Winter 2017 Issue 102The Eighth LineWinter 2017 Issue 102The Eighth Line

In This Issue:

• Privacy Breaches Part 1• Patients with Dementia• Finance & Audit Update

The Circle of Care

The Circle of Care

Eye on Evanston – Calgary

Position: Optical Sales/ Optometric Assistant. Additional Information: Student Opticians Encouraged to Apply. Eye on Evanston is an eye clinic in NW Calgary with an emphasis on comprehensive ocular health exams and quality patient/customer care. We are looking for full time and part time staff to fill positions for Optometric Assistant/Sales Associate. Ideal Candidates would be friendly and professional. Position includes scheduling exams, checking insurance benefits, invoice/billing, and performing preliminary diagnostic testing on patients, assisting in dispensing, sales of glasses and contact lenses, and other administrative duties. Also assist in day to day operations of the office such as maintaining frame inventory, billing, and accounts receivables. We offer a competitive salary. Vision care benefits are included. Optometry/Optical experience is an asset. Student Opticians are encouraged to apply, as you will get the opportunity to shadow and work with an experienced Optician.Please submit your resume to drkhan@eyeonevanston.com Contact: Dr. Khan, Address: 2060 Symons Valley Parkway NW #8110, Calgary, AB, T3P 0M9 Phone: 403.457.9669 E-Mail: drkhan@eyeonevanston.com Website: www.eyeonevanston.com

Mainstreet Vision Care - Edmonton

Position: Managing Optician. Additional Information: We are a well-established optometric practice of over 35 years with a loyal patient base and a busy dispensary. We offer the latest technology in our eye exams, including OCT and fundus photography. Our beloved long-time office manager

Classifiedis looking to move to a part-time position and pass the torch to a licensed optician who is just as passionate about patient care. They must be knowledgeable in all aspects of opticianry, with a good knowledge base of lenses.Management experience is a plus but not required. Edging experience is an asset. Must be a licensed optician (contact lens license not required).We are open Monday to Saturday, evenings on Wednesday and Thursday. Closed Sundays and all stat holidays. Position includes medical benefits with full-time hours (30 hours or more per week).Don’t miss this exciting opportunity. Please email you resume to mainstreet1@hotmail.ca. Contact: Jason Meyers, Address: 6135 – 28 Ave, Edmonton, AB, T6L 6N5, Phone: 780.462.8209 Fax: 780.463.1107 E-Mail: mainstreet1@hotmail.ca Website: www.mainstreetvisioncare.com

Costco Optical - Edmonton North

Position: Licensed contact lens practitioner. Additional Information: Looking for a highly motivated, customer oriented individual willing to work in a fast paced environment. Costco offers excellent compensation and benefits package. To apply please go to Costco.ca and complete the on line application form . Contact: Tracey Serediak, Address: 13650-50th st Edmonton AB T5A 4Y3, Phone: 780.475.9477 Fax: 780.476.7509

Spruce Grove Vision Care - Spruce Grove

Position: Licensed Optician/Student Optician. Additional Information: Spruce Grove Vision Care is looking for a full time Optician/Student Optician. Applicant must be able to work in a fast paced environment, and be a team

player. Position can include benefits and monthly bonuses. Contact: Karen Kreye. Address: 216 Main Street, Spruce Grove, AB, T7X 0G2, Phone: 780.962.3370 Fax: 780.962.6054 E-Mail: karen@sgvisioncare.com Website: sgvisioncare.com

Urban Optique – Calgary

Position: Optician/Student Optician. Additional Information: Hiring Full Time and Part Time staff. We are looking for an energetic person to join our fast paced, busy Optical office. You must be eager to learn, a team player and possess a strong work ethic. Duties include selling glasses and contact lenses, answering phones, and overall customer service. Student and Licensed Opticians welcome. We offer group health benefits and bonus program. We have great hours and are closed on Sundays and Statutory holidays. Please send your resume to Christina Logee. We will contact you for an interview should we wish to proceed. Contact: Christina Logee, Address: #132 4935-40 Ave, NW, Calgary, AB, T3A 2N1 Phone: 403.880.1094 E-Mail: christina.logee@iris.ca

Hello fellow opticians, it has been a busy a busy season as many interesting developments have occurred in the last while. The College/Association had a meeting with the government to discuss current practices as well as scope increase abilities. They were very productive and cordial with follow up discussions and meetings planned. Speaking of changes if you have not heard our name for the College has changed to reflect the Association aspect of the organization. Going forward we will be the ACAO (Alberta College and Association of Opticians) which I think is a very exciting change for our profession and its recognition.

If you have not heard the Colleges of the Opticians of Ontario as well as the College of Optometrists have filed an injunction with the Ontario courts in regards to online dispensing with Clearly Contacts. It should be interesting to see how this all unfolds. We continue to work towards a strong vision screening program that we can assist the health care system by early detection of children with visual limitations, and aid in helping get them to get an eye exam if so needed which will help with their learning requirements. I hope all of you had a wonderful holiday season and hope that your New Year will be a great year for all of you.

Scott Smith, RO, RCLPPresident

The Prez Mez

Help Stop Blindness & Hunger in Africa & AsiaH.S.B.H.A.A is a non-profit, non-denominational and non-religious charity here in Calgary, Alberta. (lic #323125). We have a function every year to raise funds for the blind, very poor and the hungry for people in Africa & Asia. This year we are focusing on the blind and holding a Enchanted Evening.

Holiday Inn South403.287.2700

4206 MacLeod Trail SECalgary, Alberta

February 11, 2017 at 7:30 p.m. Regular Price: $65.00 VIP Price: $100.00

Live band and DJ, silent auction, raffles

100 % of the net proceeds from the function will go to the Jubilee Hospital in Kenya, Africa. The hos-pital treats 460, 000 patients a year. At H.S.B.A.A not “one cent’ is used for administration costs, it is fully run by volunteers.

FACTS:Every five seconds one person goes blind in the world. (WHO)Every minute one child goes blind in the world. (WHO)There are 37 million blind persons in the world, of which 90% (34 million) in developing countries.Africa has the highest incidence of blindness at 10 million. This will jump to 20 million by 2020.Over 100 million Africans are at risk of eye infections leading to blindness. (WHO)80% of the blindness in the world is preventable.

