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PSWs have a role standard  which says “personal support workers do for a person the things that the person would do for themselves, if they were physically or cognitively able”.

There is a great deal of variation around the kind of care PSW’s provide, with some PSWs providing medical care such as changing wound dressings and administering medication, and others providing  ‘only’ personal care such as bathing, transfers from bed and housework. What PSWs can and cannot do varies based on their training, supervision and employer policies.

An estimated 57,000 PSWs in Ontario work in the long-term care sector, 26,000 work for agencies that provide community and home care, and about 7,000 provide care in hospitals.

Changes to the Long-Term Care Act in 2010 outlined a minimum standard of education for PSWs working in that sector specifically.

PSWs working in long-term care homes are required to work under the supervision of a registered nurse or registered practical nurse

Some have suggested that rather than standardizing education for PSWs, more standards should be put in place around PSW supervision, scope of practice and work environment in long-term care and community agencies.

92% of PSWs are women, and many work at multiple part time jobs, involving a great deal of shift work.  PSWs are often paid minimum wages with few benefits.

Community colleges, continuing education programs and private career colleges offer courses or programs of varying durations, with no standardized core curriculum across the programs. There is no single body in Ontario that monitors the quality of these programs.

a PSW Registry to collect information about the training and employment status of the nearly 100,000 PSWs in Ontario

Long-Term Care Task Force on Resident Care and Safety

“a registry is a mechanism of counting and it doesn’t ensure anything about quality, preparation or standards.”

in the past two months there have been stakeholder consultations around educational standards for PSWs

Catherine Richards, Cause for Concern: Ontario’s Long Term Care Homes (Facebook group)

“PSWs have high expectations put on them but very little support to do their jobs.”

In my opinion, what we need most is a ministry (MOHLTC) that will demonstrate leadership by clarifying the role of the PSW in long-term care, nursing homes, hospitals and yes, home care, and to consistently enforce high standards of care

PSWs should feel able to rely on consistent supervision and clear guidance from registered nursing staff and management, yet from my observation there is a lack of communication between PSWs and RPNs/RNs in a long term care home setting, and rarely in my experience is honest communication encouraged to include patients/residents and families. In home care, PSWs have even less support or supervision which should concern people.

PSWs are rarely afforded the time to properly perform the necessary tasks assigned to them and they often bear the brunt of complaints

it is the leadership that must accept the bulk of responsibility when PSW care standards are low

Ombudsman oversight would provide an immediate and direct incentive to elevate care standards

In Nova Scotia, a registry was put in place for Continuing Care Assistants (the provinces’ equivalent to PSWs) in 2010 which has been used to communicate directly with CCAs as well as keep track of where they work. In addition, the registry provides resources and the development of a personalized learning plan to help care givers who do not have the provincial CCA obtain further training. British Columbia has also recently introduced a registry for Care Aids and Community Support Workers.

CUPE addresses these issues in Our Vision For Better Seniors’ Care: http://cupe.ca/privatization-watch-february-2010/our-vision-research-paper

having someone help you bathe, dress, eat and even wash your hair is as important as the medical care

I have worked in a Long-Term Care Facility for four years and have many concerns

it doesn’t take a rocket scientist to figure out that some point of care is being neglected

need to have more PSW staff on the front line

“it is like an assembly line here in the morning”

I don’t think these people are getting the dignity and respect they deserve.

We want to stop responsive behaviours, we need to know what triggers are. what is the root cause

We can’t do this with having less than 15 mins per resident for care.

I also believe that registering PSW’s will eliminate those who are in the career for just the money.

I have been a PSW for 8 years

Every year they talk more and more about residents rights, dignity ect ect … and yet every year, residents have been given less one on one time, poorer quality of meals, cut backs on activities and more than anything else, a lessened quality of care provided by over worked PSW’s.

Residents have floor mat sensors, wheelchair sensors, wander guard door alarm sensors, bed alarm sensors and add that to the endless stream of call bells and psw’s pagers sounding, it sounding like you are living inside a firestation with non-stop fire

they do not provide the staff to PREVENT the resident from falling

bell fatigue

This registry is just another cash grab

Now, it will be that much easier to put the blame on us.

