People that work as health careprofessionals are exposed to extremelystressful situations involving those in direneed of assistance. Those health careprofessionals who bring a level of caringand compassion to the plight of those theyare trying to help risk suffering fromcompassionate fatigue. This condition isdescribed in the literature as an extremestate of tension and preoccupation with thesuffering of those being helped to thedegree that it is traumatizing for the helper.Those suffering from compassionate

fatigue may sacrifice themselves to theextent that they exhibit poor self carebehaviours and, in extreme cases, suffersymptoms typically associated with post-traumatic stress disorder. Constantexposure to the stressor of caring deeplyfor those in extreme distress leads tosymptoms such as overeating, substanceabuse, lethargy and irritability. All of thesefactors contribute to the high rate ofturnover among these professionals.

The most likely to suffer fromcompassionate fatigue are those front lineworkers dealing with trauma patients. Thenurses and social workers that work withthis patient population and their familiesare typically the type of people thatpossess an overwhelming desire to helptheir fellow man/woman, often to theirown detriment. This group needs torecognize that they are vulnerable toneglect their own needs or place the needsof others ahead of their own.

To avoid the effects of compassionatefatigue, the literature suggests a number ofdifferent strategies including:

Seek, find, and remember appreciation

from supervisors and clients: These andother activities increase workersatisfactions that sustain them emotionallyand spiritually in their helping.

Make it known that you wish to berecognized for your service: Recognitionalso increases worker satisfactions andsustains them.

Select one or more advocates: They arecolleagues who know you as a person andas a helper and are committed tomonitoring your efforts at self care.

Make a formal, tangible commitment: Awritten, public, specific and measurablepromise of letting go of work in off hoursand embracing rejuvenation activities thatare fun, stimulating, inspiring, andgenerate joy of life.

Set deadlines and goals: The letting go ofwork plan should set deadlines and goalsconnected to specific activities of self care.

Generate strategies that work and followthem: Such a plan must be attainable andfollowed with great commitment andmonitored by advocates of your self care.

TABLE OF CONTENTS

1 • Compassionate Fatigue: Caringfor Yourself While Caring forOthers

2 • Access to Justice for SeniorCitizens

• Practical Strategies for HealthCare Professionals Conference

3 • Audio-Video Recording ofMedical Examinations

4 • Upcoming Events

Compassionate Fatigue:Caring For Yourself

While Caring For Others

AUGUST 200728TH - The Annual 2007 United Senior Citizens of Ontario Inc.Conference, Best Western Hotel, Cobourg

Pat Brown is presenting on – “The Threshold, the Deductible and the Elderly”.

SEPTEMBER 20077TH - St. Michael’s Hospital, Head Injury Clinic: FOREmidableGolf Tournament

John McLeish and Dale Orlando are participating in and are associate sponsors of this annual event.

14TH - Seventh Annual Spinal Cord Conference, Discharge andBeyond: Piloting your Future, Burlington Convention Center,Burlington

Pat Brown and Dale Orlando are Co-Chairing this conference attended by case managers, rehabilitation professionals and specialists in MVA legislation. Pat and Dale are also presentingon “Understanding the Turbulence: New Developments in Automobile Legislation”.

16TH - Canadian Paraplegic Society: 12th Annual WheelchairRelay Challenge, Yorkdale Shopping Centre, Toronto

McLeish Orlando will be participating in and sponsoring the event.

25TH & 26TH - The Canadian Institute’s Advanced Forum onMotor Vehicle Accident Litigation: Latest Developments andTrends in Advancing and Defending First Party and LiabilityClaims, Marriott Bloor Yorkville Hotel, Toronto.

Pat Brown is presenting on “Playing to the Jury: Selling Your Client’s Case to Jurors”. Dale Orlando is presenting on “High Jumping Over the Raised Bar: Overcoming Threshold Challenges in the Tort Action”.

OCTOBER 200718TH - The Law Society of Upper Canada, CLE: PersonalInjury and Mental Capacity Law – Strategies for ClaimsInvolving Incapable Parties, Donald Lamont Learning Centre,Toronto

Dale Orlando is presenting on “Structuring the Settlement withan Eye to Capacity Issues”.

