Crisis Conditions Persists In Long Term Care

If you think things are getting better in Long Term Care, think again. In the Sunday Toronto Star (February 7, 2021) newspaper there is a special section showing that Health Minister after Health Minister says things are going to change. To date not much has.

The articles outline appalling conditions and more horror as tragedy after tragedy unfolds. The reporters say as they researched the stories it became clear that they are writing the same stories as those getting written 5, 10 and even 20 years ago.

When is our Federal Government going to implement national standards? When are Long Term Care Administration and Boards (not staff) going to be held accountable? When are random inspections going to occur so deficiencies can be identified and plans put in place to address these ongoing issues?

Long Term Care Facilities do not need warnings. It’s time someone was held accountable.

I express my concerns to politicians both federally and provincially. I then receive a form letter from the provincial Health Care Minister and the Federal Minister from Seniors that essentially say they too are gravely concerned.

Yet exactly the same issues we heard about in the spring are occurring one year later. It doesn’t take a rocket scientist to realize that doing the same thing won’t have new results.

Before the government puts money toward Long Term Care, wouldn’t it be novel if they talked to the experts – those who work in the facility. Talk to the staff who care for the residents day to day not the Administration, the Board members or the Case Managers. Practical suggestions need to be heard.

Next they need to talk to family caregivers, who in most cases are supplementing the care their loved ones receive – or they were until the pandemic hit. Ask questions such as where do they see money being used for the benefit of the residents. Again practical suggestions would be offered.

Those of us who have navigated the complicated system to see that our loved ones receive quality care, know what is missing. We saw first hand gaps in services. It is certainly not the dedication of staff. They are working as hard as they can. Nowadays people in Long Term Care have more complex needs because we are all living longer.

Staff need to be offered full-time positions. There needs to be stability for the residents as well as the staff. This is not a new idea. It has been said over and over, especially since the pandemic.

Governments, Boards and Administration realized that having part-time positions was a cost-saving measure. This is criminal for staff as well as residents.

For seniors to have a constant parade of caregivers is confusing and even frightening. Staff need time to get to know their patients, learn of their likes and dislikes, and are able to build trust. A community is built. If staff have to work at two or three different facilities this cannot happen.

If you, as a future recipient of such care, want to change things it’s time to make Administration, Boards and Government departments of various Long Term Care Facilities accountable. Ask specific questions. Find out the name of the person responsible and address the letter or email to him or her.

Questions such as:

How many residents do you have?

Are there only single rooms with a private bath?

Do you have rooms for couples?

What is your target staff to resident ratio? How is this calculated? Who is included in calculations?

How many full time Licensed Practical Nurses do you have on staff daily? Are they available seven days a week?

How many part time Licensed Practical Nurses do you have on staff?

How many full time care aids are on staff daily?

How many part time care aids?

How many full time cleaning staff?

How many part time cleaning staff?

How many full time registered nurses?

How many part time registered nurses?

How many full time physical therapists?

How many part time physical therapists?

How many full time occupational therapists?

How many part time occupational therapists?

How many full time recreational therapists?

How many part time recreational therapists?

How many full time nurse practitioners?

How many part time nurse practitioners?

How many full time kitchen staff do you have?

How many part time kitchen staff do you have?

How many full time facilities staff are there?

How many part time facilities staff are there?

Do you have a volunteer coordinator??

Which positions are available seven days a week and which ones are only filled Monday to Friday.

It was my experience that my parents would fall ill Friday evening. The Registered Nurse and Nurse Practitioner were only available Monday to Friday. So a trip via ambulance to the hospital happened. It was a waste of resources for Emergency Medical Services, Emergency Room Services and was traumatic for residents.

Often a diagnosis of a recurring urinary tract infection took four to six hours in an emergency department to diagnose. Many residents became agitated and confused while being transported or while waiting. If a Registered Nurse or Nurse Practitioner was one site this could have been handled much more cost effectively as well as humanely.

What can we do? Continue to write letters and e-mails to those who make decisions. Contact the media to keep the care of those who built our country top of mind. If media write a story you enjoy, let them know. Perhaps you have follow up idea for them. Educate yourself as to the differences between private and publicly funded facilities.

If you are a baby boomer, chances are at some point you or someone close to you is going to need some sort of supportive care. It’s time to act to ensure changes are made. We can’t wait any longer.

Happy New Year!

Photo by Karley Saagi on Pexels.com

With a vaccine in our future we can feel hopeful. Like you, I wonder when and then pray that we all stay safe until it is administered.