When we do our 1.5hrs worth of charting every night they tell us to lie and say we have done restorative care and other tasks which had no time to do so they can provide funding which never seems to result in more staff.

for the Cupe reps reading this. You make me sick. Your union doesn’t back us up in the slightest and you have allowed for MANY additional tasks to be put onto psw’s without any increase in pay.

In the past year alone our charting has become computerized and went from 25mins to 1.5hrs. We now provide restorative care like rehab workers and now are officially responsible for applying and charting for medicated creams, not to mention the additional time spent now that prn behavior meds were discontinued and restraints removed created chaos

when your union reps come into meeting with us to “support” us, they side with our managers

about this registry

my sister works for 12 dollars H in Retirenment home

she has over 40 Residents

you should work in Long Term Care then, you will make a few buck more, still have 30-40 residents but at least you have a partner. On the other hand though, unlike retirement homes, for those 30-40 people, you will be dealing with aggressive behaviors, resistive residents, dementia, 75% of your residents will require a mechanical lift, you will have 1-2hrs worth of charting to do on top of your already hectic work load which they will not provide you more time to complete it, so only expect to get one 15min break in an 8 hr shift and often stay late to finish your charting.

As long as retirement homes are privily own they will always be run under the landlord and tenant act. That’s why they can work you like a dog and get away with it.

My 95 year old Dad is in LTC.

PSW’s simply do NOT have time to maintain, let alone enhance seniors’ quality of life.

there are NO rules or regulations about what the ratio of PSW staff to residents “should be”

quality is more than assistance with daily hygene, feeding, dressing, providing meds, getting people up in the morning, putting them to bed in the evening

psw’s are not only caregivers/ nurses we r also sometimes ONLY friend

The solution to our problem begins at the top, and this all seems very backwards to me.

Personal support workers are one of the back bones of the health care system.

Eleven years later, and nothing has changed? Something’s wrong here!

But I will not let this discourage me from taking the course, because no other job I’ve had has even come close to being as rewarding or fulfilling

is to many P.S.W in Ontario,and is not respect for them

Too many PSW’s are working as a Casual Employee

The pay is better in Long Term care as we know but PSW’s work for that extra few dollars more an hour

Most of us enjoy the field but more work has to be done to take care of your PSW’s and a pat on the back is just not going to do it.

administration has to stop being greedy with their big wages and start finding more money to invest in your front line, the PSW

Shepter's story illustrates a problem that extends far beyond a single California nursing home. ProPublica and PBS "Frontline" have identified more than three-dozen cases in which the alleged neglect, abuse or even murder of seniors eluded authorities.

For more than a year, ProPublica, in concert with other news organizations, has scrutinized the nation's coroner and medical examiner offices [1], which are responsible for probing sudden and unusual fatalities. We found that these agencies -- hampered by chronic underfunding, a shortage of trained doctors and a lack of national standards -- have sometimes helped to send innocent people to prison and allowed killers to walk free.

If a senior like Shepter dies under suspicious circumstances, there's no guarantee anyone will ever investigate.

"a hidden national scandal."

Because of gaps in government data, it's impossible to say how many suspicious cases have been written off as natural fatalities.

In one 2008 study, nearly half the doctors surveyed failed to identify the correct cause of death for an elderly patient with a brain injury caused by a fall.

Autopsies of seniors have become increasingly rare even as the population age 65 or older has grown. Between 1972 and 2007, a government analysis [2] found, the share of U.S. autopsies performed on seniors dropped from 37 percent to 17 percent.

"father was lying in a hospital bed essentially dying of thirst, unable to express himself -- so people could have a nice, quiet cup of tea."

"We're where child abuse was 30 years ago," said Dr. Kathryn Locatell, a geriatrician who specializes in diagnosing elder abuse. "I think it's ageism -- I think it boils down to that one word. We don't value old people. We don't want to think about ourselves getting old."

A study published last year in The American Journal of Forensic Medicine and Pathology found that nearly half of 371 Florida death certificates surveyed had errors in them.

Doctors without training in forensics often have trouble determining which cases should be referred to a coroner or medical examiner.

