets going fast

Left to right, Sasha Gerson, Joanna Wasel and Frances Belzberg will be honoured by CHW on Sept. 22. (photos from CHW Vancouver)

Welcome to September! A few signals that summertime is ending are the kids going back to school, the Jewish holidays quickly approaching and the return of Jewish community gatherings like the upcoming Canadian Hadassah-WIZO (CHW) Vancouver luncheon.

On Sept. 22 at the Richmond Country Club, CHW is holding an event to honour exceptional volunteers. As a volunteer organization driven by women, which focuses on the welfare of children and women in Israel but is also concerned with the health care of all Israelis, CHW often chooses to recognize the contributions of local women who make a difference to the lives of those in our local community.

This year, the organizing committee of the luncheon, headed by CHW volunteer Toby Rubin, selected three visionaries who have put their considerable talents as organizers, motivators and mentors to work to improve various areas of Jewish life in Vancouver. Sasha Gerson, Joanna Wasel and Frances Belzberg represent three different generations of volunteers and all contribute in diverse ways to the community.

Gerson is well known in the Russian-Jewish community. For years, she helped immigrants settle in Vancouver through her work at Jewish Family Services. Her most public role is as an award-winning radio host. Twelve years ago, she and her partner, Dmitry Shiglik, launched Radio VERA, a weekly Russian-English talk show. Her motivation is to bring Jews together, and her volunteer activities through the radio have included organizing trips to Israel, festivals for children and music events. She interviews people primarily in Vancouver but has guests from Russia and Israel on her show. She is also a CHW volunteer, currently serving as treasurer of CHW Vancouver.

Familiar to those who are connected in any way to Camp Hatikvah, Wasel is known as a volunteer extraordinaire. She is currently serving her fifth year as president of the Camp Hatikvah board and, during her presidency, she has expanded participation in the camp’s programming. One of her most important legacies is the introduction of Family Camp, which was first held eight years ago. This program has brought a camp experience to more than 220 people every year since its inception.

“You’re never too old or too young to be a camper!” said Wasel of Family Camp. She sees the weekend-long experience as a chance for adults to make new friends. “People bond and it establishes a foundation for the Camp Hatikvah community. In addition to being good, quality family time, we see it as a community-building experience,” she said.

Camp Hatikvah is associated with the Young Judaea movement, a Zionist organization that dates back to 1917. Historically, CHW has been associated with Young Judaea, as well, providing funding for national programs including Biluim Canada and Israel.

The third honouree, Belzberg, has had a life-long commitment to philanthropy and Jewish community building. She has been involved with CHW for 67 years, most of those in Vancouver. Having contributed in the early years of her marriage to Hadassah in Edmonton, Belzberg knew that joining a Hadassah chapter when she moved to Vancouver would help establish close friendships in a new city. She continued as a volunteer in many leadership roles, including chair of the Hadassah Bazaar, and on the national board as well.

Belzberg’s dedication to community extends beyond CHW. She also has served as Jewish Federation of Greater Vancouver’s first women’s division chair and has held many other leading fundraising roles, including with St. Paul’s, B.C. Children’s and Vancouver General hospitals. She was a founder of the Dystonian Medical Research Foundation and was recognized for her diverse and numerous efforts with the Order of Canada in 1995. Belzberg has given countless hours as a volunteer, driven by a belief she explained this way: “Without community involvement,” she said, “there will be no future for the Jewish people. It is up to us to combat antisemitism and make sure our communal organizations remain strong.”

Those who attend the Sept. 22 luncheon, 11 a.m. to 2 p.m., will have the opportunity to hear a short address by each of the honourees. Proceeds from the event will benefit one of the many educational projects CHW supports in Israel – the CHW Centre for Clinical Training and Community Care, Hadassah Academic College in Jerusalem, is one of the fastest-growing institutions of higher learning in Israel. It is a pluralistic college with a range of undergraduate and graduate degrees, from health and life sciences to information and computer technology.

Luncheon tickets are selling fast, said Rubin. With more than 100 already sold and capacity at 150, those interested should purchase tickets soon. For more information or to register, call the CHW office at 604-257-5160.

Michelle Dodek is a freelance writer living in Vancouver.

Stories with a message

Michael Klein recently had his first book published. (photo from Michael Klein)

Dr. Michael Klein has published almost 200 scientific articles. Earlier this month, he launched his first book, Dissident Doctor: Catching Babies and Challenging the Medical Status Quo (Douglas & McIntyre).

Klein, who, with his wife Bonnie, splits his time between Robert’s Creek and Vancouver, is professor emeritus of family practice at the University of British Columbia, adjunct professor of family practice McGill University in Montreal and senior scientist emeritus at B.C. Children’s Hospital Research Institute. He was recognized as a member of the Order of Canada in 2016 for playing “a vital role in placing maternity care at the heart of family medicine.”

Klein has had a significant impact on the way the Canadian medical system has come to view midwifery and he played a prominent role in midwives becoming part of the healthcare system, first out east and later in here in British Columbia.

“I’m on the board of Canadian Doctors for Medicare, an organization that is trying to save Medicare from various encroachments from private interests, including U.S. multinationals,” Klein told the Independent. “We are about improving and extending Medicare. We are not about justifying things as they are. But, we are very much unhappy with the way privatization is going, which is a solution that is worse than the disease.”