We hope that Alberta Opticians will come and support us for this meaningful cause. Thanking you, Karim Asaria, RO, RCLP

H.S.B.H.A.A: www.hsbhaa.com • Email: heart4africa@live.com • Ph: (403) 254-5325

In August, I took a call at the College office from a fellow optician asking me how she would be required to handle a situation in her office that involved a patient file and a possible privacy breach. The story is interesting and worth sharing with all of our members, but before we explain this particular situation in detail, I feel it would be worthwhile to revisit privacy regulations in general.

After visiting our members during practice reviews, it became clear that a solid understanding of privacy regulations seems to be an area that most opticians are lacking in, and honestly this applies to me too. In order to improve my own understanding, I have done some research and plan to address privacy regulations over the course of the next three newsletters to try and unravel at least some of their mystery.

Where should you turn for information on privacy regulation?A good resource is the key to understanding. The

resources section of our website has some information regarding privacy legislation for members. A more complete source is the Office of the Information and Privacy Commissioner of Alberta (OIPC). Maureen and I recently worked with their office to complete a Privacy Impact Assessment (PIA) for the ACAO’s School and Community Vision Screening program. Undertaking the PIA allowed me to connect with someone at the OIPC who was able to answer my questions about privacy regulations. Making that connection has taken some of the fear away from asking about and admitting my ignorance of privacy regulation.

According to the mandate on the OIPC website, “the Information and Privacy Commissioner is an Officer of the Legislature who reports directly to the Legislative Assembly of Alberta and is independent of the government. The Commissioner performs the legislative and regulatory responsibilities set out in Alberta’s three access and privacy laws”. It is the Commissioners duty to review and investigate complaints relating to the collection, use and disclosure of personal and health information, but also to provide advice, recommendations and education about the acts.

What are Alberta’s 3 access and privacy laws?The 3 privacy laws that govern Alberta all have the same basic premise. They control the manner in which information may be collected, used and disclosed.

1. Freedom of Information and Protection of Privacy Act (FOIP) – this act applies to 1,151 public bodies. It includes school boards, post-secondary institutions (such as NAIT which trains opticians in Alberta), librar-ies, health authorities, government depart-ments and municipalities among others.

2. Health Information Act (HIA) – This act ap-plies to roughly 54,900 health custodians of regulated health professions, Alberta Health and Alberta Health Services among others.

Part 1 of 3

1https://www.oipc.ab.ca/media/762451/Annual_Report_2015-16.pdf

Privacy Breaches & Your Patients Lisa Bannerman, RO, RCLP

2 Chapter 1 – Introduction (1.3) Health Information Act Guidelines and Practices 2011, page 5 Government of Alberta Health and Wellness http://www.health.alberta.ca/documents/HIA-Guidelines-Practices-Manual.pdf

3. Personal Information Protection Act (PIPA) – this act applies to provincially regu-lated private sector organizations such as businesses, corporations, associations, pro-fessional regulatory organizations (such as the ACAO) and private schools among oth-ers.

Which laws apply to opticians?For the most part, opticians are subject to the Health Information Act (HIA). PIPA would govern any information not subject to the HIA for opticians which would include things like employee information. PIPA governs the collection, use and disclosure of personal information and personal employee information by private sector organizations in Alberta. You must provide consent for this collection, use and disclosure. However, if you are an employee, consent is not required for any personal information required for a work relationship.

For this article, we are going to look at the HIA in a little more depth. As opticians in Alberta, you are regulated health professionals under the Health Professions Act, and the information you collect from your patients or customers is considered health information. “The Health Information Act contains rules about the collection, use and disclosure of health information and aims to make the process transparent to those involved in the health system as well as to the general public. The rules are intended to protect the privacy of individuals and the confidentiality of their health information; ensure that health information is shared appropriately; and ensure that health records are managed and protected properly.” The HIA allows opticians to share and exchange health information for the provision of care. The act also gives individuals the right to access and request corrections to their own health information.

A link to the HIA may be found on our website, or at http://www.qp.alberta.ca/documents/Acts/H05.pdf. As custodians under the HIA, opticians in Alberta have a duty to safeguard the health information of our patients. Custodians are responsible for the health information they collect, use and disclose and are also responsible for the health information collected, used and disclosed by their affiliates.

As regulated opticians, the definition of custodian that applies is:

• A health services provider who is designated in the regulations as a custodian, or who is within a class of health services providers that is designated in the regulations for the purpose of this sub clause; section1 (1)(f)(ix) HIA

There are many definitions of who may be an affiliate, but the most likely for opticians is:

• An individual employed by the custodian

• A person who performs a service for the cus-todian as an appointee, volunteer or student or under a contract or agency relationship with the custodian

We need to consider and be aware of what access the person cleaning our office at night may have, or even the IT person responsible for our computers. As custodians, you are responsible for that access, not the affiliate.

Each practice must designate a Privacy Officer who is responsible for implementing the custodians privacy program which is to be backed up by privacy policies and procedures. A designated Privacy Officer ensures the regulations put forth in the HIA are upheld, but does not act as the custodian. Each regulated optician is still responsible for the appropriate collection, use and disclosure of information.

Opticians work in a variety of offices and often in conjunction with other eye care professionals. Those working for box stores or large chain stores will have corporate privacy policies and procedures, and often a Privacy Officer who may not be working directly in the retail location. In this situation it is important for opticians to remember that their head office is not the custodian of the health information they collect.

Collection, use and disclosureThe HIA definition of health information covers any information about an individual that is collected and recorded when a health service is provided.

The Act defines two types of health information:

1. Diagnostic, treatment, and care information

2. Registration information

As it relates to health information, “collect” means to gather, acquire, receive or obtain. This may be done by taking a medical history, having a patient fill out a form, by survey, in writing, by telephone, or various other methods. A custodian is bound by the Act whether they collect the information or if one of their affiliates collects it on their behalf. This means that it is important for custodians to make sure that all affiliates understand the Act, and what information they are authorized to collect. Affiliates may only collect health information that is required for them to carry out their responsibilities as assigned by a custodian.