OCTOBER 200718TH - The Law Society of Upper Canada, CLE: PersonalInjury and Mental Capacity Law – Strategies for ClaimsInvolving Incapable Parties, Donald Lamont Learning Centre,Toronto

John McLeish is presenting on “Guardianship Damages in Personal Injury Cases – The Availability of Guardianship

Damages in Tort and No-Fault”.

18TH - The Law Society of Upper Canada, CLE: AccidentBenefits: Recent Changes and Developments, Donald LamontLearning Centre, Toronto

Pat Brown is presenting on “Section 42 Examinations in a PostDAC World”.

26TH - Ontario Trial Lawyers Association: 2007 FallConference, The Westin Prince Hotel, Toronto

Dale Orlando is presenting on “The Use of Demonstrative Evidence in Opening”.

NOVEMBER 20078TH - The Law Society of Upper Canada, CLE: The Oatley-McLeish Guide to Proof of Personal Injury Damages (PartThree): The Central Nervous System, Amputations, the Sensesand Burns, Donald Lamont Learning Centre, Toronto

John McLeish is co-chairing and presenting this program.

23RD - The Canadian Society of Medical Evaluators, 2007Annual Conference, OBA Conference Centre, Toronto

Pat Brown is presenting on “Recording Defence Medicals and IME’s: When is an Order Necessary”.

One Queen Street E., Suite 1620Box 76, Toronto On M5C 2C5

PHONE: (416) 366-3311FAX: (416) 366-3330

TOLL FREE (Canada Wide)1-866-685-3311

www.mcleishorlando.com

4

Upcoming Events

On June 21, 2007 McLeishOrlando were co-sponsors of the5th annual Practical Strategies forHealth Care Professionals. Thetheme of this year’s program wasAdvances in Neurotrauma. One ofthe objectives of the program wasto present to the attendees thelatest scientific developments inthe treatment of spinal cord andbrain injuries. Another objective

was to present to the attendees themost modern rehabilitationtechniques for treating spinal cordand brain injuries. To ensure thatthe objectives were fulfilled, someof the best professionals involvedin research and the treatment ofspinal cord and brain injuries wereinvited to speak at the conference.The faculty included Dr. MarkBayley, Dr. Elizabeth Bosman, Dr.

Catherine Craven, Dr. NoraCullen, Dr. Jane Gillett, Dr. CherylMasanic, Dr. Thomas McAllister,Cathie Percival, Dr. Milos Popovicand Dr. Michel Rathbone.

A record number of peopleattended the conference. Thoseattending included case managers, occupational therapists,physiotherapists, speech language

Ontario citizens will be going back to the polls on October10th in order to vote for the next Ontario government. Formany of us, it is an opportunity to reflect back on what hashappened over the years since the last election as it relatesto auto insurance. For many seniors it is an opportunity tochallenge candidates on issues that impact on their lives andtheir loved ones. Many seniors who have not been involvedin a car accident or hurt by a bad or drunk driver are unawareof what entitlements they may or may not have.

Did you know that in order for a retired senior to obtain anyaward for pain and suffering or health care costs against thebad driver that they must show that the injury “substantiallyinterferes” with “most of their usual activities of dailyliving”?

Did you know that the above test is different and stricterthan the test that applies to employed people even thoughthe claim is not for loss of income?

Did you know that even if a senior satisfies the above test,that the insurance company will keep as a deductible$30,000.00 of their pain and suffering award if it is under$100,000.00?

Did you know that the present $15,000.00 deductible thatapplies to fatal accidents virtually eliminates anycompensation being granted to a grandparent for the deathof one of their grandchildren?

Did you know that the same $15,000.00 deductiblevirtually eliminates any compensation your grandchildrenwould be entitled to if you were killed in a car crash causedby a bad or drunk driver?

Did you know that as a result of these restrictions, fewerlawyers are able to take on seniors’ claims on a contigentbasis due to the associated risks and reducedcompensation?

Did you know that Ontario has one of the most complicatedno fault accident benefits system in North America?

Repeated attempts have been made by varying groups tohave the present government change these measures whichwere to be temporary in nature. It is time for change. Whatis the candidate in your riding going to do about this?

Audio-Video Recordingof Medical Examinations

pathologists, social workers,registered nurses and othersinvolved in the care of individualssuffering from the effects of aspinal cord injury or brain injury.The overwhelming response fromthose attending was that thespeakers delivered cutting edgepapers.