Isolation has certainly given us time for self-reflection. The freedom we have always enjoyed is gone. We can’t call up a friend to meet for coffee or go out for meal. No more browsing in shops or going on trips. No one-item grocery shopping or attending a music concert or the theatre.

There are still ways to connect with others, via phone call, Zoom, Skype or FaceTime and while it’s better than nothing, it certainly isn’t the same as an eyeball to eyeball conversation. And I do miss the hugs!

Cooking and baking has always been my respite and more so these past months. A friend and I like to refer to our minds as ‘monkey minds’ and cooking slows down the constant flow of random thoughts. For me it is one of the few activities where I must totally concentrate on the rhythm of chopping, stirring and measuring to be successful.

I have had other friends tell me it’s sewing, meditation, music or playing pickle ball or enjoying games of bridge. Many get lost in a good book, television or movies. We have all discovered ways to centre our thoughts and cope with our present reality.

I think the most shocking thing for most of us is that we are coping well. Yes, we all have our ‘down’ days. Maybe, because of our age, we know ‘this too shall pass’ and so we just put on our big boy or girl pants and carry on.

My friends and I chat about how blessed we are because we have a home to live in, a steady income and are healthy. We also laugh about how tidy/clean our homes have become and some of us have even cleared areas or things we have been meaning to do for a long time.

As this New Year begins let’s give ourselves credit that, for the most part, we have remained positive; we’ve probably spent more time in the fresh air than we have since we were kids; we have come to value our resilience and most days we find a way to laugh.

It might be time to think about plans for the coming months. How can we maintain our attitudes, especially if you experience the winter season as many of us do.

I’ve thought about this and my plans include:

  • Meal planning – dinner only (I used to do it when our kids were small and now I want to have one less thing to think about each day. So far it’s helping) I’ve completed 2 weeks.
  • I just started a 30 day meditation course to see if it helps me control my ‘monkey mind.’ It only takes about ten minutes so it suits my attention span!
  • I have a set schedule to clean our bathrooms. Never had one before so I shall see how it works. Again it takes away the constant thoughts of “I should.” I’ve completed 4 weeks.
  • Continue my walks and add in physio-recommended exercises. I’m good with walks, sporadic with exercises.
  • Take at least one course each month on line. So far I have completed one on working a food processor, one on making bread and two on writing.
  • In the summer my husband and I went to different city parks for walks. We are going to continue this plus takes regular trips to the mountains.
  • Only watch the news once a day.

Will I continue? Who knows. I don’t get fussed if I don’t complete the goals. I just find if I state them, I’m more likely to carry though.

I do want to be as kind to myself as I try to be with my family and friends, so no judgement. I learned this a long time ago and it continues to serve me well, especially these past months.

So…… it appears that we will continue to enjoy our own company for a few more months. What can you do to make the time enjoyable?

Healthy Mind and Body Equals a Happier, Longer Life

I was chatting with a friend who was telling my about the ways she kept busy and motivated while isolating and following the guidelines for COVID.

We were comparing ideas and she suggested it would make a good blog. She is trying new recipes and was about to make some apple pie jam.

We also talked about trying different spices including cumin, coriander and sometimes adding cinnamon to a main course recipe. We both enjoy experimenting.

Also she was organizing a beach walk which would be a socially-distanced reunion of long-term friends. She said she was thinking about adding a mystery guest if this becomes a regular walking group. The mystery person could mask-up and his/her identify would be guessed. We said it would even work on Zoom.

She was also looking into renting a metal detector to use as she did her daily beach walks.

“Wouldn’t it be fun to find something?” she said. “Even an earring.” Part of the fun is the anticipation of what might transpire.

Coincidentally as she went for her daily walk after our chat, there was a fellow with a metal detector exploring the beach. She was able to find out more.

I told her how two friends and I were attempting to write a novel…one chapter at a time. I started it and then the next person writes a chapter and so on. We just completed Chapter 12. It’s fun to see where it goes. When I see an email from one of the women I’m so excited to see what our ‘new friends’ are up to.

Another friend does crosswords so decided to subscribe to a national newspaper on Saturdays when her favourite crossword is there. She said she saves the paper for a day when she feels like doing it. No time lines anymore.

Over the summer we got a group of our long-term friends together for socially distanced lunches. We all took our own lunches and chairs. We had wonderful, safe visits.

Now winter is here we have continued to meet -wrapped in blankets, mittens, scarves and bringing hot drinks. We also seek out spots that are protected from the wind. The meetings don’t last as long but we all value face-to-face.

I play two word games on the IPAD every morning. One is called Wordscapes and the other is Word Stacks. Both are free. I even do word search and crossword puzzles just to keep my mind active. From what I read it is important do different types of puzzles to stimulate the brain.

