Our problem with understanding speech could lead to someone else making decisions about our medical treatment and our care after hospital visits… Oftentimes we have written about the deciding role of speech comprehension for the quality of life we lead. In our experience we have seen that most people coming in through our doors don’t always think about their future, at least in regards to the next 10-20 years.   Yet it is in our fifties and our mid sixties that we should think deeply where and how we want to spend our best years.

Often we write about the role of hearing aids in helping minimize the loss of speech comprehension and to aid with the correct use of our cognitive functions. Oftentimes we are met with these types of opinions: “Oh I don’t worry myself with these things, I still have time”  or “I don’t know how many more years I will live”. Very often we try to reassure our patients that it’s right now that they are potentially making one of the biggest decisions of their entire lives, Deciding whether they want help and change to better their lives, through the use of hearing aids.

Our confidence and self assurance comes as a result of not only many years of wisdom and experience but firstly from our knowledge of the laws and regulations governing the province of Ontario, a knowledge which unfortunately many of our kin are not educated on. That’s why we need to be more aware of how the laws of our province are structured, especially towards the care of the elderly and their family and guardians. That’s why we’re wishing everybody the best future and guiding our own destiny, through being self sufficient from other people’s decisions and thoughts, we have decided to start writing more on this theme because it is relevant and important to people our age and older.

In a situation where we end up in a hospital because we’re sick, being at an older age might not permit us to return home as we had anticipated, our demising health could result in us being moved to a nursing home because at this point it is seen as unsafe for us to return to our own home. We end up going to a care facility straight from the hospital in a situation where it is deemed that we need to be cared for and can no longer care for our own health and life because we are seen as a danger to ourselves.

One of the fundamental criteria used to judge our well being and ability to care for ourselves is our ability to communicate and our ability to comprehend what is being said to us, as well as our awareness of the situation we are in and the state of our mind. In this case having hearing loss (and at this point the majority of us do because that is the process of aging) with years of not using hearing aids (sort of like not wearing glasses for many years) our level of understanding and comprehension is so diminished that we do not stand a chance of being seen as self sufficient.

Most often this shows us as a person that is incompetent and unable to make decisions and function as a general member of society, our ability to make our own decisions is taken away from us and left in the hands of a caregiver or an institution, this is standard health care protocol and there is little arguing it, our ability to understand speech and communicate is the foundation to showing other that we are able to function in society and do things for ourselves.

We need to also remember that in Canada it is standard that people with hearing loss wear hearing aids, that is the whole purpose of government funding and benefit programs for hearing instruments, these programs cover the partial and sometimes full cost of a hearing instrument. Thus it is assumed that if you are not wearing a hearing aid then your hearing is completely fine because you do not need them, but while many do not wear them their hearing ability is already diminishing and they have a hard time hearing and understanding people, these people need to stop struggling and get their hearing checked as soon as possible.

Information regarding the theme in today’s article can be found in:

“ DISCHARGE FROM HOSPITAL TO LONG-TERM CARE: ISSUES IN ONTARIO ”
By: Jane E. Meadus Barrister & Solicitor Institutional Advocate
This article was originally published in the Advocacy Centre for the Elderly’s
Fall 2010 Newsletter, which is available at: http://www.acelaw.ca

In this article you can also find information regarding how to deal with the process of transferring a patient from the hospital to a special care facility, if and when that person has been deemed to be unable to care for themselves and may present a danger living alone without additional care and when they are no longer capable of making their own decisions.

 “ If the patient is evaluated as being incapable of making the placement decision, the authority to make that decision passes to their SDM. However, this cannot be done merely because the team does not like the decision of the person/SDM If it is the decision of the SDM which is unacceptable, the CCAC (and only the CCAC) may challenge the decision of the SDM by bringing an application to the Consent and Capacity Board (CCB) alleging that the SDM is not complying with the statutory principles for giving or refusing consent set out in the HCCA.15 There is no ability to challenge the decision of the competent person who is not “complying” with “hospital policy” regarding choices. “

In the above stated situation it is critical as to who assumes the role of the SDM, because it does not always have to be the person closest, and quite often and unfortunately it is a representative of the Consent and Capacity Board. Later we will present more information on this theme taken from the source below.

„ Consent & Capacity Board – This information is based on the Health Care Consent Act (1996). “

Hierarchy of Substitute Decision-Makers (Health care consent act of Ontario; 1996)

1. The incapable person’s guardian of the person
2. The incapable person’s attorney for personal care
3. A representative appointed by the Consent and Capacity Board
4. A spouse or partner
5. A child or parent or children’s aid society
6. A parent who has only a right of access
7. A brother or sister
8. Any other relative (related by blood, marriage or adoption)

The Public Guardian and Trustee is the decision maker of last resort if no other person is capable, available or willing to give or refuse consent on behalf of the patient.

If you read the list above you will notice that a spouse or partner is only on the 4th place and a child is only on the 5th place. It is very important to ensure we are doing everything possible to take care of our health, not only physically but most importantly our mental health and cognitive functions, our understanding of speech. So that we are never diagnosed as being incapable or “unable to care for ourselves” or taken to be in that sort of state. We wish this for everyone, and also stress that everyone to start thinking about their future and later years so that we can prepare and be ready for anything we may encounter down the road.

We invite anyone interested in the themes discussed in this article to come in for free consultation to
METRO HEARING AID CLINIC in Mississauga, where you can learn much more on this and other topics regarding your life and health.

Alicja Tobola M.A., HIS, Janusz Tobola B.Sc.,HIS
Metro Hearing Clinic

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