State officials in Washington and Maryland routinely check the veracity of death certificates, but most states rarely do so

there has to be a professional, independent review process

a public, 74-bed facility

Some counties have formed elder death review teams that bring special expertise to cases of possible abuse or neglect. In Arkansas, thanks to one crusading coroner, state law requires the review of all nursing-home fatalities, including those blamed on natural causes.

Of the 1.8 million seniors who died in 2008, post-mortem exams were performed on just 2 percent. The rate is even lower -- less than 1 percent -- for elders who passed away in nursing homes or care facilities.

As the chief medical examiner for King County, Harruff launched a program in 2008 to double-check fatalities listed as natural on county death certificates. By 2010, the program had caught 347 serious misdiagnoses.

Thogmartin said "95 percent" of the elder abuse allegations he comes across "are completely false," and that many of the claims originate with personal injury attorneys.

Decubitus ulcers, better known as pressure sores or bed sores, are a possible indication of abuse or neglect. If a person remains in one position for too long, pressure on the skin can cause it to break down. Left untreated, the sores will expand, causing surrounding flesh to die and spreading infection throughout the body.

Federal data show that more than 7 percent of long-term nursing-home residents have pressure ulcers.

"Very often, that is the way these folks die," he said. "It is a preventable mechanism of death that we're missing."

"Occasionally, there are elderly people who are being assaulted. But this issue of pressure ulcers is a far, far bigger issue, and really nationwide."

a new state law requiring nursing homes to report all deaths, including those believed to be natural, to the local coroner. The law, enacted in 1999, authorizes coroners to probe all nursing-home deaths, and requires them to alert law enforcement and state regulators if they think maltreatment may have contributed to a death.

"It was a horrible place,"

A 2004 review of Malcolm's efforts by the U.S. Government Accountability Office concluded that the "serious, undetected care problems identified by the Pulaski County coroner are likely a national problem not limited to Arkansas."

prompted Medicare inspectors to start citing nursing homes for care-related deaths and to undergo additional elder-abuse training.

Still, nursing homes inspections are not designed to identify problem deaths. The federal government relies on state death-reporting laws and local coroners and medical examiners to root out suspicious cases

They found such problems repeatedly at Riley's Oak Hill Manor North in North Little Rock.

investigations led state regulators to shut down the facility, in part because of the home's failure to prevent and treat pressure sores

staffing in homes is a constant challenge. Being a caregiver is a low-paying, thankless kind of job. (at one time you could make more money flipping burgers than caring for our elderly- priorities anyone??) With all the new Medicare cuts, pharmacy companies who continue to overcharge facilities for services, insurance companies who won’t be regulated, our long-term facilities are in for a world of hurt- which will affect the loved ones we care for. Medicare cuts mean staffing cuts- there are no nurse/patient ratios here- meaning you may have one nurse for up to 50 residents. Scary? You bet it is!!  Better staffing, better care, everyone wins.

Lets not just blame the caregivers. Healthcare and business do not mix. When a business is trying to make money, they will not put the needs of patients and people first. To provide actual staffing (good-competant care with proper patient to caregiver ratios) the facilities would not make money.

When the federal government realized a national strategy was needed, it created Canada Health Infoway, a not-for-profit corporation that has received $2.1 billion since its founding in 2001 to invest in provincial electronic health projects and set pan-Canadian standards for interoperability.

The greatest cost pressure on the system, however, may be the demographic shift and the steady rise in the number of senior citizens requiring chronic care.

The provinces will look to expand a collective drug-purchasing plan, set new guidelines to cut the number of unnecessary medical procedures and improve home care for senior citizens. These strategies were on the table Friday as provincial health ministers hunkered down in Toronto for two meetings on overhauling the nation's universal health-care system and wrestling down its cost.

The second, chaired by Ontario Health Minister Deb Matthews, focused on dealing with the nation's aging population.

The provinces are also looking at ways to cut back on pricey diagnostic tests and surgeries such as MRIs, knee replacements and cataract removals. After consulting with health-care professionals, they hope to draw up a series of voluntary guidelines, to be presented this summer, on when such procedures are necessary and when they can be skipped.