Those who attended the program

felt that what they learned made asignificant impact on their abilitiesto better assist those suffering theeffects of a spinal cord or braininjury.

The gross proceeds from theconference totalled $12,335.00.All of the proceeds are beingdonated to the Toronto RehabilitationInstitute.

2 3

Access to Justice for Senior Citizens

Practical Strategies for Health CareProfessionals Conference

The creation of a full and reliablerecord is particularly important ininstances where the claimant haslanguage or cognitive impairmentsthat prevent him or her fromproviding an account of theexamination or instructing his or herlegal counsel. The right to instructand advise counsel is essential in theadversarial process.

The necessity of electronicrecording of medical examinationsin such circumstances has beenrecognized by the Court in Gutierrezv. Jaffer, [2006] O.J. No. 650 (Ont.S.C.J.). In Gutierrez, our firmrepresented a plaintiff who hadsevere cognitive deficits arising outof a near-drowning incident wherehe was suspected to be under waterfor over 10 minutes and VSA forsometime thereafter. Our concern inthis case was our client’s inability toconvey what happened during theexamination due to his cognitive

difficulties and inability to recallevents. The benefits of video-tapingthe examination to our client in thiscase include the following:

• The creation of a full and reliablerecord of statements made by ourclient, which will in turn facilitatethe fact-finding process, avoidcontroversy and expedite theconduct of a trial by narrowingareas of discrepancy between theexaminer and our client;

• Provide an objective platformfrom which to assess and contrastinter-assessment discrepanciesbased on the subjective perspectiveof different assessors;

• If multiple recordings are createdover a period of time, there is anability for subsequent assessors toconsider our client’s progress ordecline, as well as consistencies orinconsistencies in ability or verbalresponse; and

• Facilitate settlement.

In our case, the Court ordered thatthere be no editing of the video-recording, the operator not bepresent in the room during theexamination and the tape havesufficient capacity to eliminate anyinterruptions to the examination.These parameters, and othersidentified by Mr. Justice Quigley inWillits v. Johnston, [2003] O.J. No.1442 (Ont. S.C.J.), serve to alleviateany concern that the integrity of theexamination will be compromised.

On June 21, 2007 McLeishOrlando were co-sponsors of the5th annual Practical Strategies forHealth Care Professionals. Thetheme of this year’s program wasAdvances in Neurotrauma. One ofthe objectives of the program wasto present to the attendees thelatest scientific developments inthe treatment of spinal cord andbrain injuries. Another objective

was to present to the attendees themost modern rehabilitationtechniques for treating spinal cordand brain injuries. To ensure thatthe objectives were fulfilled, someof the best professionals involvedin research and the treatment ofspinal cord and brain injuries wereinvited to speak at the conference.The faculty included Dr. MarkBayley, Dr. Elizabeth Bosman, Dr.

Catherine Craven, Dr. NoraCullen, Dr. Jane Gillett, Dr. CherylMasanic, Dr. Thomas McAllister,Cathie Percival, Dr. Milos Popovicand Dr. Michel Rathbone.

A record number of peopleattended the conference. Thoseattending included case managers, occupational therapists,physiotherapists, speech language

Ontario citizens will be going back to the polls on October10th in order to vote for the next Ontario government. Formany of us, it is an opportunity to reflect back on what hashappened over the years since the last election as it relatesto auto insurance. For many seniors it is an opportunity tochallenge candidates on issues that impact on their lives andtheir loved ones. Many seniors who have not been involvedin a car accident or hurt by a bad or drunk driver are unawareof what entitlements they may or may not have.

Did you know that in order for a retired senior to obtain anyaward for pain and suffering or health care costs against thebad driver that they must show that the injury “substantiallyinterferes” with “most of their usual activities of dailyliving”?

Did you know that the above test is different and stricterthan the test that applies to employed people even thoughthe claim is not for loss of income?

Did you know that even if a senior satisfies the above test,that the insurance company will keep as a deductible$30,000.00 of their pain and suffering award if it is under$100,000.00?

Did you know that the present $15,000.00 deductible thatapplies to fatal accidents virtually eliminates anycompensation being granted to a grandparent for the deathof one of their grandchildren?

Did you know that the same $15,000.00 deductiblevirtually eliminates any compensation your grandchildrenwould be entitled to if you were killed in a car crash causedby a bad or drunk driver?