If the health information being collected is non-identifying, meaning that someone else who sees the information could not determine who the person is from that information, it may be collected by a custodian for any purpose. An example of collection of non-identifiable health information can be found within the ACAO School and Community Vision Screening Program. At the end of an event,

the only information that will be maintained will be the location of the event, the number of students or individuals screened, ages of the individuals and if the results of the screening fell outside of the normal limits of the screening equipment. This is being collected for statistical purposes only, and would not allow for the identification of any individual. In practice, most of the information that opticians will be collecting will be identifiable information.

If the health information is individually identifying, the collection must by authorized by an enactment of Alberta or Canada or must be necessary to allow the custodian to carry out an authorized purpose under section 27 of the HIA. The main points of this section that would apply to opticians include, but are not limited to:

(a) providing health services;(b) determining or verifying the eligibility of an individual to receive a health service;(c) conducting investigations, discipline proceedings, practice reviews or inspection relating to the members of a health profession or health discipline;

For the entire list of authorized purposes, please refer to section 27 of the Health Information Act.

Another point to consider under collection of health information is that the information must be collected directly from the individual, unless the Act authorizes otherwise. Consider a child or possibly a dementia patient. In an instance such as these, the Act allows the information to be collected from the individuals authorized representative.

Example: A patient comes to your office for a

contact lens fitting. An optician may ask someone such as a receptionist to gather basic information

from the patient. This could include name, address, date of birth, prescription information and previous

eye care history.

Use of health information means having access to or sharing health information between affiliates of the custodian. As noted above, the individually identifying health information collected by a custodian may only be used to carry out an authorized purpose such as providing health services, determining the eligibility of an individual to receive a health service, or for conducting investigations, discipline proceeding, practice reviews or inspection relating to the member of a health profession or health discipline.

If an optician has the written consent of a patient to disclose health information, they may do so. There are also situations in which opticians are allowed to disclose health information without written consent. Opticians may disclose personal health information of a patient to another custodian within the circle of care without the authorization of that patient, for specific health care purposes. The custodian is responsible for making sure that only the information that is required is disclosed.

Some of the authorized purposes for collecting, using, and disclosing health information without consent within the circle of care, as per section 27 of the HIA, that would apply to opticians include: • Providing health services;

• Verifying eligibility to receive a health service;

• Investigations, practice reviews, or inspections of a health professional;

• To facilitate health service provider education;

There are allowances within the HIA for disclosure of health information without consent outside of the circle of care as well. These can be found in sections 35-45 of the HIA and include such things as;• Family members in certain circumstances;• Individuals or authorized representatives of individuals;• Persons acting in the best interests of an incompetent individual;• Health professional bodies, auditors, and quality assurance committees;• Entities authorized to obtain information or

disclosures required by other legislation,

e.g., courts and subpoenas;• Police when investigating a life threatening injury to the individual; and• Any person to avert or minimize an imminent danger

When disclosing information, the optician must log or note the following;

• Name of the person to whom information was disclosed

• The date

• Purpose of the disclosure

• Description of the information disclosed

This applies to written files, or electronic files and the information must be kept on the patient file or record for 10 years.

Access to records – who owns the information?We get asked on a regular basis about files and if patients have a right to the information in their file. The best way I can explain it is that the physical file belongs to the optician, and that optician has a responsibility to maintain the record. However, the patient is entitled to the information contained within that file, except under very specific circumstances. So, if your patient asks for their file, you would keep the original, and provide the patient with a photocopy. Over the years of working as an optician, I have seen a number of things written in files that opticians would not want their patients to see. This is something to keep in mind every time you record information in a file.

For opticians who work for a company that has multiple locations, if another location requests health information for a patient who is now at their location, do not send the entire file. As the custodian, you should copy the appropriate portions of the file, but still keep the original in your office. If an optician retires, or leaves a job, they may transfer custodianship of their patient files to a successor custodian. If the optician does not transfer the files, they must be stored securely, and access must be granted for the 10 year retention period if requested. At the end of 10 years, the files must be destroyed in a secure manner.

continued on next page

Example: An optician may ask another optician to review a patient file in order to offer a second

opinion. Or, an optician may provide details of care to an optometrist or ophthalmologist if requested.

One of the core regulatory duties of a College is to establish and maintain a Continuing Competence Program to promote high practice standards amongst its members. With this in mind the ACAO has formed a Quality Assurance committee, chaired by Dean Thompson, to revise the way we think about continuing education and in turn create a new Continuing Competence Program.

At our 2016 AGM, Connie Chong, COBC Registrar, spoke about the characteristics of an effective Continuing Competence Program. She explained that continuing education is most effective when it is engaging, applicable, and measurable.

The College of Opticians of British Columbia (COBC), Alberta College and Association of Opticians (ACAO), Opticians of Manitoba (OOM), and the Saskatchewan College of Opticians (SCO) have been collaborating on

Quality Assurance

the development of the new program. Our goal is to have a program that is evidence-based, aligned with the national competencies, and engaging for members. The foundation of this new program will be an assessment tool which will provide opticians with a personalized profile to guide their continuing education (CE). These assessments will also help the ACAO cater articles, seminars, and other CE opportunities to those areas where our members show a need for more education.

One common request we have heard from members is the option to work towards specialty designations. A new Continuing Competence Program could also allow members to focus their CE on a specialty once they have proven their proficiency in the basic national competencies. We are still in the development process of this new program and would appreciate any feedback our members have on their interactions with the current system or what they would like to see in a new program.

Our very interesting story…

Finally, back to the phone call from our member and the situation she called the office about. The optician had a long time patient come in asking some questions about her previous care. During the course of the conversation, the patient said she wanted her file as it belonged to her. The optician got distracted for a moment, and during that short time, the patient grabbed her file and fled the office. The question I received was “do I have to do anything about reporting this?” If we look back on what I have discussed so far in this article we know a couple of things;

• The Health Professions Act would apply as there would be identifiable health information contained within that patients file, such as possible health history, and prescription information

• The physical file belongs to the optician (the custodian) and needs to be kept for a minimum of 10 years after the last entry as per the HPA

• The patient would have been entitled to the information in the file, which would be served by a photocopy of the contents of the file

So does the optician need to do anything? The answer, as I confirmed with The Office of the Information and Privacy Commissioner of Alberta is, yes. So what exactly is it that needs to be done? In the spring edition of the 8th line we will visit privacy breaches, breach preparedness, mandatory reporting, best practices to safeguard information and best practices for what the HIA does not address.