The provinces will look to expand a collective drug-purchasing plan, set new guidelines to cut the number of unnecessary medical procedures and improve home care for senior citizens. These strategies were on the table Friday as provincial health ministers hunkered down in Toronto for two meetings on overhauling the nation's universal health-care system and wrestling down its cost.

The first session was part of the Health Care Innovation Working Group

The first session was part of the Health Care Innovation Working Group

The second, chaired by Ontario Health Minister Deb Matthews, focused on dealing with the nation's aging population.

Last year, the working group produced a deal that saw the provinces and territories, with the exception of Quebec, team up to purchase six generic drugs in bulk, which resulted in savings of $100-million annually.They want to take a similar approach to buying name-brand medicines. Mr. Ghiz estimated such a plan could save $25-million to $100-million more.

Last year, the working group produced a deal that saw the provinces and territories, with the exception of Quebec, team up to purchase six generic drugs in bulk

They want to take a similar approach to buying name-brand medicines. Mr. Ghiz estimated such a plan could save $25-million to $100-million more.

The provinces are also looking at ways to cut back on pricey diagnostic tests and surgeries such as MRIs, knee replacements and cataract removals. After consulting with health-care professionals, they hope to draw up a series of voluntary guidelines, to be presented this summer, on when such procedures are necessary and when they can be skipped.

The greatest cost pressure on the system, however, may be the demographic shift and the steady rise in the number of senior citizens requiring chronic care.

finding ways to keep seniors out of hospital.

For all the provinces' innovations, however, Mr. Ghiz said they could use more help from Ottawa.

“Hopefully, some day, the federal government will be at the table with dollars and with ideas – we're open

Similarly, Canadian Healthcare Association President Pamela Fralick dubs the blueprint as “not a health budget.” “There’s shared leadership in this. We’re still looking to the federal government for some leadership on issues, which they’re not necessarily embracing at the moment,” she says.

the absence of any indication that the federal government plans to pursue the introduction of any manner of accountability mechanisms surrounding health outcomes as part of transfer payments to the provinces for health care

Among other health and research-related measures:

$6.5 million over three years will be provided to researchers at McMaster University to conduct an evaluation of “ways to achieve better health outcomes for patients while also making the health care system more cost-effective, through greater implementation of medical teams.”

Commencing this year, physicians will be included among the “target occupations” in the Pan-Canadian Framework for the Recognition of Foreign Qualifications, under which foreign-trained professionals who seek to work in Canada will have their qualifications assessed within a one year period.

Mr. Ryan has proposed cutting federal spending on Medicaid by $810 billion over 10 years. Mr. Obama’s expansion plan, by contrast, would cost an additional $642 billion over the same period

More than half of current Medicaid spending is on the elderly and the disabled. About half of Medicaid recipients are children; an additional 25 percent are elderly or disabled people.

States have generally not been allowed to cut Medicaid eligibility since the passage of the health care law in 2010, but many have slashed optional benefits and payments to doctors and hospitals instead. Even states that support the planned Medicaid expansion, like California and Massachusetts, have made such cuts

critics of the block grant plan say it would inevitably shrink the medical safety net for the poorest Americans. The Urban Institute, a nonpartisan research group, estimated that under a similar House budget proposal last year, 14 million to 27 million people could lose Medicaid coverage by 2021.

The feds could work with the provinces to set up a “buyer in chief,” trimming costs for everyone by flexing our purchasing-power muscle through a single-payer system. Taking $600 million from the escalator, matched with existing expenditures by the provinces and territories, could start a process that, over five years, could build toward a pan-Canadian formulary of the 100 most commonly prescribed drugs, negotiate a better price through bulk buying, and collectively save ourselves billions.

bring a preventive, child-focused dental care program to every child under 14 in their schools for an estimated $564 million nationwide. The feds could provide a 50-cent dollar for every province that signs up. A $300 million investment through the new funds, matched by what the provinces already spend, would save billions down the road and improve lives

Far too many people turn to our hospitals for want of options for primary health care in the community.

integration of care between our hospitals and our communities

Take $700 million from the escalator funds today and start the process of expansion

that’s what Canadians want: change that buys better health, better care and better control of costs