About his new book, Klein said, “It began as something that I was writing as stories for my children and grandchildren … and, it got out of hand.”

At it happened, publishers at Douglas & Macintyre heard Klein tell a few of these stories and wanted them made into a book.

Klein set about developing them thematically. “I had to find out what the storyline was,” he said. “It’s a great deal about birth, but it’s not a birth book, per se. In many respects, birth is a metaphor.

“It’s about birth, family practice, midwifery, social justice, and about improving our rather challenged healthcare system. At the same time, I’ve deliberately chosen stories that have a message. For example, there are stories about people who were not supposed to get better but did. Many of the stories are actually detective stories. What I mean by that is that I try to make the stories go beyond the actual patient issue…. In what context does this illness take place? ”

Klein feels this approach to storytelling makes the point that, to provide really good care, you need to understand the patient, the full breadth of their situation.

He hopes the book also serves as a primer on how to advocate for yourself and your family in the complex medical system.

“Misunderstandings and mistakes in the healthcare system are actually inevitable,” said Klein. “I talk a lot about advocacy and the importance of making sure that, if things don’t seem right, they probably aren’t right.

“Because of my involvement with Canadian Doctors for Medicare, the whole issue of privatization is explored. For me, I have a special need to express this, because I’m in a unique position. I’ve practised in Canada before Medicare. I’ve practised in the States and ran health centres without Medicare – that wasn’t a lot of fun. And, I’ve practised back in Canada with Medicare.”

The main point Klein wants to impress upon readers is that humane, holistic care in the context of a person’s whole life is the ideal. “I am not putting this out as a dispassionate physician-scientist, but as somebody who really understands the big picture and can situate the patient or the system within a very large context of where we are going as a society,” he said.

The book is almost completely free of medical jargon, although it deals with complicated issues. Klein said the book is equally accessible to medical trainees, people in the profession and to the general public.

The stories he chose, the themes he discusses and the politics, he hopes, will be easily understood by anyone who has ever encountered the healthcare system. “Not just pregnant people and their partners, but anybody; also family physicians, midwives, obstetric nurses, dulas,” he said.

Klein showed the manuscript to people in all these categories, and, he said, “it seems to work for them.”

The feedback Klein has been getting is that people love the book’s advocacy stories. He even includes his wife’s experiences following a series of strokes, when she was told she was inoperable and would die. A surgeon in London, Ont., saved her life.

“There are a series of stories of my patients and other peoples’ patients who defied the odds, and where patient advocacy has been absolutely essential,” said Klein. “Whether they are physicians or laypeople, they became engaged in the right way with the health providers and improved their outcome.

“People relate to that very strongly, regardless of whether they are patients. The experiences they’ve had when their children, spouse or parents were sick and, either they were sidelined by the system or they embraced by the system. It varies enormously with who is providing the care and what their attitudes are. I cover that in the book.”

Other stories in the book tell of how Klein battled with the U.S. army and avoided going to the Vietnam War.

He also delves into his strong support for midwives. “People wondering if home birth is safe are very interested in that section,” said Klein. “Home birth is clearly safe. However, safe in the right kind of system, with the right kind of supports and back up. In other words, an integrated system like we have in British Columbia, as opposed to the chaos of the U.S.”

The launch event for Dissident Doctor took place in Toronto on Oct. 9.

Rebeca Kuropatwa is a Winnipeg freelance writer.

New centre for excellence

Construction on the Centre of Excellence for the Deaf and Hard of Hearing is expected to be complete by fall 2019. (photo from WIDHH)

British Columbians who are deaf and hard of hearing will soon benefit from a state-of-the-art Centre of Excellence for the Deaf and Hard of Hearing that is being built by Vancouver’s Conwest Group of Companies.

The Western Institute for the Deaf and Hard of Hearing (WIDHH), a registered charity established in 1956, together with Conwest, has commenced construction on a new $16 million facility with $1 million in funding from the Ministry of Health. The $1 million in government funding, which was announced Sept. 26, will be applied to an $8 million capital fundraising campaign that WIDHH is aiming to launch to the public early next year.

“From youth to seniors, this new centre will improve people’s quality of life and help prevent those with hearing and communication challenges from feeling isolated,” said David Eby, attorney general and MLA Vancouver-Point Grey.

The centre will provide hearing aids and assistive listening device services, employment counseling, seniors outreach programs and a refurbished hearing aid program for people on limited income. It will also accommodate expansion of WIDHH’s clinical research program within the field of hearing health, telecommunications and accessibility.

“We look forward to using technology in the new facility to reach out and provide unparalleled levels of hearing health care and support to homebound seniors and those living in rural communities across British Columbia,” said Grace Shyng, interim executive director of WIDHH.

Construction on the new centre at 2005 Quebec St., in Vancouver, is expected to be complete by the fall of 2019.

Win 2 free film tickets!

A Heartbeat Away follows Save a Child’s Heart pediatric cardiologist Dr. Akiva Tamir to Africa on a medical screening mission to find children in need of lifesaving heart surgery. (photo from Save a Child’s Heart Canada)

Jewish Independent readers can win two tickets to the Nov. 2 Vancouver premiére of the documentary A Heartbeat Away at Scotiabank Theatre. Simply email [email protected] by Wednesday, Oct. 25, 5 p.m., to be entered in a draw. The winner will be contacted.