Lisa Bannerman, RO, RCLP

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Privacy Breaches continued

Have you been encountering an increasing number of clients exhibiting symptoms of dementia, such as forgetfulness, confusion, difficulty to understand and follow instructions, and so on? Additionally, did you know that dementia could present with visual symptoms? If you have not yet seen an increase in the number of clients exhibiting forgetfulness, communication challenges etc. it is very likely to happen in the coming days.

Dementia could also present with visual symptoms that may be difficult to comprehend. According to current stats, there are about 43, 000 Albertans who have a diagnosis of dementia, and several more who are experiencing symptoms of the disease, but do not have a diagnosis yet. This number is expected to double by 2031, if nothing changes. If a person with dementia walks into you practice, would you have the appropriate knowledge and skills to serve your client?

What are the things you should be aware of when your patient has dementia? How can you ensure that your patient has a good experience in the examining room and you are able to provide appropriate services to your client?

The first step is to have a basic understanding of dementia – how the disease impacts individuals, the challenges to be prepared for when working with individuals with cognitive impairment, followed by acquisition of appropriate knowledge and skills to meet those challenges.

What exactly is dementia? Dementia is a general term that refers to progressive decline in mental abilities, which is severe enough to affect a person’s ability to live independently. The common symptoms associated with dementia include memory loss, difficulty making decisions, communication difficulties, challenges with visual perception, rapid mood swings, behaviour changes, and difficulty carrying on with the activities of daily living.Memory loss associated with dementia is unique in that it involves forgetting recent events, and recent conversations while long-term memory remains intact. This means that a person with dementia would remember their childhood, and events from the past very clearly, while forgetting a recent event or a conversation completely.

Impaired decision-making could be as simple as going out in the cold without a coat, gloves, and toque, or more complex such as being overwhelmed when offered several choices, or not knowing the best way to carry out a task.

Communication challenges associated with dementia include inability to express oneself and difficulty understanding others. When immigrants who learn English language at a later age develop dementia, they are likely to forget English vocabulary and speak in their native language, or use a mix of languages.

Figure 1: Symptoms associated with dementia

Impaired reasoning & judgment Loss of memory

Communication Difficulties Visuo-spatial impairment

Mood and behaviour changes Difficulty with day-to-day function

When Your Patient has Dementia

Padmaja Genesh, BSc, MBBS, BA (Gerontology)

Visuo-spatial impairment causes difficulties interpreting what the eyes are seeing and also understanding the three-dimensional orientation of objects. For example, a dark shadow on the floor or a dark patch on the carpet could appear like a deep dark hole, or a shiny floor could look like a wet floor, or a white cup on a white table cloth would be almost invisible. A person could also have difficulty recognizing faces, and assessing distances and depth. This is because of damage and dysfunction of the posterior part of the brain, known as the occipital lobe.

A rare type of dementia that initially impacts the occipital lobe – Posterior Cortical Atrophy (PCA) – presents with visual symptoms alone, with well-preserved memory. The symptoms including difficulty recognizing faces and objects in pictures, problems with literacy, and numeracy, driving difficulties, etc. first manifest in a person’s mid-50s or early 60s. A person with PCA would approach opticians with complaints of eye problems, but their vision tests would turn out to be normal. As the disease progresses they would go on to develop memory symptoms, difficulty in doing things with their hands- such as wearing a shirt or a seat belt, dialing a number on the telephone, reading line by line and so on.

The cause of PCA is Alzheimer’s disease in more than 90% of cases, with Lewy Body Dementias, Corticobasal degeneration, and prion disease accounting for the remaining cases. A lack of awareness of PCA could result in the person being prescribed stronger glasses or cataract surgery.Other symptoms of dementia include rapid, unexplained mood swings, behaviour changes, and a difficulty carrying out the activities of daily living.

Causes of dementiaThere are several different causes of dementia. Approximately 5% of dementia is caused by conditions that can be completely controlled and modified. These reversible causes of dementia include medication interactions, prolonged use of anticholinergics, nutritional deficiencies, Vitamin B12 deficiency, thyroid disease, depression, and delirium. Normal Pressure hydrocephalous, a condition characterized by collection of cerebrospinal fluid in the cavities of the brain can also cause symptoms of dementia.

However, 95% of dementia is incurable, and the most common cause of dementia is Alzheimer’s disease. Other common causes include vascular dementia, Lewy Body Dementias (LBD), and Fronto-temporal lobe dementia (FTLD).

Alzheimer’s Disease: (AD) This is a progressive degenerative disease of the brain characterized by Amyloid plaques (abnormal deposition of protein) in different parts of the brain and neurofibrillary tangles inside the nerve cells (neurons).

The plaques destroy connections between neurons and slow down communication in the brain, while the tangles cause death of cells, and shrinking (atrophy) of the brain.

Though age is a risk factor for developing AD, 5% to 15% of AD can occur in individuals below 65 years of age.

Figure 1: Microscopic view of a Healthy brain & brain affected by Alzheimer's Disease

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Vascular DementiaVascular Dementia occurs as a result of interruption of blood flow to any particular area of the brain, causing death of nerve cells in that area, or stroke. A single massive stroke or a series of mini strokes could lead to vascular dementia. Though the presenting symptoms depend on the part of the brain affected, some early symptoms include confusion, disorientation, poor decision-making, communication challenges, and emotional disturbances.

Lewy Body Dementias (LBD) LBD is caused by accumulation of Alpha-synuclein protein in the brain stem and other parts of the brain. This group includes Dementia with Lewy Body (DLB) and Parkinson’s Disease Dementia. Common symptoms include fluctuating cognition, visual hallucinations, features of Parkinson’s disease, and acting out dreams.

The visual hallucinations involve the individual seeing clear and convincing images of people, animals, and things that are not actually there, occasionally causing distress to the individual and to those who work with them. These hallucinations have been attributed to deposition of the protein in two specific regions of the brain- namely the pulvinar, and the fusiform gyrus, responsible for processing visual signals.

Fronto-temporal lobe dementiaFTLD is a spectrum of disorders associated with progressive damage to frontal and temporal lobes of the brain. Common symptoms include personality changes, apathy, poor decision-making, communication challenges, mood changes, inappropriate behaviour, and verbal and physical aggression. The age group affected is usually 40-70 years.