The most obvious way to fix the problem would be to bring prescription drugs under Medicare. To do so would also make economic sense: in a recent Canadian Medical Association Journal study I coauthored, we found that implementing universal public drug coverage would save the private sector a whopping $8.2 billion annually. It seems counterintuitive to think that covering more people would cost us less. However, if we bargained more effectively and purchased medications in bulk, the prices we pay for those drugs we already buy publicly would go down. If access to health care in Canada is truly based on need, not ability to pay, there is no justifiable reason to exclude prescription medications from our public plans. As we head into election season, let's demand some big ideas from our politicians that will really improve the health of Canadians. A basic income and universal pharmacare would be a good start. If we did those two things, there would be a real, measurable impact on the health of our communities. After all, that's what government is for. Dr. Danielle Martin is a family physician and vice-president of medical affairs at Women's College Hospital in Toronto. A renowned advocate for Medicare, Martin will be speaking about "Creating a Healthy Canada: An Agenda for Today ... and Tomorrow" on Wednesday at City Hall.

"I'm here to listen to the province's eight million people, not the 8,000" general practitioners, Barrette told reporters on Nov. 28, the day he made public one of his more controversial proposals - threatening doctors with penalties of up to 30 per cent of their income if they don't see more patients.

Most people who observe the health-care system would say something had to give, something needed to be done," said Antonia Maioni, a professor in McGill University's Institute for Health and Social Policy.

During a heated exchange in the National Assembly with Diane Lamarre, the PQ's health critic, Barrette insinuated that she might be suffering from a "form of epilepsy" after she kept repeating the same questions about Bill 10. That remark drew a rebuke from House Speaker Jacques Chagnon.

But it's not Barrette's zingers that have made him so polarizing as health minister: it's his plans to overhaul the public system and the way he's gone about it.

Barrette, by comparison, announced his reforms only four months after being appointed health minister. None of his proposals - from abolishing regional health agencies to penalizing doctors financially - were alluded to in the Liberal election platform.

The reforms were unveiled in quick succession as Bills 10 and 20, with no public consultation beforehand.

Barrette has had a hard time garnering widespread support for Bill 10, his effort at restructuring Quebec's health system. The bill has two goals: to downsize Quebec's costly, Byzantine health bureaucracy, and to streamline the governance of its institutions.

Critics have assailed Bill 10 not so much for its goal of cutting administrative costs by more than $200 million a year as its objective to eliminate the boards of directors of many health institutions - from rehab centres to hospitals. Quebec's anglophone community is particularly concerned that many bilingual institutions would vanish in "one fell swoop," as former Liberal MNA Clifford Lincoln has warned. The bill would also confer on the health minister - in this case, Barrette - the power to hand-pick members of so-called mega boards.

140 amendments in December

continue to make services available in English - a measure that critics contend is still no guarantee for the anglo community. The relatively high number of amendments - even for a complex piece of legislation like Bill 10 - would suggest that Barrette underestimated both the opposition to his reforms and the possible unintended consequences.

In November, Barrette tabled Bill 20, which the minister himself described as "first the carrot, now the stick."

Like his first piece of legislation, Bill 20 has two goals: to compel both medical specialists and family doctors to follow more patients or risk being docked their pay; and to no longer cover in vitro fertilization under medicare.

Many couples and fertility specialists are also incensed by his plan to de-list IVF from medicare, denouncing his proposals as draconian and hastily formulated. There's no doubting that Barrette's proposed reforms are part of the Liberal government's austerity agenda. But beyond that, it's not so clear what his overall vision might be for Quebec's beleaguered health system, critics argue. And that lack of vision might mean the difference between whether those reforms succeed or fail.

Dozens of people have lost some of their sight after undergoing botched operations provided by a private healthcare firm at an NHS hospital.The hospital in Somerset is facing a string of claims for compensation after half the 60 patients who underwent the procedure suffered complications.

Dozens of people have been left with impaired vision, pain and discomfort after undergoing operations provided by a private healthcare firm at an NHS hospital.

The son of the 84-year-old patient, who asked not to be named, said his father was referred for the cataract surgery by his GP. The retired salesman, from the Somerset Levels, did not consider he needed the operation but agreed to the treatment.

