Protecting The Vulnerable (PART ONE)

As I listened to federal and provincial politicians talk about the crisis in caring for the elderly I felt hope. They all appear to want to change the way we care for those in any kind of elder care. Now it’s up to us to advocate and turn the talk into thoughtful action.

If we were to run day cares or any child care the way elder care is operated there would be a huge outcry and rightfully so. Let’s maintain those same standards for those who grew our country. Let’s look at dignified and specialized care for our elders.

As I watched my grandparents live out their last years in institutionalized care I always thought it was a crime that my one grandmother was in a room for two.

At 92 she deserved to have her own space. The lady beside her never seemed to get out of bed or have visitors. My grandma had dementia and she would ask me who the lady in her room was. It must be so confusing to suddenly be in such as place.

I often visited a former boss who was in a long term care home and his roommate groaned and called out. I felt such sadness that he could not live in the dignity he offered his staff throughout his career. If he was up I would take him to another area where we could visit without interruption.

I had hoped that would have changed. It did not. As my friend, here in Calgary, sought out placements for her dad, the only ones available offered shared rooms.

Why, when in your 80s or 90s should you be thrust into something that even University students now complain about! It seems cruel.

My first wish would that seniors or those needing 24 hour care all have single rooms with their own bathroom.

When my parents moved from Assisted Living to Long-Term Care they were not allowed to bring their own beds. They would now use hospital beds. I understand this as some residents needed care that was better administered if the bed was lowered or raised.

At 6’2″ my dad did not fit in a standard-sized hospital bed and there were no extra-long beds available. We explained to the staff what dad would need, weeks ahead of the move.

However Dad suffered, scrunched up or trying to get comfortable laying on an angle until one was located. How was this making the place feel welcoming? What happened to those vulnerable patients who did not have advocates?

Second I would look at patient-based care. This would mean that once a person entered into care, they did not move again. The care came to the person, not the person having to move to another facility.

Moving is upsetting and while most of us find change difficult those with even mild dementia find any change totally confusing. Aging in place would allow staff to get to know their patients and patients would feel more comfortable in their familiar surroundings as they moved from one level of care to the next.

My parents were able to be moved together, from an assisted living place to a long-term care placement. We had to choose a place in a different town as five years ago there were only two placements available for couples.

We were lucky as at 90 and 89 years old they had the security of each other, so didn’t feel quite so vulnerable. While both friendly and out-going, it was extrememly difficult on them to make this transition. I can imagine how difficult it would be to be moved and feel and be all alone. Both had complex health needs and I spent hours working with the new staff to ensure their needs were met.

We expect these vulnerable elders to move to a new facility, a new room, new people, new routines and new staff. Is this humane? In some cases couples are split up and other times these patients are moved miles and miles away from their original placements. If they did have family and visitors near by, this often means that those who want to visit are driving hours to see them.

Care aids, licensed practical nurses, cleaning staff, physio therapists, occupational therapists, the handy man, the registered nurses and the nurse practitioner all became part of my parents new care team.

My parents also had to change family doctors and we wanted to find one who would visit the facility. These strangers were providing, in most cases, intimate care, and trust needed to be gained on all fronts. Why do we expect our elders to move and then adapt? We need facilities to offer all levels of care in one location.

My brother and I were a united team and toured facilities before making a choice as to which one we thought would best suit our parents. My husband and I had done the same for his parents seven years earlier and let me tell you, once through the door, we certainly got a feel for the building. There was absolutely no consistently between facilities.

We liked to tour the facility without an appointment. It is often eye-opening.

Some seemed impersonal and cold while others immediately felt welcoming. I always wondered what happened to the seniors with no advocates. It is heart-breaking to think of their bleak future.

We were conscious of how residents were being treated. We watched how staff interacted with each other as well as residents. While some places had luxurious facilities our focus was on the care our loved ones would receive.

We looked for smaller eating areas and clean, happy places where residents weren’t marooned in the hall or at the table. We looked for light. Some places seemed so dreary and as we age we know our eye-sight isn’t as sharp.