Other causes of dementiaDementia is associated with other conditions such as Korsakoff’s syndrome, brain injury, Down’s syndrome, and some rare conditions such as Multi-System Atrophy (MSA), and Creutzfeldt Jakob Disease. Individuals with MS, Huntington’s Disease, epilepsy etc. can develop cognitive impairment, though they may not progress to full-fledged dementia.

Frontal Lobe

Personality and mood Social graces Initiative Judgment and reasoning

Parietal Lobe

Analytical thinking Spatial Orientation Recognition of

objects & sounds Sequencing

Occipital Lobe

Visual information processing

Face recognition

Temporal Lobe

Memory Language

Limbic System

Emotions Organizing

memory etc.

Figure3: Major parts of the brain and their functions. Any disease involving these parts of the brain can affect their corresponding functions

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Communication challengesIndividuals with dementia have difficulty expressing themselves and understanding others. They could have the following challenges:

• Difficulty naming commonly used objects, and finding the right word

• Loss of word meaning

• Difficulty processing language

• Difficulty understanding written and spoken words

• Difficulty following instructions

Tips for effective communicationIt is extremely important to be mindful of the person’s abilities when you communicate with them. Here are some tips for effective communication:

• Make eye contact, and smile

• Use simple words, and speak slowly in short sentences

• Be mindful of your tone and body language

• Give step by step instructions

• Give enough time for the person to respond

• Use positive language, avoiding ‘don’t’ and ‘no’

• Repeat to facilitate communication; rephrase, if necessary

• Avoid distractions, and refrain from asking too many questions

• Use humor, to reduce anxiety and lighten the mood

Behaviour changes in dementiaMood and behaviour changes associated with dementia are called the Behavioural and Psychological Symptoms of Dementia (BPSD). Some of the BPSDs include anger, excessive anxiety, irritability, getting easily frustrated, apathy, and verbal and physical aggression. Other changes include repetitive behaviour, inappropriate comments, or sexual behaviour, having hallucinations (seeing, hearing and feeling things that are not real), paranoia/suspicions, delusions, and tendency to wander off.

Though the person’s behaviours and actions might appear meaningless to others, every behaviour has a meaning for the person with dementia, and therefore, we need to find out its origin.

Behaviour TriggersCommon triggers for behaviour changes include the following:

1) Health-related causes such as pain, discomfort from medications, delirium from an infection, impaired vision or hearing

2) Unmet physical hunger, thirst, full bladder) need, or emotional need or anxiety and fear

3) Boredom

4) Environmental factors such as lighting, room temperature, noise, unfamiliar people, unfamiliar surroundings

5) Your approach and style of communication

Responding to Behviour ChangesGoing through an eye exam can be a bit overwhelming and nerve-wracking for the person with dementia. It will be extremely beneficial to apply knowledge of dementia to make your office environment more dementia friendly. The unfamiliar surroundings, the lights, the machines etc. can contribute to anxiety and agitation. It is important to spend some time to make a connection with the person and put them at ease. It is a good idea to ask the family to bring the person’s comfort objects with them to the appointment, and have the family member stay near the person during the assessment and treatment sessions.

If your client becomes overwhelmed or exhibits a mood and temperament change during the appointment, take a break. Ensure personal comfort, and speak calmly to reassure the person. Respond to the emotion expressed. Try to identify possible triggers for the behaviour and problem-solve, seeking family’s input. Refrain from correcting the person or orienting them to the reality. Providing a security object or distracting the person to a favorite object or topic would help.

ConclusionDue to population aging, for the first time in Canadian history, people over the age of 65 years outnumber those between 0-14 years of age. Therefore, all service providers will be working with an increasing number of seniors and increasing number of people with dementia in the coming years, since the risk of dementia increases with age. Hence it is extremely important for all service providers to be adequately prepared to face the silver tsunami.

References:

Alzheimer’s Society UK (n.d.) Communicating. Retrieved from https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=130

Latest information on dementia stats from http://www.alzheimer.ca/en/Get-involved/Raise-your-voice/Latest-info-stats Posterior Cortical Atrophy from http://www.alz.org/dementia/posterior-cortical-atrophy.asp Rare causes of dementia from https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=135 What causes visual hallucinations in Dementia with Lewy Body from https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=2172

In Memoriam

Robert Behm, RO - License. 42 It is with great sadness that we announce the passing of Robert Behm, License 42 on December 24, 2016 at the age of 87. Bob, as he was known to those who worked with him, was clever, resourceful and had a sharp wit. He was loved by the many opticians who were mentored by him over his lengthy career and will be sorely missed. He was a member of our profession from 1965-1997. Our thoughts go out to his family and friends.

Join Our Team!The ACAO is currently recruiting potential Board members and volunteers for various committees within our organization.

WHO?

All registered ACAO members are eligible to volunteer.Registered Opticians and Contact Lens Practitioners are both needed for various roles. Students are also encouraged to volunteer and provide their unique perspective and knowledge.

Non-Practicing or retired?You’re still eligible to volunteer with us.

WHAT?

Are you great at training new staff in your office? Perhaps you’d be interested in mentoring student Opticians or becoming an examiner for the national exams.

Are you interested in maintaining professionalism within our industry?By becoming a member of our Hearing Tribunal (reviewing complaints), acting as a PLAR interviewer (interviewing international applicants), or sitting on our Negotiations Committee (dealing in government relations), you’d have a hand in ensuring best practices within our profession.

Want to be a leader in your profession?By joining the ACAO Board you can bring forward concerns and feedback from the member perspective. Joining our Board can provide the opportunity to expand and advance professional development such as leadership, networking and strategic planning.

Whether it is an interest in governance or implementing new programs, if building the profession and making and impact within the profession is a passion, then this position is for you.

HOW?

Yes I want to volunteer.The volunteer application forms included with the annual renewal of your license. You can also visit the volunteer page on our website at www.opticians.ab.ca and download the Volunteer application form or contact Julie Therou at (780) 429-2694 or by e-mail at coa@opticians.ab.ca

What about Board positions?All Board positions are filled by general election at our Annual General Meetings. Nomination forms are sent to the membership in January and posted to our website. If you’re interested in running for a Board position just fill out the nomination form with five signatures endorsing you as a candidate and submit it to the ACAO by the deadline provided on the nomination form.