The routine cataract operations were carried out by the private provider in May to help to reduce a backlog at Musgrove Park hospital in Taunton. But the hospital's contract with Vanguard Healthcare was terminated only four days after 30 patients, most elderly and some frail, reported complications, including blurred vision, pain and swelling.

The trust refused to talk in detail about what happened pending the conclusion of its own investigation. It also refused to discuss who would pick up any bill for compensation or details of its contract with Vanguard.

But, when the problems surfaced, a senior member of staff at Musgrove Park appeared to concede that the hospital would be liable for any payments.

One 84-year-old man claimed he has lost his sight and his family is calling for a full independent inquiry after it emerged that half of the 60 patients who underwent surgery suffered complications.

The son said the procedure took 15 minutes and his father felt it was "very rushed".

"My father is traumatised and depressed with the loss of his eyesight. Previous pleasures of gardening and watching sport on the TV have been taken away from him.

Among the questions the family want addressed in an independent inquiry is whether Vanguard was brought in to save the trust from paying a financial penalty because of the backlog.

Laurence Vick, a medical negligence lawyer, who has been approached by some of the victims, said the case highlighted the "uneasy relationship" between the NHS and the private sector.

He said the question of who paid when outsourced NHS treatment failed was of growing importance as more services were handed over to the private sector.

By Bob Peterson / Rethinking Schools

long history of being staff-dominated.

And it has. In New Orleans, following Katrina, unionized teachers were fired and the entire system charterized.

But it recognizes that our future depends on redefining unionism from a narrow trade union model, focused almost exclusively on protecting union members, to a broader vision that sees the future of unionized workers tied directly to the interests of the entire working class and the communities, particularly communities of color, in which we live and work.

It requires confronting racist attitudes and past practices that have marginalized people of color both inside and outside unions.

Having decimated labor law and defunded public education, Walker proceeded to expand statewide the private school voucher program that has wreaked havoc on Milwaukee, and enacted one of the nation’s most generous income tax deductions for private school tuition.

For nearly a decade we pushed for a full-time release president, a proposal resisted by most professional staff.

“Social Justice Unionism: A Working Draft”

Social justice unionism is an organizing model that calls for a radical boost in internal union democracy and increased member participation.

business model that is so dependent on staff providing services

building union power at the school level in alliance with parents, community groups, and other social movements.

The importance of parent/community alliances was downplayed

instead of helping members organize to solve their own problems.

Our challenge in Milwaukee was to transform a staff-dominated, business/service-style teachers’ union into something quite different.

only saw the union newsletter after the staff had sent it to the printer.

Key elements of our local’s “reimagine” campaign and our subsequent work include:

Building strong ties and coalitions with parent, community, and civic organizations,

broader issues

action.

earliest victories was securing an extra $5/hour (after the first hour) for educational assistants when they “cover” a teacher’s classroom.

lobby

enlist parents

we amended the constitution

consistently promoting culturally responsive, social justice teaching.

encourage members to lead our work.

release two teachers to be organizers

appear en masse at school board meetings

to shift certain powers from the staff to the elected leadership

new teacher orientation and mentoring are available and of high quality.

The strength of the Chicago Teachers Union (CTU) 2012 strike,

rested in large part on their members’ connections to parent and community groups

Karen Lewis

Portland, Oregon, and St. Paul, Minnesota

In Milwaukee, our main coalition work has been building Schools and Communities United,

We wanted to move past reacting, being on the defensive, and appearing to be only against things.

Key to the coalition’s renewal was the development of a 32-page booklet, Fulfill the Promise: The Schools and Communities Our Children Deserve.

concerns of the broader community beyond the schoolhouse door

English and Spanish

Currently the coalition’s three committees focus on fighting school privatization, promoting community schools, and supporting progressive legislation.

schools as hubs for social and health support,

This work reminds me of the words of activist/musician Bernice Johnson Reagon, of Sweet Honey in the Rock: “If you are in a coalition and you are comfortable, that coalition is not broad enough.”

Our new professional staff is committed to a broader vision of unionism with an emphasis on organizing.