A Heartbeat Away, by Tal Barda and Noam Pinchas, follows Save a Child’s Heart pediatric cardiologist Dr. Akiva Tamir to Africa on a medical screening mission to find children in need of lifesaving heart surgery – surgery that is not accessible in Tanzania, where, every day, five children die from heart disorders and rheumatic heart disease. In the documentary, Tamir and his team examine hundreds of children, although only a handful can receive the treatment that will save their lives. When 6-year-old Julius arrives at the clinic in critical condition, Tamir is forced to choose whether to operate on the child, who has very little chance of surviving. Tamir and his team take viewers on an emotional rollercoaster, as they deal with the most serious question of who to treat. The experienced physicians find it hard to detach from the emotional bond they share with their small patients.

The documentary focuses on the challenges of receiving adequate health care in developing countries, and the challenges providers face when so many are in need – how do they pick who to treat?

According to Marni Brinder Byk, executive director, Save a Child’s Heart Canada, “Congenital heart disease is responsible for more deaths in the first year of life than any other birth defect. Due to a high prevalence of acquired and congenital pediatric heart disease in developing countries, and a lack of skilled medical personnel dealing in pediatric cardiac care, there are thousands of children in need of cardiac intervention, and hundreds of medical personnel living in developing countries that require advanced training.”

To date, she said, the Israel-based Save a Child’s Heart has “provided care to over 4,400 children from 55 countries in Africa, Asia, Eastern Europe, the Caribbean, South and Central America, and the Middle East.”

In an interview with Eretz Magazine, Barda, who also directed the documentary, said, “The first thing that the documentary film needs to give the viewer is information. However, for me, the next move is touching the individual’s story…. My dream is to have as many people as possible watch this movie. The story comes from a different world, creates a sense of acquaintance and a better way of coping and looking at things…. There is something very powerful in this story, which is happening in the current dire reality of Israel and the world. It is about people who are taking their professional skills and doing something good with them. They go out of their comfort zone and do something for the benefit of the other. These doctors are taking care of all hearts, simply because they are beating hearts.

“The message here is very powerful, in my opinion,” she continued. “The organization is taking care of all children: Israelis, Africans, Palestinians….” To view the official trailer of A Heartbeat Away, visit vimeo.com/151644429.

The Nov. 2 screening event in Vancouver is chaired by Lana Pulver. It starts at 6:30 p.m. with a wine and cheese reception, followed by the screening of the documentary and a question-and-answer period with a panel of experts on pediatric global health and cardiac treatment. Tickets are $36, with all proceeds benefiting Save a Child’s Heart. To purchase tickets or make a donation, click here or call toll-free 1-844-924-9113.

NCSY at Sheba centre

Dr. Amit Segev gets his heart checked out by one of the participants in NCSY Canada’s Jewish Journeys summer program. Segev gave all the teens a stethoscope to commemorate their visit to Sheba Medical Centre. (photo from SMC)

More than 30 teenage participants from NCSY Canada’s Jewish Journeys summer program were recently treated to a VIP tour of Sheba Medical Centre’s Olga and Lev Leviev Heart Centre.

Dr. Amit Segev, director of Sheba Medical Centre’s cardiac division, showed the group a short presentation of how the heart can malfunction and what doctors can do to save patient’s lives in such instances. As there is nothing like a dose of reality to enhance the experience, Segev showed the teens a live view of a medical procedure being performed on a patient suffering from a heart malfunction.

As a token of appreciation for their visit – and perhaps spur their interest in a future medical career – Segev gave each participant a Sheba Medical Centre stethoscope.

Continuing to bring hope

Fantaye, Gary Segal and Tesfaye in 2015, on a return visit by Segal to Gojam, Ethiopia. (photo from Gary Segal)

Thirty-seven spine surgeries, six nursing/midwifery scholarships, development of Sebi Sarko Rural Health Centre and the establishment of a pediatric program reaching more than 14,000 children living in rural areas. That’s part of what has been accomplished with the $1 million-plus that was raised in Vancouver five years ago at An Evening to Bring Back Hope.

The 2012 event honoured Dr. Rick Hodes, medical director of Ethiopia for the American Jewish Joint Distribution Committee (JDC) and senior consultant at Mother Teresa Mission. It also established a partnership between JDC in Ethiopia and the University of British Columbia Branch for International Surgical Care. With the monies raised in 2012, UBC Branch has developed curriculum with Hodes and engaged in spine-disease research in Ethiopia; as well, there have been physician and nurse exchanges between UBC-Vancouver General Hospital and Ethiopia’s Gondar Hospital.

This year, on June 8, An Evening to Bring Back Hope honours both Hodes and spine surgeon Dr. Oheneba Boachie-Adjei, and raises funds for the continuation and expansion of their work, as well as that of JDC and UBC Branch. Boachie, president and founder of FOCOS (Foundation of Orthopedics and Complex Spine) in Accra, Ghana, has performed most of the complex surgeries on Hodes’ spine patients since the two doctors starting working together in 2006.

The fundraising event includes a symposium and lunch at Congregation Beth Israel, at which attendees will be able to ask JDC staff questions about JDC’s humanitarian work and philanthropy, and a gala dinner at Vancouver Convention Centre-East. Event partners are JDC, UBC Branch and the Jewish Federation of Greater Vancouver. As in 2012, gala chairs are Gary and Nanci Segal.