As we age our cognitive functions such as memory, attention, awareness, reasoning and judgement decline. Research is showing cognitive function improves if we do specific things at least three times a week.

Many of my friends have tried new crafts. Some are knitting and crocheting some great things and the quilters are busier than ever.

Two friends have kept up their ukulele skills that we began at our winter home. Any time you can develop new skills your brain is being actively engaged. There are excellent lessons you can access virtually.

Friends are busy doing jig saw puzzles and I know couples who have kept a running score of their cribbage game since April! Other are trying new card games. I play solitaire with a deck of cards and am trying some new solitaire games. If you play solitaire on the computer it is a good idea to try it using real cards. It uses different skills.

We like board games like Rummikub, Quirkle and Sequence. Some friends are playing bridge on line. There seems to be lots of ways to keep busy. Sometimes the first step is to just DO IT!

Keeping motivated is difficult. Everyone I talk to struggles at times. Our church sent out a challenge and it is to walk 8000 steps a day between now and Christmas Day. We will have covered a distance of 144 km or 90 miles – the distance Mary and Joseph walked from Nazareth to Bethlehem.

Five women I met in Palm Springs are going to complete this challenge. This first week as we walk we are to think about hope, the second week peace, third love and the fourth week joy.

What a treat to read emails from these five special ladies telling me what their thoughts of hope were and that they had completed the first day of the challenge.

My regular walking partner and I talked about hope as we braved the nippy west wind and enjoyed the sun.

What do you do to keep motivated? How do you stretch your brain and exercise your body? The goal is to keep moving and thinking so once we can resume more normal activities we have the get up and go to do so!

Comfort Food and Conversations

When I was growing up, our kitchen was the heart of our home. People dropped in and the coffee pot was always on and the cookie jar full or there was a cake cooling on the counter.

Mealtimes were important to nourish minds and body and a lively conversation with lots of belly laughs was the norm. We usually had a hired man and quite often ‘extras’ joined us. I loved mealtimes and the lively conversations.

Once I was married and began writing a parenting column for our city newspaper it came as a shock to learn that not everyone sat down together for meals. With busy lives, extracurricular activities and jobs pulling parents in different directions, family meals were not the norm.

Research definitively proved that family mealtimes were important to child development and well being. Unfortunately it wasn’t happening.

The COVID pandemic has changed that behaviour for many. Preparing and sharing meals is happening in more homes and people are beginning to appreciate the benefits of sitting together and eating.

I see advertisements for ‘conversation starter cards’ for family and friends and it amuses me to think we need that sort of support to ‘have a visit.’ I suspect our grandparents would think that is ridiculous!

Since the pandemic, has your mealtime changed? For me finding recipes or adapting existing ones that don’t have us eating leftovers for days has become important. Also trying new things has my husband taking a bite then looking at me and saying, “What do you call this?” 🙂

I am easily bored so it’s true he never knows what surprise he will have at mealtime! Although lately I am reverting back to favourites we enjoyed during our first years of marriage. I suspect he is rather relieved.

I think it’s the cold and early snow and the fact that there is no magic cure for COVID in the near future that has perpetrated my change to comfort foods. I even made some fruit cakes over the week end. While I always made them for my parents and in-laws, this is the earliest I have completed that task.

I have been chatting with friends and it is true that comfort foods have become important in there uncertain times. We decided they bring a sense of normalcy and levelness to our topsy-turvy world.

I thought I’d share two easy recipes that you can adapt to one or two people. The first one is something my mom made and was a favourite. I think she liked the fact that I was eating both eggs and milk because I never preferred them. Plus she could make it for four or fourteen. She called it Welsh Rarebit but it isn’t like the recipes I have seen. Here is her own take.

Welsh Rarebit 350 -400 F 45-60 minutes

Grease a pan with edges (I use spray or use parchment paper)

Put on 4 slices of bread

Cover with slices of cheddar cheese (not processed but any hard cheese would work)

Mix up an egg and milk like you would for scrambled eggs. If you use more bread add more eggs and milk. Pour this mixture over the bread and cheese and bake till golden brown and not soggy.

Easy Chicken Thighs 350F 60 minutes plus…..

A good friend passed this along years ago. I continually made this for my parents and my husband’s parents and it was always a hit. It is easy to transport if you are preparing meals for others. Serve with rice or potatoes and this can easily be adapted to the number of people you are serving. It is so easy and kids like it too.