Did you know that as a result of these restrictions, fewerlawyers are able to take on seniors’ claims on a contigentbasis due to the associated risks and reducedcompensation?

Did you know that Ontario has one of the most complicatedno fault accident benefits system in North America?

Repeated attempts have been made by varying groups tohave the present government change these measures whichwere to be temporary in nature. It is time for change. Whatis the candidate in your riding going to do about this?

Audio-Video Recordingof Medical Examinations

pathologists, social workers,registered nurses and othersinvolved in the care of individualssuffering from the effects of aspinal cord injury or brain injury.The overwhelming response fromthose attending was that thespeakers delivered cutting edgepapers.

Those who attended the program

felt that what they learned made asignificant impact on their abilitiesto better assist those suffering theeffects of a spinal cord or braininjury.

The gross proceeds from theconference totalled $12,335.00.All of the proceeds are beingdonated to the Toronto RehabilitationInstitute.

2 3

Access to Justice for Senior Citizens

Practical Strategies for Health CareProfessionals Conference

The creation of a full and reliablerecord is particularly important ininstances where the claimant haslanguage or cognitive impairmentsthat prevent him or her fromproviding an account of theexamination or instructing his or herlegal counsel. The right to instructand advise counsel is essential in theadversarial process.

The necessity of electronicrecording of medical examinationsin such circumstances has beenrecognized by the Court in Gutierrezv. Jaffer, [2006] O.J. No. 650 (Ont.S.C.J.). In Gutierrez, our firmrepresented a plaintiff who hadsevere cognitive deficits arising outof a near-drowning incident wherehe was suspected to be under waterfor over 10 minutes and VSA forsometime thereafter. Our concern inthis case was our client’s inability toconvey what happened during theexamination due to his cognitive

difficulties and inability to recallevents. The benefits of video-tapingthe examination to our client in thiscase include the following:

• The creation of a full and reliablerecord of statements made by ourclient, which will in turn facilitatethe fact-finding process, avoidcontroversy and expedite theconduct of a trial by narrowingareas of discrepancy between theexaminer and our client;

• Provide an objective platformfrom which to assess and contrastinter-assessment discrepanciesbased on the subjective perspectiveof different assessors;

• If multiple recordings are createdover a period of time, there is anability for subsequent assessors toconsider our client’s progress ordecline, as well as consistencies orinconsistencies in ability or verbalresponse; and

• Facilitate settlement.

In our case, the Court ordered thatthere be no editing of the video-recording, the operator not bepresent in the room during theexamination and the tape havesufficient capacity to eliminate anyinterruptions to the examination.These parameters, and othersidentified by Mr. Justice Quigley inWillits v. Johnston, [2003] O.J. No.1442 (Ont. S.C.J.), serve to alleviateany concern that the integrity of theexamination will be compromised.

People that work as health careprofessionals are exposed to extremelystressful situations involving those in direneed of assistance. Those health careprofessionals who bring a level of caringand compassion to the plight of those theyare trying to help risk suffering fromcompassionate fatigue. This condition isdescribed in the literature as an extremestate of tension and preoccupation with thesuffering of those being helped to thedegree that it is traumatizing for the helper.Those suffering from compassionate

fatigue may sacrifice themselves to theextent that they exhibit poor self carebehaviours and, in extreme cases, suffersymptoms typically associated with post-traumatic stress disorder. Constantexposure to the stressor of caring deeplyfor those in extreme distress leads tosymptoms such as overeating, substanceabuse, lethargy and irritability. All of thesefactors contribute to the high rate ofturnover among these professionals.

The most likely to suffer fromcompassionate fatigue are those front lineworkers dealing with trauma patients. Thenurses and social workers that work withthis patient population and their familiesare typically the type of people thatpossess an overwhelming desire to helptheir fellow man/woman, often to theirown detriment. This group needs torecognize that they are vulnerable toneglect their own needs or place the needsof others ahead of their own.

To avoid the effects of compassionatefatigue, the literature suggests a number ofdifferent strategies including:

Seek, find, and remember appreciation

from supervisors and clients: These andother activities increase workersatisfactions that sustain them emotionallyand spiritually in their helping.

Make it known that you wish to berecognized for your service: Recognitionalso increases worker satisfactions andsustains them.