“I am very pleased that Dr. Boachie will also be a focus of attention at the event,” Gary Segal told the Independent. Hodes, an observant Jew, and Boachie, a devout Baptist, “together work tirelessly to treat the sick and poor of all religions and ethnicities.”

“I truly believe that in today’s world filled with negativity, intolerance and discord, this cause and message of inclusion and multiculturalism resonates louder than ever,” said Segal.

Segal first met Hodes as part of a Federation/JDC trip to Ethiopia in 2007. He spent more time with Hodes on a family trip in 2008. “The more time I spent with Rick in clinic and at his home with his very large family of adopted and fostered children that all needed Rick’s help, the more heroic and inspiring Rick and his life story became to me,” said Segal. When hosting Hodes and his extended family of 18 children (at the time) for dinner, Segal learned that Tesfaye – whose spine had collapsed from tuberculosis – could not be operated on in Ghana, and thought, “I knew that I had to do whatever I could to save Tesfaye’s life.”

According to the fundraiser’s website, Segal “spent almost a year pursuing the possibility of bringing Tesfaye to Vancouver for spine surgery and, finally, on his 18th birthday, May 20, 2009, Tesfaye arrived in Vancouver and was welcomed into the Segal home. On June 12, ‘Team Tesfaye,’ led by surgeon Dr. Marcel Dvorak at VGH … successfully perform[ed] delicate 14-hour life-saving surgery.”

“For decades,” Segal told the Independent, “I have always given of my time and money to help a variety of community organizations and causes – I grew up with wonderful examples of this in both my mother and father. Helping Tesfaye was a unique experience, where the ‘giving back’ became such an intimate, personal and integral part of my life.

“On my 2010 trip back to Ethiopia after Tesfaye’s surgery, I retraced and revisited what his life was like before surgery. Understanding Tesfaye’s courage, dignity, perseverance and optimism – that he kept in the direst, most uncomfortable and debilitating of situations – motivates and inspires me daily, and always keeps my problems in perspective.

“Seeing the transformation in Tesfaye’s life and what it has meant to his family and entire village, further inspired me to found this Bring Back Hope initiative,” he continued. “One of the highlights of my life was that 2010 trip to Tesfaye’s remote village in Gojam – a typical village with mud huts, no electricity or running water – as the entire village celebrated his miraculous rebirth for three days, with feasting, chanting and Agew shoulder dancing. Seeing ‘up close and personal’ the impact of changing even one individual’s life, it became my vision to introduce Rick’s story to more people by holding a large dinner of caring people from different faiths and backgrounds, and to hopefully raise a lot of money to change more lives. Thus, the Bring Back Hope initiative was launched through the inaugural Evening to Bring Back Hope 2012.”

But his efforts extend beyond the events. “I never imagined before meeting Tesfaye that, one day, I would have a whole extended family in Ethiopia become part of my family,” he said.

It was hoped that Tesfaye’s sister, Fantaye, would be joining her brother at this year’s Bring Back Hope. Unfortunately, she won’t be able to make it – but for “good news” reasons, said Segal, “as she is about to graduate from Grade 12 at a high school in Ethiopia’s capital city Addis Ababa and the national exams she has to write to qualify for university only end on June 8.”

“I met Fantaye in February of 2010,” explained Segal, “when I flew over to Ethiopia to accompany Tesfaye on the journey out to his remote village in Gojam to be with him to experience his family and village seeing him standing upright for the first since he was crippled with TB of the spine at 8 years of age…. Tesfaye, living in the capital Addis Ababa since he was 12, heard that his mother wanted Fantaye to get married; he was concerned she was too young, being only 12 years old, and feared the husband’s family would force her, once she was married, to stop going to the village school. At his request, I asked his mother, Yeshi, to wait until Fantaye was older and completed school, but, sure enough, she was married a few months later, at the age of 12.”

When Segal returned to Ethiopia in December 2012 on a Bring Back Hope-related trip, he found, to his “surprise and delight,” that, “through Tesfaye’s persistence and insistence, Fantaye had left her husband and village to join her brother in Addis Ababa and live with him and go back to school. This took a lot of courage on the part of a then 14-year-old girl, going against the wishes of her family and entire village. At the same time, it took Tesfaye’s courage of conviction as to what was right for his sister for this to happen; I attribute this to Tesfaye understanding the greater world outside the village and Fantaye seeing the transformation of Tesfaye.”

Even after 27 years working with JDC in Ethiopia, Hodes still finds inspiration from his patients.

“The courage which Ethiopians live with who have spinal deformities is simply inspiring,” Hodes told the Independent. “Kids who are in pain but still go to school, kids who are teased at school but persist, kids who have no parents and are self-supporting as young teens but go to school and come for treatment.

“And the love which they show for each other is exemplary. I have a single mom who has a paralyzed son who has simply devoted her entire day – every day – to caring for this boy, who is now improving. In fact, I just brought him to Ghana five days ago for intensive physical therapy to see if we can jump-start his improvement.

“I bought a bag of cookies for a young boy with a bad back. He put them in his pocket. ‘Why don’t you eat it?’ I asked. ‘Later,’ he said, ‘I want to share it with my brother.’

“I have another mom who has a son who had a complex heart problem giving him very little oxygen. This boy could not walk more than three steps and the mom has made sure that he moves forward in life by carrying him, piggy-back, everywhere. She carried him to school, carries him home, brought him to Addis Ababa every month for phlebotomy, to remove the extra blood his body produces. And now he’s able to walk, after corrective heart surgery in India.