Nomination FormYou can find the 2017 Nomination Form on our website at www.opticians.ab.ca under the News and Updates link.

The finance and audit committee has just finished a review of fees, which included evaluating the fees charged by other health professions across Canada, and comparing them to the fees of the Alberta College and Association of Opticians. The purpose of this review was to ensure that our fees are reasonable and in line with other health professions.

As a non-profit organization, the ACAO relies entirely on member fees to fund our operations. There are government mandates about what regulatory bodies must accomplish on behalf of the public and registered members, and we provide services beyond those minimum requirements. In other words, the bare minimum that we are required to charge our members covers only the legally required activities, and the additional services we provide require extra funding.

During the course of the review, the F&A committee noticed that the larger the organization, the smaller the fee that can be charged. For example, the nurses’ fees are $584.00 for the college and association; they can afford this because there are 37,100 nurses in Alberta, and they also have to pay union dues. Their college and association budget is much more substantial than ours due to the amount of people paying into it, and they are therefore able to charge their members less.

Another group, the optometrists, have 764 members and pay $1,100.00. They also pay an additional fee to their association for member representation.

Finance & AuditBecause the ACAO is a college and association, you do not have to pay separately as some groups do. In addition to paying your college and association fees in one convenient place, you are also paying your national fees. Because we are a consolidated group, we are able to pay the OAC a lump sum on your behalf, and save you money in the process.

With over a thousand registered opticians, some of whom are non-practicing, the costs of running the organization are currently covered. If we were to charge less fees, we would be able to provide fewer services.

After considering all of the information, the committee decided that the original motion should stand, and the fees should increase annually based upon current requirements and the cost of living. The reasoning behind the increase of 1% this year was examined and deemed understandable.

Some members may be frustrated by the increase in fee prices every year, and we understand that it can seem like a lot of money. However, we are committed to keeping your fees as low as possible by finding cost effective ways to perform our operations whenever possible. We hold these reviews to make sure that we are able to stay on budget and still provide services to our members. We have been fortunate in that we have not had to increase fees more than the minimum amount for a number of years; we have only made incremental increases to keep in line with the cost of living so that we do not fall behind.

The year-end rush went much easier this time around as we have become more comfortable with the online registration process. Next year, we are hoping to implement a system that generates the receipt as an email, so that you will be able to submit your receipts to your employer for reimbursement immediately, and you will have easy access to a replacement copy, should you need one, when you are doing your income tax.

The changes that have been implemented over the year include a focus on volunteerism and committees. By getting more of you involved in some of the aspects of our operation, we hope to open channels of communication between members and the college, to keep members informed and better able to participate. We also hope that relying on member involvement will ease some of the strain on our budget, allowing us to keep costs down so that we don’t have to increase fees.

Keeping in mind the desire for better communication, we are currently redesigning our website, and hope that the new layout and presentation of content will better help you find the information and resources you need. The new design will be responsive, so you will be able to access it on your phone or tablet as well as your computer. We hope to launch at the beginning of 2017.

Over the past few weeks I have received a few questions about status of registration, so I am going to try to explain what we do. When a person registers as practicing, it means that they are ready to work and are up to date in all aspects of their education and competency. When a person registers as non-practicing, it means that while their competency is up to date, they are not able to practice in Alberta. In order to register as non-practicing the member must swear that they will not practice, even under an optometrist. Non-practicing status is like a registration waiting room; you are not licensed to practice, but you are keeping yourself ready to return to practice at any time.

So why would a person choose to register as non-practicing? This category was designed for the member who is stepping out of

Maureen’s Desk

Post-It Notes:

The AGM will be held on May 7, 2017 at the

Radisson Hotel in Red Deer, AB.

Further information to come!

2017 NACOR Exams will be

held at NAIT on February 4th-5th & May 27th-28th

Con-Ed deadline for 2017 is June

30th

Please visit us on our website at opticians.ab.ca

and on Facebook

dispensing for an extended period of time, but expects to return in the future. An example would be maternity leave: the member applying for non-practicing status would know in advance that they would be off work, and plan accordingly.

How do you apply? The time to apply for non-practicing is at the beginning of a cycle. When you are registering for the coming year in November, you need to let us know your plans for the next year. So, if you are planning on maternity leave in June, you would pay half practicing fees and half non-practicing fees for the year. Non-practicing fees are payable on a quarterly basis, but we do not give refunds, so make sure you are taking advantage of the reduced rate when registering by calling the office and talking to the registration staff.

How long can you remain non-practicing? Every three years, we check on your continuing competency to make sure your knowledge and skills remain up to date. At that time if you do not have your continuing education completed, you will not be able to register again; this is the same for practicing and for non-practicing members. In this way, we are able to make sure that you’re still skilled enough to practice when you’re ready to return.

Clear as mud? Sometimes the best way to fill in the blanks is to ask, and we’ll try to help; the new website will have a page dedicated to explaining this status in greater detail, and any of your remaining questions can be answered by someone in our office. Don’t hesitate to call. I am wishing you all the peace of the season and hoping that all of your wishes for the year came true!

Maureen Hussey, RO, RCLPRegistrar / Executive Director

Early Bird Winners!

KIMBERLY MAYER has won 1st prizeCongratulations, Kimberly!

GLORIA MOLNER has won 2nd prize

Congratulations, Gloria!