Select one or more advocates: They arecolleagues who know you as a person andas a helper and are committed tomonitoring your efforts at self care.

Make a formal, tangible commitment: Awritten, public, specific and measurablepromise of letting go of work in off hoursand embracing rejuvenation activities thatare fun, stimulating, inspiring, andgenerate joy of life.

Set deadlines and goals: The letting go ofwork plan should set deadlines and goalsconnected to specific activities of self care.

Generate strategies that work and followthem: Such a plan must be attainable andfollowed with great commitment andmonitored by advocates of your self care.

TABLE OF CONTENTS

1 • Compassionate Fatigue: Caringfor Yourself While Caring forOthers

2 • Access to Justice for SeniorCitizens

• Practical Strategies for HealthCare Professionals Conference

3 • Audio-Video Recording ofMedical Examinations

4 • Upcoming Events

Compassionate Fatigue:Caring For Yourself

While Caring For Others

AUGUST 200728TH - The Annual 2007 United Senior Citizens of Ontario Inc.Conference, Best Western Hotel, Cobourg

Pat Brown is presenting on – “The Threshold, the Deductible and the Elderly”.

SEPTEMBER 20077TH - St. Michael’s Hospital, Head Injury Clinic: FOREmidableGolf Tournament

John McLeish and Dale Orlando are participating in and are associate sponsors of this annual event.

14TH - Seventh Annual Spinal Cord Conference, Discharge andBeyond: Piloting your Future, Burlington Convention Center,Burlington

Pat Brown and Dale Orlando are Co-Chairing this conference attended by case managers, rehabilitation professionals and specialists in MVA legislation. Pat and Dale are also presentingon “Understanding the Turbulence: New Developments in Automobile Legislation”.

16TH - Canadian Paraplegic Society: 12th Annual WheelchairRelay Challenge, Yorkdale Shopping Centre, Toronto

McLeish Orlando will be participating in and sponsoring the event.

25TH & 26TH - The Canadian Institute’s Advanced Forum onMotor Vehicle Accident Litigation: Latest Developments andTrends in Advancing and Defending First Party and LiabilityClaims, Marriott Bloor Yorkville Hotel, Toronto.

Pat Brown is presenting on “Playing to the Jury: Selling Your Client’s Case to Jurors”. Dale Orlando is presenting on “High Jumping Over the Raised Bar: Overcoming Threshold Challenges in the Tort Action”.

OCTOBER 200718TH - The Law Society of Upper Canada, CLE: PersonalInjury and Mental Capacity Law – Strategies for ClaimsInvolving Incapable Parties, Donald Lamont Learning Centre,Toronto

Dale Orlando is presenting on “Structuring the Settlement withan Eye to Capacity Issues”.

OCTOBER 200718TH - The Law Society of Upper Canada, CLE: PersonalInjury and Mental Capacity Law – Strategies for ClaimsInvolving Incapable Parties, Donald Lamont Learning Centre,Toronto

John McLeish is presenting on “Guardianship Damages in Personal Injury Cases – The Availability of Guardianship

Damages in Tort and No-Fault”.

18TH - The Law Society of Upper Canada, CLE: AccidentBenefits: Recent Changes and Developments, Donald LamontLearning Centre, Toronto

Pat Brown is presenting on “Section 42 Examinations in a PostDAC World”.

26TH - Ontario Trial Lawyers Association: 2007 FallConference, The Westin Prince Hotel, Toronto

Dale Orlando is presenting on “The Use of Demonstrative Evidence in Opening”.

NOVEMBER 20078TH - The Law Society of Upper Canada, CLE: The Oatley-McLeish Guide to Proof of Personal Injury Damages (PartThree): The Central Nervous System, Amputations, the Sensesand Burns, Donald Lamont Learning Centre, Toronto

John McLeish is co-chairing and presenting this program.

23RD - The Canadian Society of Medical Evaluators, 2007Annual Conference, OBA Conference Centre, Toronto

Pat Brown is presenting on “Recording Defence Medicals and IME’s: When is an Order Necessary”.

One Queen Street E., Suite 1620Box 76, Toronto On M5C 2C5

PHONE: (416) 366-3311FAX: (416) 366-3330

TOLL FREE (Canada Wide)1-866-685-3311

www.mcleishorlando.com

4

Upcoming Events