“I had an orphan boy with no relatives at all,” continued Hodes. “He came to Addis Ababa, supported himself by shining shoes, went to school and slept in a taxi at night until someone took him into their home. He, too, has had surgery and is now back in school.

“When I’m having a tough day – I frequently feel overwhelmed – it’s patients like this who keep me going, and remind me why I’m here.”

Hodes’ International Life-Saving Surgery Program 2016 annual report describes that year as “game-changing.”

“This was the first year that the Ethiopian government gave us support – they paid for the air tickets of 22 patients to Ghana for spine surgery,” explained the doctor. “They are continuing the air ticket support this year.”

Also in 2016, he said, “Our contract with the Ethiopian government ended its standard, three-year period and the program closed for evaluation. It was given an unprecedented five-year renewal.

“We have moved into new facilities at a government trauma hospital called AaBET [Addis Ababa Burn Emergency Medicine and Trauma] Hospital, where we see patients five days a week. We have started discussions to send two Ethiopian doctors to Canada for spine training. We now have several teams coming to Ethiopia to operate – in fact, we have three different spine teams coming this month, and will get at least 40 surgeries done inside Ethiopia!”

In addition to treatments, there have been discoveries. “We have described some new deformities, which we are now defining with Greek letters,” said Hodes. And, he added, “We believe we’ve made a major discovery about spine deformities caused by neurofibromatosis.”

In 2016, Hodes said there were 359 new spine patients, with 111 surgeries conducted on 105 patients. “We got two spines done in the U.S., and helped two patients go to India for heart care,” he said. “So far this year, we have 101 new spine patients.”

Hodes said the price for spinal surgeries ranges from $13,000 (or a little less) to $21,000, averaging about $18,000. For hearts, he said, “some patients need procedures (done in the catheterization laboratory) where a balloon is blown up to expand a narrowed valve or close a hole in the wall of the heart. Those cost around $2,000. Surgery costs depend on the complexity of the case, and generally run from $5,000-$10,000.

“If we get surgery done in North America, it’s at no cost to us, other than an air ticket. We just had two boys return from complicated surgery in Texas, and another from California.”

Hodes stressed, “I cannot sufficiently thank the people of Vancouver who are helping me. Their help is, quite literally, life-saving.”

For tickets to the gala ($500, with tax receipts issued for eligible portion) and sponsorship information, call Mercedes Dunphy at 604-710-4491 or Nanci Segal at 604-813-5550. For more information on the initiative, visit bringbackhope.com.

Caring for our seniors

Louis Brier Home and Hospital. (photo from cjnews.com)

“Louis Brier offers our residents variety in programming and services, as well as safe and quality care. Residents and families remain the primary decision-makers for the care received, as resident and family-centred care is at the core of our goals. All care is governed by our Jewish and professional values and standards of excellence,” Angela Millar told the Independent.

Millar is the director of quality and risk management, accreditation and resident experience for the Louis Brier Home and Hospital and Weinberg Residence. She was responding to questions from the Jewish Independent about the 2017 British Columbia Residential Care Facilities Quick Facts Directory, published by the Office of the Seniors Advocate (OSA). The directory “lists information for 292 publicly subsidized facilities in British Columbia that offer residential care services to seniors,” including Louis Brier.

The information was “gathered primarily from residential care facilities, health authorities, the Ministry of Health and the Canadian Institute for Health Information.” The data on licensing incidents and complaints is from the 2015-16 fiscal year, while the “inspection data was a snapshot taken on Dec. 7, 2016.” The 2017 OSA report can be found at seniorsadvocatebc.ca and the most recent inspection information from Vancouver Coastal Health at inspections.vcha.ca.

Millar explained, “Louis Brier is an affiliate of Vancouver Coastal Health, providing residential care for seniors. Vancouver Coastal Health provides an annual operating budget and Louis Brier Home and Hospital also receives donations from the Louis Brier Jewish Aged Foundation, which provides music and art therapy, Jewish culture and synagogue, kosher food and supplementation of medical equipment.”

The OSA directory mentions the Louis Brier Jewish Residence Society, as well as separate resident and family councils.

“The resident council represents the seniors who live at Louis Brier, ensuring they have a voice in how their home is run,” said Millar. “The council is supported by staff and meets monthly to discuss concerns, develop suggestions and plan activities. The executive director of resident care services and the chief executive officer attend meetings to provide updates, answer questions and develop plans to address concerns where needed.

“The family council is an independent group of family members and friends who meet monthly to support each other and advocate for the seniors residing at Louis Brier. A staff member liaises with the council and senior management team, who are often invited as guests. The family council acts as a forum to share experiences, learn and exchange information.”

In the 2017 OSA directory’s statistics on care services and quality, Louis Brier performed better than the B.C. average in percent of residents receiving physical therapy (34.3% versus 13.2%) and occupational therapy (10.3% versus 7.6%) but not in percent of patients receiving recreation therapy (1.1% versus 27.9%). With different percentages, Louis Brier fared similarly in the OSA’s 2016 report.

Noting that the data collected for the OSA report is “a snapshot at one time in a period,” Millar said, “I believe that the data is collected utilizing a seven-day observation tool throughout only one week in a quarter. Of course, my personal concerns are related to the validity and reliability of the data that is reported and thus the ability to generalize or glean valuable information from that data.