We need to become the “go-to” organizations in our communities on issues ranging from teacher development to anti-racist education to quality assessments.

nonprofit organization, the Milwaukee Center for Teaching, Learning, and Public Education

We provide professional development and services to our members

reclaim our classrooms and our profession.

We partner with the MPS administration through labor/management committees

multiple committee meetings, inservice trainings, book circles (for college credit), and individual help sessions on professional development plans or licensure issues.

we offered workshops that drew 150 teachers at a time.

More teachers were convinced to join our union, too, because our teaching and learning services are only open to members.

mandate 45 minutes of uninterrupted play in 4- and 5-year-old kindergarten classes

We also won a staggered start

convincing the school board to systematically expand bilingual education programs throughout the district.

school-based canvassing around issues and pro-education candidates, and organizing to remove ineffective principals.

With the plethora of federal and state mandates and the datatization of our culture,

It’s clear to me that what is necessary is a national movement led by activists at the local, state, and national levels within the AFT and NEA—in alliance with parents, students, and community groups—to take back our classrooms and our profession.

social justice content in our curriculum

waiting to use any perceived or real weakness in public schools as an excuse to accelerate their school privatization schemes,

On the other hand, speaking out can play into the hands of the privatizers as they seek to expand privately run charters

including participation on labor/management committees, lobbying school board members, and balancing mass mobilizations with the threat of mass mobilizations.

In the end, we recognize a key element in fighting privatization is to improve our public schools.

In Los Angeles, an activist caucus, Union Power, won leadership of the United Teachers Los Angeles, the second largest teacher local in the country.

So in their study, Report on Food Provision in Ontario Hospitals and Long-Term Care Services: The Challenges and Opportunities of Incorporating Local Food, it follows that Padanyi and her team found substantial barriers to requiring that all public health-care facilities in Ontario incorporate local food into their patient and visitor food service.

Simply put, we're not there yet. We have a hard enough time agreeing on the definition of local food, let alone providing it en masse to sick and elderly people.

Having looked at some institutional case studies in our area, they say local food can be offered to patients and residents very successfully, on a facility-by-facility basis.

Realistically, though, not much will change on the hospital-food frontier as long as the province gives hospitals peanuts for food care. True, no one checks into the hospital for its food. But it's sure one more reason to check out.

Report on Food Provision in Ontario Hospitals and Long-Term Care Services: The Challenges and Opportunities of Incorporating Local Food

After decorating Halloween cookies together, Han brings his own masterpiece, smothered in smarties and sprinkles, to Clark and encourages her to try it. Few words are exchanged, but smiles and giggles are constant at the intergenerational program at Youville Residence, a long-term care facility for seniors in Vancouver. Han Jr. is among a half dozen children visiting this day from the Montessori Children's Community - a daycare located on the same site as Youville, at 33rd and Heather.

Montessori Children's Community administrator Kristina Yang said it's a win-win situation. "Even if there is not a lot of communication with words you can see the beautiful smiles on everyone's face. Many of the children come to know a lot of the seniors and when they pass by our window they'll be excited waving and saying 'Hi ,'" Yang said.

Youville occupational therapist Sheralyn Manning said the children's visits are a big part of the seniors'day. Besides planned events, such as doing crafts together, every so often the children will visit when the weather is bad and they are not able to play outdoors. Manning pointed out the friendship between Clark and Han has been particularly touching to watch and Clark has a recent craft project Han gave her prominently displayed in her room. When most people think of nursing homes the image that comes to mind is a stand-alone building offering residential care only for the aged.

It's a place seldom visited unless you are a family member, friend or volunteer. But these days more homes are trying to build bridges to the wider community. Of B. C.'s 460 government and private nursing homes, only a handful have daycares or doctor's offices on site, said Daniel Fontaine, CEO of the B. C. Care Providers Association, which represents 60 per cent of the privately-operated homes. But none are attached to a facility that offers a large variety of community services. One of the best Canadian examples of a nursing home that achieves just that, said Fontaine, is Niverville Heritage Centre, near Winnipeg. It is home to 116 seniors but is also a gathering place for major community events.