Pan with edges (Spray with oil)

Package of chicken thighs – I buy skin on/bone in then take the skin off

Sauce

3/4 cup ketchup

1/2 cup brown sugar

1 tsp. soya sauce

1 1/2 cup water

Yep that’s all that’s in it! Mix up sauce. Pour over chicken and cook till chicken is done. I like to let the chicken get brown. My friend uses chicken pieces and sometimes adds a tin of fruit to fancy it up……….Serve with rice or potatoes.

Do you have a favourite comfort foods you’ve been making? Share the recipe if you wish. I know my husband would be happy to try something new!!!!!! 🙂

The Future of Care For Seniors….It’s Time To Stop Talking and Act!

Our Federal Government says it’s working to set national standards in long-term care. My question is “why wasn’t this a priority as soon April 2020 as the trends of residents dying at an alarming rate at the begging of COVID-19?”

Hearing about ‘discussions’ with all parties makes me furious. Let’s stop talking and do something! I wrote to our provincial government and got much the same answer – they are meeting…….. At least I got an answer. When I wrote tour local MP (twice) he has been silent.

Meeting, discussing etc. is not going to help. We need action NOW. The main recommendations from those who understand the deficiencies include:

  • no more than one resident per room
  • access to own bathroom
  • staff work at one facility only
  • fast track certification for personal care workers
  • increase staff/resident ratio

It appears that standards of infection control and availability of safety protective gear is better. The issue is if there aren’t enough staff, this does absolutely nothing.

It’s easy to provide PPE (personal protective equipment). What seems to be difficult is implementing standards.

Let’s see the provincial and federal government act now. We hear of care workers exhausted from masking up, wearing goggles, working extra shifts, etc. and while many politicians are quick to say “The conditions for senior care is egregious”, no one has actually implemented any sort of action that will help. Meetings and discussions aren’t helping our seniors!

One politician said “problems existed with seniors care long before COVID-19.” My question is so why aren’t you acting NOW?

Safe guards are woefully inadequate within our seniors care facilities. If, and most medical professionals say ‘when,’ the COVID-19 cases being to rise again, many of these low-paid and exhausted staff will leave. That was a pattern in March and April. Remember the military being sent in to care facilities to help?

If we want to stop this needless annihilation of our seniors – “this shock-wave that cracked wide all the fractures within our nursing home system” (July 2020 Report, Royal Society of Canada) , quit discussing and act.

Even the safe guards, we as caregivers had before COVID-19 are stripped away. Because of fear of infection, no outsiders are allowed into the seniors care homes.

While family members could supplement care, that option is no longer available, thus elevating the work load for staff. I often helped my parents to the toilet, made their beds, took them for walks, got them snacks, did their laundry, helped them dress and later on, feed them. I know others did the same. Without this volunteer help, no wonder we hear of residents being left alone for hours. There just aren’t the number of staff to help.

So what can we do? Let’s be vocal about our concerns. Let’s hold all levels of government accountable. Write letters. Phone your politicians. Talk to Directors at your local seniors places and find out what they need. What are their concerns? We can make a difference. In this case I believe the squeaky wheel will get attention.

Plan For The Winter

We are all talking about what we are going to do over the winter months now our winter homes are off-limits, at least for the next few months. How many crosswords, word searches, sudoko, movies, jigsaw puzzles and books can we tolerate?

How can we stay busy, fit and happy? For those of us living where snow and ice arrive, it means taking precautions if we are going out walking. While this spring and summer walking was a lifesaver, we understand once the snow arrives, a fall and a broken bone have the potential to change our lives forever.

There are lots of great winter sports like skiing, curling and snow-shoeing; now it’s a matter of… while the mind is willing can the body take it?

Personally we are looking at renewing our gym membership because, to our knowledge there haven’t been any reported cases of infection at our local gym. We can use the machines and stay fit without risk of falls…unless, of course, we fall off the treadmill or exercise bike!

Some of our friends have discovered ways to play bridge virtually and will continue that practise.

Most of us have completed home projects such as organizing closets, drawers and clothes. When we first got home in March we purged and just last week we again each collected a bag of clothes we no longer needed and got them ready to donate. There are still some drawers to go through.

Personally I love to bake and cook so I’m organizing new recipes I’ve tried from the Internet into a binder. It sure beats all the bits and pieces of tattered papers I’ve collected over the years.

Another project, for me, will be is to organize all the files on the computer…..I know I will have the time, it will be a matter of settling down to do it. I have to add it to my ‘to do’ list or it won’t get done.

We have a great group of long-term friends and over the summer we met at a local park, brought our lunch and chairs and had socially distanced visits. It was such a good sanity saver. Perhaps there is a way to meet over the winter at a public fire pit for a visit. With wood, the right clothes and hot dogs to roast it could work. One of our famous Chinooks would certainly help.

