Patient feels shafted by the system

Mallory Clarkson
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Lack of preventative care leads to health complications

Clarenville resident Barry Moores says his inability to access foot care has caused health complications for him.

Clarenville — For most people, the simple task of grabbing clippers from the bathroom, bending down and trimming your toenails is second nature.

But, for Barry Moores of Clarenville, whose multiple sclerosis keeps him housebound and reliant on a wheelchair, it’s complicated.

He can’t bend down and do it himself.

His home-care worker can’t do it because of regulations.

Because of his condition, a professional must do the clipping. A nick or cut could be detrimental to his health because of his MS.

Because of the time that has passed since his last professional trim, one of his big toenails became overgrown, then cracked. Now it’s infected.

His doctor prescribed antibiotics to fight the infection and Moores has to keep his foot elevated all day. The medication is helping his toe, but is wreaking havoc on his body — aggravating his MS symptoms.

He’s worried that if the infection worsens, his toe may have to be amputated.

Quite simply, Moores is at his wit’s end.

A nurse used to provide foot care for him, but that service ended six months ago.

Jackie O’Brien, a media specialist with Eastern Health, said home and community care nurses employed by the organization do not provide foot care.

It’s not Eastern Health’s mandate to do so, she said.

O’Brien said Eastern Health directs patients to private practices that provide specialized care, but it’s up to the patient to “Make contact with the health-care provider, set up this type of care and take responsibility for their own health care.”

She explained that the home and community care nurses employed by Eastern Health offer acute care services, chronic care and chronic disease management and support, assessment for placement to long-term care, home supportive services and palliative and end of life care.

O’Brien said if a client can’t leave his or her home, home visits are available. But although post-hospital care, like changing dressings, is provided by these nurses, preventative maintenance, like foot care, isn’t.

As for Moore’s contention that nurses who were providing foot care to him could no long do it because of their workload, O’Brien confirmed there are two community nurses providing services in a region that includes Random Island, South West Arm and the Harcourt to Clarenville area.

She also confirmed there are three positions assigned to the area, but one position is vacant. It will be filled March 7.

Asked whether registered nurses have to take a special course to provide foot care to patients, O’Brien said, “We believe that is correct. However, we are unable to comment on how many nurses have this certification or how many clients require this type of care, as it is not a service that is offered by Eastern Health.”

The process

O’Brien explained that people who need foot care may qualify for financial assistance to help pay for a private service.

She says social workers can assess the client’s needs and provide information.

“For example, (social workers) may decide a client needs 24-hour (home) care or they need foot care. If the client needs foot care, they direct them to where they can find that service.”

Moores said he has already gone through the process.

He said he kept calling his social worker every couple of weeks to get the service, to no avail. He also called his doctor to come to his home to examine his split toenail.

“I didn’t think I had to go any further (than) my social worker and my doctor — those were the people I talked to,” he said. “It wound up getting tossed into other correspondence. I didn’t keep anybody in the dark about this.”

While Moores contends that the two nurses in Clarenville who provided foot care in the past had full slates and couldn’t continue caring for him, O’Brien said there haven’t been any cases where home care has ceased for this reason.

“There is no wait list for home and community care services; clients are admitted to and discharged from the program based on the nurses’ assessment of a client’s needs,” she wrote via email.

“The demand for home and community care services has increased over the past year; however, this has not impacted service delivery and there is no incident of where our nurses have not been able to provide a service.”

Moores, meanwhile, just wants his toenails trimmed.

“It’s absurd,” he said last week. “If they could find a solution as quick as they find an excuse, we’d be off to a good start here.”

He sees it as systemic failure at Eastern Health.

“They’re not able to put together the simplest of needs,” Moores said, adding health care should be second nature to Eastern Health.

“They’re not called Eastern Mechanical (and) they’re not called Eastern Carpet and Flooring — they’re called Eastern Health. Where are these services that I was led to believe were the mandate of this organization?”

The Packet

Geographic location: Clarenville, Random Island

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