I am a Developmental Service Worker who works in the province of Ontario. I am considered an unregulated health care professional and am currently the primary care provider to the first two individuals in our agency's 30+ year history that are expected to die at home. Palliative care, RN delegation of tasks to unregulated health care professionals and E.D.I.T.H are all foreign to the agency that I work for. In fact those topics were so foreign that we were expected to provide CPR, regardless of the resident having a DRN in place, because our agency was afraid of the liability that comes with our mandate to provide lifesaving care in a medical emergency. This mandate is put in place by the Ministry of Community and Social services. It took me over two months, but our agency has finally flipped it's decision and we are no longer expected to provide CPR to an individual in our care who has a DNR , but I still continue an uphill battle when it comes to the management of palliative care inside of a group home setting.
From my experiences over the past year, I truly believe that more time is needed in educating our sector as well as other sectors who run 24 hour care and are also employing unregulated health care professionals, exactly how wide our scope can become within the mechanisms of delegation. An example of this is we are currently unable to administer pre dosed medications into a sub-Q line, regardless of the Champlain LHIN and their partners CCAC and the Regional Palliative Care Team at Elizabeth Bruyere in Ottawa offering to teach our staff team how to do so. The reason for this is it doesn't fit into our mandate. I have seen my residents in crisis for up to six hours waiting for a RN to come in and administer what was supposed to be a PRN medication. By showing agencies the flexibly of UCP's and our ability to be delegated tasks that are typically shown to family members who have no health care experience to administer these same drugs would save those in our care hours of unnecessary suffering. Clear direction of what a UCP is able to do, and how the mechanism of delegation works would be key to our success. As those in our population continues to age to ages that haven't been seen before, palliative care and expected death inside the home will become more and more common. Right now I feel like we are being reactive and the process of implementing forward thinking when it comes to health care for those in our service is straining and suffers from serious drag while our board and senior management grapple with legal implications and liabilities that I feel would not be a concern if the education was there.
Agencies that provide round the clock total care for adults with developmental disabilities should be giving the opportunity to take advantage of these above listed elements so we could provide the care our residents need in a timely fashion. Also worth mentioning is if our population adopted EDITH protocols for those in our care, we are freeing up hospice/palliative care beds and hospital space needed by patients who do not receive the type of care we provide our clients. So far this has been my experience with palliative care in Canada. Further questions or comments can be provided by contacting me at the email address I have listed in my registration process.