One big sign for us was when we were on a tour did the guide stop and chat or smile with residents. Was there a sense of community? Did staff know residents by name? Were there doctors, hair dressers, hearing technicians etc. who visited the facility or would caregivers be responsible for taking the residents to medical and personal care appointments?

Trying to get both my parents into a vehicle, storing their walker and wheelchair and then doing the same thing once at the appointment was an exhausting experience, not just for them, for me too! I looked for accessible transportation but that was a red tape nightmare…….after multiple phone calls, getting numerous letters attesting to the fact my parents actually needed accessible rides finally found me giving up……it was just too much. Why does it have to be so difficult? It felt like everything I tried to access to make my parents life easier was two steps forward and five backwards.

I was a family caregiver for over twenty years and most of my friends have either experienced or are experiencing it now. It is time to actually do something. No more studies! Save the money and actually make some changes.

Ask those of us who have lived the experience and are looking at our future and do not want to put our children through what we went though or go through what our parents endured. We understand. We know the restricitions these facilities live under. Ask staff and listen.

A politician visiting sees an entirely different view than those of us who have spent hours negotiating ‘the system’ watching staff and interacting with residents.

Many more of my thoughts and recommendations are coming soon. What do you think?

Published by Joan Craven

Joan Craven has been a

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5 Comments

  1. Good Morning Joan, Thanks for this, it so much needs to be said and to be shared. And, I cannot help but add the story of my mother here. She lived in Salmon Arm BC and we moved her into the community assisted living home in 2001, about the time there was a change in government in BC. Mom moved into a room of her own. Meals were cooked in the kitchen at the facility. They were excellent and healthy. We know because we could book ourselves in and join her for a meal. We had to pay for ours of course. 😀 There were regular activities scheduled for resident participation. Mom loved gardening and the outdoors. Staff took her on walks in her wheelchair around the pond. She took part in regular discussion groups, card games, and, most important to her, exercise classes. There were movies and happy hours in the social area. Staff took care to see she was able to participate. After about a year, the government made changes to the funding system and, although I wasn’t aware of it at the time, may have privatized some aspects of the care. The changes were dramatic. One of the first we noticed was that the meals were no longer cooked on site. They were apparently cooked in Vernon (about an hour away) and delivered to the residence. As one might expect this had a significant impact on the meals. The quality and variety took a deep dive.

    The second big change we noticed was the number of activities provided for residents. In the past, when we visited, Mom was almost alway away from her room involved with others in various activities. Now she was always in her room. We talked to staff about this and they responded almost in tears sometimes. Their staff had been cut to such and extent that they were no longer able to provide the range of activities they had been able to in the past. In fact the Recreation Director’s position had been cut so the Personal Care Assistants were trying to add that to their work. We were fortunate in that we were able to hire someone who would come and take Mom for walks regularly and so that helped somewhat. However, it in no way made up for what had been lost. Joan, I am sure you are getting lots of these responses, again, thanks for doing this.

    Louise

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    1. Thank you for your wise perspective Louise. I agree that the staff are trying their best, it’s just not humanly possible to care for so many with complex needs. The socializing is so important and staff have no time to be able to chat, reassure and build relationships. The first things cut are positions like the recreation director, much like educational aids and psychologists in the school systems. These positions are not ‘add ons’ – they are key to maintaining the high quality we wish to have.
      We too hired someone to come in weekly and visit. It made a huge difference to mom’s outlook. She had a friend when most of her other friends had passed away. If we have the means to supplement the care it makes a huge difference. Unfortunately so many can afford this.

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  2. What an excellent post JOan and a very scary one particularly as I’m nearing the age of those who are in long term care and your comparison of child care vrs long term care was excellent!!! I trie twice to post this on your blog but it wouldn’t post. Kept saying my email was incorrect 😡 You are such a gifted writer as well as such a caring person. I treasure you as a friend!!! ❤️

    Sent from my iPad

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  3. This is a wonderful article ! Thanks for sharing this ! You lay out things so clearly !

    Sent from my iPad

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  4. Great post. The Covid crisis has made it impossible to ignore the heart-breaking and, at times, criminal inadequacy of our long-term “care” system.

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