“My concerns aside, data collection is only looking at therapeutic interactions of the rehab team with residents – one PT/OT [physical or occupational therapist] per four residents and one rec therapist per eight residents – unfortunately rehab and rec resources [do] not abound, and our aim is to maximize the outcome and benefit to as many residents as possible given the resources that we have. As such, many of our programs and interventions are designed to accommodate larger groups of residents and most likely beyond the guidelines of the seniors advocate data collection parameters. It would help to understand how these parameters have been established and whether they have been evaluated for reliability in terms of producing valid data to help draw conclusions in relations to quality of care and residents’ outcomes.”

Millar emailed the home’s May recreation calendar, which can be found at louisbrier.com/events, “as an example of the plentiful and very rich programming that we are proud to provide our residents.”

In the 2017 directory, Louis Brier fares better than the provincial average in many areas: there were no substantiated licensing complaints and no reported incidents of disease outbreak or occurrence, abuse or neglect, food poisoning, medication errors or missing or wandering persons. With respect to falls with injury or adverse event, there were 5.1 per 100 beds, compared to a B.C. average of 11.9; and, in the category of other injury, 1.4 per 100 beds at Louis Brier compared to a provincial average of 1.6.

There is only one measure in which Louis Brier fared lower than the provincial average in the 2017 directory. In the year examined, there were nine reported incidents of aggression between persons in care at Louis Brier, or 4.2 per 100 beds, as compared to the provincial average of 1.5 per 100 beds; the 2016 OSA directory lists zero such incidents at the home.

With respect to four other quality measures, Louis Brier fared better or comparable to the provincial averages in three areas – percentages of residents diagnosed with depression, residents receiving depression medication and use of daily physical restraints. However, with respect to the percent taking antipsychotics without a diagnosis of psychosis, 40.8% of Louis Brier residents who were taking antipsychotic medications had not received a diagnosis of psychosis, compared with the B.C. average of 26.9% in the 2017 report, and 41% versus 31% in the 2016 report. As well, the OSA directory reports that, while 16.2% of Louis Brier residents had been diagnosed with depression, 48.1% of residents were receiving depression medication; in the 2016 directory, the respective figures were 21.1% diagnosed and 52.3% receiving depression medication.

“Your specific question with regards to prescription of specific treatments, medications and diagnoses is not something that can be responded to in a simple way…. While nursing staff are responsible to deliver care to the residents every day of the year, they, however, have limited control on what and how medications are prescribed and why,” said Millar. “Nurses advocate on behalf of the residents and may raise questions and awareness, however, changing physician practice or implementing best practices as it is related to the medical field and residential care are an entirely different area for discussion and attention. To understand and evaluate whether medications and treatment are prescribed appropriately requires a comprehensive approach by both the nursing and medical staff. We are certainly committed to ensure our residents receive safe, quality care and are continually monitoring medications and treatments as possible.”

Millar explained, “Louis Brier is regulated by the Community Care and Assisted Living Act, as well as the Hospital Act, which is enforced by Community Care Facilities Licensing.

“Currently the facility is showing its commitment to quality care by preparing for an Accreditation Canada Survey in May of 2018. Accreditation Canada will assess our organization against standards of excellence with regards to leadership, long-term care, medication management, infection control and governance.”

She described Accreditation Canada as “a significant wealth of information and resource for organizations in their quest to improve and achieve the highest level of care and quality possible within the industry” and invited the Independent and its readers to the Louis Brier Accreditation Fair on May 23 “to learn more and see how you can get involved.”

Millar noted that Louis Brier also has “just developed a quality and risk portfolio including a director of quality and risk management [QRM], manager of QRM, an infection control practitioner, as well as a QRM coordinator. Within this team, there are also individuals responsible for resident experience, including social work, volunteer coordinator and the manager of the companion program.”

As for staffing levels overall, Millar said, “I believe that there could never be enough staff and resources; however, we do have to work within our funding boundaries, given what we have. We can say with great confidence that Louis Brier has, most likely, more resources in terms of rehab and recreation staff than many other organizations (mainly because we are so greatly supported by the Louis Brier Foundation): we have over 300 volunteers and over 100 companions that help us deliver outstanding care to all of our residents. To that end, Louis Brier shares a common goal with the seniors advocate – of providing safe, quality care to our elders. Furthermore, Louis Brier certainly supports the efforts and intention of the seniors advocate in evaluating and advocating for additional resources to be allocated to the long-term care sector to help providers support and deliver excellent care to our seniors.”

Docs cover range of topics

The Jewish Seniors Alliance Spring Forum featured Dr. Saul Isserow, left, and Dr. Larry Goldenberg. (photos by Binny Goldman)

“If I had known I was going to live so long, I’d have taken better care of myself” – Eubie Blake

Approximately 120 people attended the Jewish Seniors Alliance Spring Forum on May 7 at the Peretz Centre for Secular Jewish Culture. Called Ask the Doctors, it featured Dr. Saul Isserow and Dr. Larry Goldenberg, who were ready to answer the audience’s many questions.