CHARLENE PERROTT has won 3rd prizeCongratulations, Charlene

Registrar Changes

Provisional EyeglassSabrina Sapizak 2361 August 24, 2016 Sarah McGuire 2353 August 30, 2016Consuelo Westley 2296 August 30, 2016Carmelita Maclellan 2348 September 1, 2016Tammy McKenzie 2354 September 20, 2016Alicia Bhardwaj 2319 October 19, 2016Asia Haugrud 2223 November 2, 2016

New EyeglassAdrianne Gill-Bignall 2534 September 19, 2016Wade Medford 2535 September 19, 2016Nicholas Medina 2536 September 19, 2016Sabrina Sapizak 2361 September 24, 2016 Consuelo Westley 2296 September 24, 2016 New Contact LensJadwiga Kowalczuk 2232 September 25, 2016

New Non-PracticingAdria Ferrero 2217 August 29, 2016

Upgrade to PracticingYanet Chavarria 1893 August 29, 2016Jodie Badura 1953 October 1, 2016Brian Hoeft 152 October 6, 2016Nicholas Medina 2536 October 11, 2016Wade Medford 2535 October 11, 2016Amanda Lavay 1716 October 19, 2016Ashwinder Gill 2408 October 20, 2016Satnam Sidhu 2003 October 26, 2016Colette Vizcarra 2210 November 9, 2016

Name ChangeCharlotte Udell(Mitchell) 1266 September 27, 2016Laurie Bonnell(Flynn) 2184 November 17, 2016Kendra Peyton(Dondale)2024 November 21, 2016

ReinstatedTrisha Freerksen 1235 September 7, 2016Lenka Smidova 2068 September 30, 2016Jo-Dea Schive 540 October 6, 2016Halgit Shalomov 2311 October 25, 2016Mahtab Nematollahi-Davejanee 1826 October 31, 2016

Suspended From PracticeGabrielle Anctil 1782 January 1, 2017Renee Benoit 2378 January 1, 2017Gordon Bishop 277 January 1, 2017Kaylee Diaz 2327 January 1, 2017

Susan Foster 1788 January 1, 2017Mike Harding 1039 January 1, 2017Neil Inkster 239 January 1, 2017Nicole Foster 1634 January 1, 2017Penny Kelly-Reisdorf 2186 January 1, 2017Tyler Kenny 2383 January 1, 2017Jeff Lanigan 1019 January 1, 2017David Lee 1926 January 1, 2017Wei Min Lin 1641 January 1, 2017Satish Malik 2129 January 1, 2017Masuma Manji 2399 January 1, 2017Candace McDowell 1496 January 1, 2017Jamie McQueen 2388 January 3, 2017Barbara Melenka 1052 January 1, 2017Sharlyn Morales 1989 January 1, 2017Phuoc-Cuong Ngo 1562 January 1, 2017Heather Nolin 992 January 1, 2017Christianne Paquet 985 January 1, 2017Steven Petersen 874 January 1, 2017Neal Philpott 1605 January 1, 2017Cheryl Portmann 1557 January 1, 2017Tina Rusnell 1311 January 1, 2017Angela Saranchuk 1777 January 1, 2017Derryl Schendel 961 January 1, 2017Megan Stark 2363 January 1, 2017Devon Stewart 2393 January 1, 2017Christine Steeple 2273 January 1, 2017Terry Tilden 1462 January 1, 2017Velma Veloria 2310 January 1, 2017Kevin Zhou 2077 January 1, 2017Stephanie Zwiers 1903 January 1, 2017

Left the Province Ashif Mecklai 2080 September 29, 2016Erin Slabe 1485 October 11, 2016Paulette Lecomte 1365 November 1, 2016Scott Nash 607 November 28, 2016Steve Gosse 669 November 28, 2016Karendeep Tathgar 2141 November 30, 2016

RetiredShannon Fernhout 983 October 17, 2016Bryan Boser 969 November 15, 2016Helen Scott 1330 November 21, 2016 Martin Mackay 26 November 21, 2016 Edisa Ho 1157 November 28, 2016 Irene MacLeod 296 November 30, 2016 Eva Matusak 1097 December 1, 2016

Change to Non-PracticingAmanda Johnson 1627 September 19, 2016Cindy Yu Yin Ma 1524 September 28, 2016

Registrar Changes

Kelly Ledoux 1369 September 30, 2016Charlotte Kessler 1131 October 5, 2016Janice Gavigan 364 October 11, 2016Laura Fulton 1637 October 18, 2016Lovepreet Singh 2398 October 26, 2016Chantel Breckenridge 1957 October 28, 2016Debbie Morrison 861 November 10, 2016Charlene Curtis 1694 November 14, 2016Marlene Fraser 1608 November 15, 2016Bernie Lemieux 1692 November 16, 2016Jessica Trieu 1813 November 16, 2016Lindsey Reid 1775 November 17, 2016Kamisha Barker 1490 November 17, 2016Nick Mehran 1488 November 21, 2016Rehanna Kurji 2033 November 22, 2016Trina Vanaalst 1504 November 22, 2016

Darlene Rasmussen 282 November 22, 2016Rema Aboudib 1268 November 23, 2016Mariam Nesbitt 2060 November 24, 2016Sherry Hall 346 November 28, 2016Svetlana Permyakova 1734 December 8, 2016Jennifer Hussein 1163 November 28, 2016Karyn Zaiffdeen 2061 November 28, 2016Jen Boser 1817 November 29, 2016Bram Champagne 1685 November 29, 2016Laurie Parkhill 212 November 29, 2016Kianoosh Arvand 845 November 30, 2016Amanda Little 1547 November 30, 2016Susan Foster 1788 November 30,2016Darci Gattinger 1472 November 30, 2016Brittany Reinbold 1805 December 2, 2016

February 25-26, 2017Clarion Hotel

2120-16 Ave Northeast, Calgary, AB

COME JOIN US!

CONTACT LENS SYMPOSIUM

MULTIFOCAL FIT GUIDE Understanding of the condensed fitting guide for Air Optix, Dailies Aqua Comfort Plus, and Dailies Total1 Multifocal lenses; Understanding the range of add powers and specifications for Alcon multifocal lenses; Understanding the lens materials used in Alcon Multifocal contact lenses; General awareness of the current and potential market for multifocal contact lenses; Familiarity with the LoseYourReaders.ca direct to consumer communications. Presented by: Marcus Ellard, Alcon BAUSCH & LOMB - TBA

Innovation - ACUVUE® VITA™ & ACUVUE OASYS® 1-Day BRAND CONTACT LENSESThis session will introduce two new lenses to the market and will cover how to identify unmet patient needs and introduce patient target. Learn about technological and clinical features and benefits including information on frictional energy in relation to daily life and how it affects a patient’s eyes and understanding how to implement the lenses into an office. Presented by: Dr. Kent Prete, Johnson and Johnson Vision Care

COOPERVISION - TBA

SUPERVISOR REQUIREMENTS CONTACT LENS The new 1 year contact lens program offered by NAIT has resulted in students having to complete the entire practicum portion of the course in half the time. Primary objective of clinical component of the contact lens program, expectations of the student and responsibilities of the preceptor and practical skills. Presented by: Karla Charland, RO, RCLP

BASIC PATHOLOGYThis session will offer the participant knowledge in the most common pathology seen in the eyes, such as various types of corneal conditions, along with cataracts, glaucoma, macular degeneration, and diabetic retinopthay. The risk factors, symptoms and treatment for each disease will be discussed. Presented by: Al Lens

RADIUSCOPE LEARNING STATION - Concurrent Session (Maximum of 10 people per session)Not many offices fit rigid contact lenses on a regular basis, but the science behind the fitting of rigid lenses is important for all contact lens practitioners to understand. Do you need a refresher on how to measure the radius of curvature of a rigid contact lens? Or maybe you are a student or a supervisor of a student?