The centre hosts 100 weddings each year. As well, about 50,000 visitors drop in at the centre annually to access their doctor's office, dentist and pharmacist or visit the full-service restaurant and pub. "We found seniors don't want to be retired to a quiet part of the community and left to live out their lives. They want to live in an active community and retreat back to their suite when they want that peace and quiet ," said Niverville Heritage Centre's CEO Steven Neufeld.

Before the centre opened in 2007, he said, members from the non-profit board that operates the centre visited traditional nursing homes and discovered that the lounges that were built for seniors were seldom used. "I remember going to one place where there was a screened-in porch that was packed. The seniors were all there wanting to watch the soccer game of the school next door ," he said. Having services like doctors'offices, dentists, a daycare, a full-service restaurant, and hair styling shop on site fulfil the centre's mission of being an "inter-generational meeting place which fosters personal and community well-being." Fontaine said it's worth noting that Niverville was able to "pull all of this together in a community with a population of less than 5,000 people." He hopes more B. C. nursing homes follow Niverville's lead.

Elim Village in Surrey, which offers all levels of residential senior care on its 25-acre site, is on that track. There are 250 independent living units, 109 assisted living units and 193 traditional nursing home beds. The village also has a 500-seat auditorium, located in the centre of the village, that hosts weddings and is available for rent for other public events. Elim Village also rents out space in one of its 10 buildings to a school, which allows inter-generational programs to take place easily between students and seniors. Another "continuing care hub " at Menno Place, in Abbotsford, has a public restaurant called Fireside Cafe, popular with staff from nearby Abbotsford Regional Hospital and Cancer Centre. There's also a pharmacy and hairdresser on its 11-acre "campus " site but these services are available only to the 700 residents and staff. "We purposely try to involve the community as much as possible ," said Menno Place CEO Karen Baillie. "It's Niverville on a smaller scale." She said Menno Place partners with high schools and church groups and hundreds of volunteers visit regularly. "Seniors are often challenged with isolation and fight depression. That's why we have different programs to encourage them to socialize ," she said.

Research shows 44 per cent of seniors in residential care in Canada have been diagnosed with depression, and one in four seniors live with a mental health problem, such as depression or anxiety, whether they live in their own home or are in residential care. A 2014 report by the National Seniors Council found socially isolated seniors are at a higher risk for negative health behaviours including drinking, smoking, not eating well and being sedentary. The report also found social isolation is a predictor of mortality from coronary disease and stroke, and socially isolated seniors are four to five times more likely to be hospitalized.

Since more seniors now remain in their own homes longer those who move into care homes are often more frail and need a higher level of assistance, said Menno Place director of communications and marketing Sharon Simpson. Seniors with dementia, in particular, can be socially isolated as friends and family often find it more difficult to visit them as they decline, she said. But Simpson said an intergenerational dance program, run by ballet teacher Lee Kwidzinski, has been a wonderful opportunity for seniors with dementia to be connected to the community. The program is also offered in four other nursing homes in the Fraser Valley. "For them it's an opportunity to see children. You can see the seniors come to life, smiling and giggling at the girls'antics. It's very engaging ," she said. "Some may not be verbal but they are still able to connect. They feel their emotions and they know whether someone is good to them. They feel these girls and become vibrantly alive. It's one of the most powerful things I've ever seen."

Creating community connections is key as Providence Health begins its planning stage to replace some of its older nursing homes in Vancouver, said David Thompson, who is responsible for the Elder Care Program and Palliative Services. Providence Health operates five long-term-care homes for approximately 700 residents at four different sites in the city. "It's always been our vision to create a campus of care on the land ," said Thompson, of the six acres owned by Providence Health where Youville is located.

He said the plan is to build another facility nearby, with 320 traditional nursing home beds. One of the ways to partly fund the cost is to include facilities that could be rented out by the larger community, which would be a benefit to the seniors as well, he said. There is already child care on site, and future plans to help draw in the community include a restaurant, retail space and an art gallery. He said another idea is to partner with nearby Eric Hamber Secondary School by providing a music room for students to practise.

"Cambie is at our doorsteps. If you have people coming in (to a residential care facility) it brings vibrancy and liveliness ," Thompson said