JSA president Ken Levitt welcomed the crowd, thanked them for giving up a sunny gardening day to attend the workshop and support the JSA, whose new motto is “Seniors, Stronger Together.” He explained that, in joining together and striving for common causes, we are stronger.

photo - Jewish Seniors Alliance first vice-president Gyda Chud, left, president Ken Levitt at the JSA’s Ask the Doctors forum on May 7 — Jewish Seniors Alliance first vice-president Gyda Chud, left, president Ken Levitt at the JSA’s Ask the Doctors forum on May 7. *(photo by Binny Goldman)*

Gyda Chud, first vice-president of JSA, introduced Isserow, who is the director of cardiovascular health at Vancouver General Hospital and of cardiology services at the University of British Columbia Hospital, as well as the medical director of Vancouver Coastal Health’s Healthy Heart Program, among other things. She also introduced Goldenberg, whose many credentials include the founding of several programs, such as the Vancouver Prostate Centre, where he is director of development and supportive care, and the Canadian Men’s Health Foundation; he is also a professor in the department of urologic sciences at UBC. Goldenberg was inducted into the Order of British Columbia in 2006, awarded the Order of Canada in 2009 and received the Queen’s Diamond Jubilee Medal in 2012.

Isserow’s topic was How to Stay Away from the Chevra Kadisha (the Jewish Burial Society). He started his talk with humour – saying that the man who asks the best question will win a finger up his tuches (bum) by Goldenberg, referring to a prostate exam – and used humour throughout to make the sad facts of aging more palatable.

Using slides to illustrate his points, Isserow stated that hardening of the arteries starts when we are young. He likened the process to a bagel, which begins to harden on the perimeter. When the blockage reaches the centre of the “bagel,” that is when the heart attack occurs. To keep things in perspective, he described life as “a sexually transmitted disease with 100% mortality.”

He discussed many risk factors: age, obesity, genetics, hypertension and smoking. He strongly suggested that diet and exercise could halt or reverse immediate risks but, unfortunately, there are no reliable warnings and heart attacks come out of the blue.

Movement is strongly encouraged, said Isserow. Just walking 10 minutes a day is a start to reducing the risk of diabetes and obesity. Walking one hour a day can reduce the risk of heart disease by 35%, he said, and the Mediterranean diet of fresh vegetables and fruit, healthy fats and whole grains, can improve health by 27%.

Isserow presented studies showing that aspirin reduces heart disease significantly. Although statins may be necessary, there are possible side effects, such as aches and pains, he said. He ended his talk by saying that health is up to the individual: walk once a day, eat well and take medications as required, when the risk is high.

Goldenberg said that one reason men die 4.4 years younger than women is the “I will not, cannot, Sam I am” syndrome, paraphrasing lines from the children’s book Green Eggs and Ham by Dr. Seuss. Many men are unwilling to reduce their drinking, smoking and/or poor eating habits, he said.

The government is trying to develop expertise in communicating effectively with men about their health, connecting with them in a way that creates the space, freedom and encouragement for positive changes in their health awareness, attitude and behaviours, said Goldenberg.

Doctors are increasing awareness with the slogan of “precision, prevention and preemptive,” he said, recommending precision and personalized communication in telling men what you want them to hear. Get males to engage in their health discussions, he suggested.

In an effort to increase engagement, Goldenberg initiated the website dontchangemuch.ca. He gave a few examples of small changes that would help: ordering half a salad and half fries, parking the car further away from your destination and walking an extra block or two.

He also referred to the Canadian Men’s Health Foundation’s youcheck.ca, “a health awareness tool built specifically for men,” according to its homepage, and he spoke of “manopause” – aging and a lower level of testosterone lead to a lower libido, crankiness, fatigue and the onset of heart and bone disease. Low testosterone has an impact on the body but there is no consensus as to solutions, said Goldenberg. Doctors need to monitor any symptoms that seem worrying, he said, adding that men need women to guide them and to emphasize that their behaviour can be changed.

An active question period followed. In no particular order, some of the responses included the following.

Aspirin can reduce blood clotting, as can diet and exercise. If you are doing all things right but your CT scan shows calcified plaque, then focus on diet, exercise and statins. People should have a base line for everything – having a colonoscopy or, for men, a test for PSA (prostate-specific antigen) levels, for example – and be aware of family history.

Tiredness could be the result of sleep disturbance, low mood or loneliness, but heart health should be checked. Beta blockers can cause fatigue because of a reduction of blood flow.

Stress management is critically important and stress levels can be related to many things: mental and physical well-being and reduction of cholesterol. Sex is healthy for overall well-being.

After the session ended, Larry Shapiro, second vice-president of JSA, presented the doctors with tokens of appreciation. Continuing with the humour that had been present all afternoon, he said, “Vive la différence!” referring to the many differences between men and women and their approaches to health.

Chud said she had seen a sign in the Weinberg Residence saying, “Never live in a community where there are no doctors,” and she wanted to add “a community without Drs. Isserow and Goldenberg.”

Stan Shear videotaped the forum, and JSA staff and volunteers deserve kudos for putting it all together.

Binny Goldman is a member of the Jewish Seniors Alliance of Greater Vancouver board.

Books for people with dementia

Eliezer Sobel created L’Chaim: Pictures to Evoke Memories of Jewish Life with his parents in mind. (photo from Shutterstock)

Eliezer Sobel’s new book, L’Chaim: Pictures to Evoke Memories of Jewish Life, was born from personal experience.

Sobel is an artist at heart and has spent his life finding ways to interact with people – through writing, facilitating workshops and running retreats over the past three decades. Three years ago, on his parents’ 67th anniversary, things took a turn for the worse.