SLIT LAMP LEARNING STATION - Concurrent Session (Maximum of 10 people per session)The slit lamp is used on a daily basis during the fitting of contact lenses, but remembering what each illumination is used for, and how to set each one up can be confusing. If you just want a refresher, or are a student or supervisor then this session is for you. This learning station will offer a technical introduction to illuminations and techniques, and then allow participants hands on practice to improve skills.

ADVANCED PATHOLOGYCorneal ectasia, various keratis, keratoconus, and corneal dystrophies can create difficulties in fitting contact lenses or even spectacles, so this session will describe each condition in detail and what, if any, treatment can be done. We will also discuss thyroid disease, dry eye syndrome, and retinal pathologies like central serous retinopathy, macular holes, and drug-induced retinal toxicities. Presented by: Al Lens

CORNEAL MAPPINGThe learning objectives for this session will include: Understand the general purpose of and scope of corneal mapping in an optometric practice; Knowledge of patient factors in obtaining corneal maps; Ability to inform a patient about the purpose of corneal mapping and what the procedure entails; Knowledge of common findings in corneal maps and implications for patient follow up; General knowledge of the importance of corneal mapping in fitting of contact lenses. Presented by: Dr. Diana Monea, Alcon REQUIREMENTS FOR FILES AND RECORDS MANAGEMENTThis session is designed to answer questions such as: What needs to be recorded in patient record? Who needs to record it and why? Who can access the record, when, where and for how much? Who can share the record? The session will also ensure that participants know when and why it is okay to dispense by the Optician, by a colleague, by a student and by other unlicensed staff. Presented by: Maureen Hussey, RO, RCLP

MINI SCLERAL FITTINGThe participants will be able to identify the varied applications of scleral lenses and how they benefit the patient by restoring vision to previously unsuccessful efforts. Fitting procedures and established assessment practices will be discussed and presented. The participants will have a working knowledge of scleral lens fitting and follow up procedures. Presented by: Jim Thompson, RO, RCLP

Contact Lens Symposium - Session Summary

Contact Lens Symposium Registration

Name: ____________________________________________________________ License #: ___________________

Address: ______________________________________________________________ Phone: ____________________________

City: ___________________________________________ Province: ______________ Postal Code: _______________________

Select Seminars: (see schedule below) Day One (Saturday)Time Main Session Radiuscope Station A Slit Lamp Station B9:00-10:00 (1 CL) (1 EC) (1 EC)10:00-11:00 (1 CL) (1 EC) (1 EC)11:15-12:15 (1 CL) (1EC) (1 EC)1:45-2:45 (1 CL) (1 EC) (1 EC)2:45-3:15 (1 EC)3:30-4:30 (2 EC)4:30-8:00 Reception (1 EC)

Day Two (Sunday)Time Main Session9:00-10:30 (2 EC)10:45-11:45 (1 EC)11:45-12:15 (1 EC)1:00-4:15 (5 CL)

Payment Type: VISA Fees: Full Weekend $393.75 Mastercard Saturday Only $210.00 Cheque/Money Order Sunday Only $210.00 Credit Card # _____________________________________________________________ ___ Expriry Date: __________________ Name on Card: _________________________________________ Authorized Signature: ___________________________________

Email: coa@opticians.ab.ca Fax : (780) 426-5576 Toll Free: (800) 594-6696

SATURDAY FEBRUARY 25, 2017

Main Session Learning Station A Learning Station B

9:00 a.m. - 10:00 a.m. Multifocal Fit Guide Radiuscope Session 1 Slit Lamp Session 1

10:00 a.m. - 11:00 a.m. Bausch & Lomb TBA Radiuscope Session 2 Slit Lamp Session 2

11:00 a.m. - 11:15 a.m. Coffee Break

11:15 a.m. - 12:15 p.m. ACUVUE® VITA™ & ACUVUE OASYS® Radiuscope Session 3 Slit Lamp Session 3

12:15 p.m. - 1:45 p.m. Lunch Provided by ACAO

1:45 p.m. - 2:45 p.m. CooperVision - TBA Radiuscope Session 4 Slit Lamp Session 4

2:45 p.m. - 3:15 p.m. Supervisor Requirements

3:15 p.m. - 3:30 p.m. Coffee Break

3:30 p.m. - 4:30 p.m. Basic Pathology

4:30 p.m. - 8:00 p.m. Reception / Appetizer Night (must RSVP)

SUNDAY FEBRUARY 26, 2017

Main Session

9:00 a.m. - 10:30 a.m. Advanced Pathology

10:30 a.m. - 10:45 a.m. Coffee Break

10:45 a.m. - 11:45 p.m. Corneal Mapping

11:45 a.m. - 12:15 p.m. Requirements for Files and Records Management

12:15 p.m. - 1:00 p.m. Lunch Provided by ACAO

1:00 p.m. - 4:15 p.m. Mini Sclereal Lens Fitting

Lunch and Breakfast provided both days - Registration Deadline February 21, 2017

Alberta College and Association of OpticiansCouncil of Directors

Judy Todd,Public Member

Jennifer Wheaton, Public Member

Scott Smith, RO, RCLPPresident

Rick Miller, RO, RCLP

Laura Anderson, RO

Val Pryma, RO, RCLP Vice-President

Nola Hornung, RO, RCLP Dean Thompson, RO, RCLP

Mary-Lynne Wagener, RO, RCLP Gene Kerns, RO, RCLPRandy Bradley, RO