“My mother is in her 17th year of Alzheimer’s and is 93,” Sobel told the Independent. “My dad was fine and taking care of her at home until he was 90. On their 67th wedding anniversary, he fell down the stairs. He fell on his head and almost died. Overnight, there were two dementia patients in the house.

“Prior to that, he was driving, cooking and shopping, as well as hiring and handling the payroll for a team of seven aides. He was amazing with it. Suddenly, overnight, I had a brain-damaged dad at 90 years old.”

Sobel and his wife lived in Virginia at the time, which is seven to eight hours away from New Jersey, where his parents lived. After the accident, however, they moved into his parents’ home.

photo - Writer Eliezer Sobel’s parents, Manya and Max, in 2016. They were the inspiration for Sobel’s series of picture books for readers with dementia — Writer Eliezer Sobel’s parents, Manya and Max, in 2016. They were the inspiration for Sobel’s series of picture books for readers with dementia. *(photo by Eliezer Sobel)*

“We stayed in the house for 10 months, taking care of my parents and trying to get the right kind of help in the house that would enable us to eventually move out,” explained Sobel. “But we stayed nearby so we could monitor and manage the scene.”

His dad recovered a substantial amount of his cognitive and physical ability, but passed away this past November.

The work on the book goes back to 2011. “She didn’t speak English words anymore,” said Sobel of his mother at the time. “She would sometimes make up her own language and sounds. She stopped reading, as far as we knew.

“One day, I came upon her accidentally…. She was flipping through a magazine and I overheard her reading the big print headlines out loud, in English, correctly. I was totally floored. Mom can still read, even if it’s just a three-word phrase.”

Sobel wanted to run out and buy his mom a picture book, one designed for Alzheimer’s and dementia sufferers, but he couldn’t find one anywhere. His next thought was to use a children’s picture book, but he was unsure whether his mother could negotiate a book with a storyline. He wanted each page to stand on its own, so it would not require the reader to recall what had happened on a previous page.

“I called up the national Alzheimer’s association and spoke with their chief librarian for the whole U.S. and her response to me was to say that there were 20,000 books for caregivers of those with memory loss,” said Sobel. “I said, ‘I am not looking for [a book for] the caregiver, I’m looking for my mother, the patient. There was dead silence on the other end of the line. She couldn’t think of any such book. Eventually, she did mention one other author who has since become an acquaintance of mine who had a few books, but they weren’t really what I wanted, so I realized I had to do this myself.

“I first did a book that wasn’t just for Jews. It was for anyone with memory loss. It was called Blue Sky, White Clouds, and came out in 2012.”

Sobel – who has also written a novel and a memoir – received such a positive response to this first picture book that he decided to make it into a series.

“My mother got to enjoy the first book a lot,” said Sobel. “Her aides would use it with her almost daily. We would observe that she would zero in on particular photos, ignore certain pages, find a photo – particularly one of a married elderly couple – and contemplate it for 20 minutes and caress the faces.

“These books are for a particular stage of dementia,” he said. “They’re appropriate for someone who’s got enough memory loss and dementia that they won’t be offended or have awareness that this is kind of a simplistic picture book, they’ll just be interested. But they can’t be too far gone, like my mother now, who can’t even look at my face, let alone my book.”

Caregivers often struggle with how to engage people with Alzheimer’s.

photo - A page from L’Chaim: Pictures to Evoke Memories of Jewish Life — A page from L’Chaim: Pictures to Evoke Memories of Jewish Life. (photo by Olaf Herfurth)

“It’s very hard to find activities to do with someone in that condition,” said Sobel. “So, what I was trying to accomplish was to give caregivers something they could share with the patient … or give patients something they could use on their own…. It was an opportunity for sharing to occur, an activity of quality time. For certain pages, in the earlier stages [of dementia], it stimulates memories, conversations, reminiscences or free association.

“I’m from the creative right brain of things, so I could find things to do with my mother, like empty a box of coins on the table and we’d spend an hour playing with them – pennies over here, stacking the quarters, making a picture of a house with the dimes. Then, I’d say to my dad, ‘See, Dad! There are lots of things you can do with Mom. You could put these coins away and do the same thing tomorrow. She won’t remember.’

“He would call me the next day, and say, ‘Ah, it didn’t work. She didn’t know the difference between a penny and a nickel.’ That was the point. He’s a mathematician and very linear … [he] could not break into the play mode. If you’re someone who’s good with little kids, you can do that with someone like my mom.”

In some ways, Sobel often finds himself feeling grateful to Alzheimer’s, because it made it possible for him and his mother to grow closer – at least for the first 10 years of her disease.

At the beginning, Sobel saw her become more available. As a Holocaust refugee, she had always been very insulated, private and afraid of others. Sobel said he went to a psychic early on in her disease, worried that his mother was losing her memories, and the psychic thought she’d be happier without them.

“It was true,” Sobel reflected. “She transformed from that scared refugee into an open, childlike, loving, laughing angel. People would feel blessed to be around her. She was delightful – greeting strangers and striking up conversations that made no sense. She and I laughed about who knows what. She and my father would dance to music. A lot of things were happy about her Alzheimer’s experience.

“I’m not saying there weren’t nightmarish times. We had our share of those as well,” he added. “She went through a violent period where she was chasing people with steak knives. We had to put her into a psych ward for 10 days.”

That was the exception, though, and Sobel said, “I had an opportunity to finally heal my relationship with her.”