I know friends who plan to keep busy quilting, knitting, and doing a variety of crafts. Others enjoy wood working, painting and home renovations.

Others are writing memories. I loved the fact that my grandparents and parents were great story tellers and mom and dad both wrote down some for us. We so appreciate them now. Don’t worry about format, sentence structure etc. just get them down.

We could also try a new instrument. Many people are enjoying the ukulele and believe me, it s easy to learn and fun. The trick is to practise. There are so many videos on the Internet that you will have simple chords down quickly, it is fool proof…I’m speaking from experience here!

As we age our thinking becomes slower and there are some simple things we can incorporate into our daily routines to improve our ‘connections.’ Brush your teeth or try eating using the non-dominate hand. Apparently this builds new brain connections. Make a list of 10 books you have read. Memorize it. One hour later see if you can repeat it. If you have always done crosswords then try a different type game. It’s important to keep learning.

Another task is to count backwards from 100 by 7,s then 6s etc. One person I was chatting with learned all the states in United States and then the capitals. Now she is working on European capitals. All good for our aging brain.

There are some excellent computer games to play. As I was reading about various individual games, the important thing is to change it up. If you are a crossword puzzle person incorporate some other types of games. Or if you prefer the math-type games try crosswords or something else. It’s important to keep challenging our minds.

What do you plan to do this winter? There are lots of possibilities. Today might be a good time to explore them. Make a plan, write it down and this might just give you a positive to focus.

Bits and Pieces…Saturday Ramblings

A few months ago a good friend recommended I read a BLOG called “Margaret At Sixty and Me.” It arrives daily in my email and I usually find something that resonates. It is based out of the United Kingdom. If you are interested, you can find it at www.sixtyandme.com

Yesterday one of the articles was called 10 Ways to Help a Friend Who is a New Widow. I found the suggestions to be practical and would apply to anyone who is suffering from loneliness during this pandemic too. I will share a couple with you.

Send a Card even when you don’t know what to say is always a good way to connect with people. It lets them know you are thinking about them. And who doesn’t like a little surprise in their mailbox? I understand that letter writing is a thing of the past and yet we baby boomers certainly appreciate a hand-written note.

Suggest Ways to Help Rather than Ask …..be specific. Instead of saying something like call me if you need anything, you might like to say – when can we go on a walk together, or would Tuesday be a good day for me to come over and weed your garden. A comment such as call me if you need anything is usually unheeded. If you truly want to help, be specific and more than likely you will be taken up on your suggestion. When upset, it is really difficult to make any kind of decision so by being specific you take that away.

Do you have a favourite BLOG you think other readers would enjoy? Let me know.

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As this pandemic continues I thought it would be interesting to hear how you are coping. When things are going wrong or you are upset about our world, what is the first thing that pops into your head?

If it is is “woe is me” or “what a terrible world” your personal philosophy may be sabotaging you rather than saving you. While you may not have taken time to verbalize your personal philosophy before, now might be a good time.

I used to lead workshops called “Dealing With Difficult People Without Becoming One Yourself.” One exercise was to identify a personal philosophy. Some participants knew right away what theirs was, while others pondered the question.

As I was pulling materials together for the workshop I began to think about my own philosophy. Did I have one? Yes I did because many years ago when faxes were the “best technology” available mine began to spit out a message late one Friday afternoon.

As I plucked that shiny, curled piece of fax paper off the machine I laughed out loud….it simply said “Blessed are the Flexible for They Shall Not be Bent Out of Shape.”

The same good friend who told me about the BLOG sent me that gem too. I immediately transferred it to a piece of cardboard and it hung on my home office wall until we moved. Whenever my life felt unhinged I would silently chant that saying. I still try to live by that philosophy today.

Take time over the next few days to come up with your own personal philosophy. Even if you haven’t formally written one down, I bet most of you have one.

While giving the workshops here are some examples I heard:

  • Focus on What’s Right With The World Instead of What’s Wrong
  • Do Onto Others As You Would Have Them Do Onto You
  • Time is Limited So Think Big
  • Look For Opportunities to Leave The World A Better Place
  • You Never See A Hearse Pulling a U-Haul
  • Your Strongest Muscle and Worst Enemy is Your Mind. Train It Well.
  • Make improvements, not excuses
  • Life Has No Remote, Get Up and Change It Yourself
  • Seek Respect, not Attention
  • The Mind is a Flexible Mirror. Adjust It To See A Better World
  • The Serenity Prayer…God Grant Me the Serenity to accept…..

Identifying a personal philosophy might just help you navigate these uncertain times.

12 Tips To Survive and Thrive During COVID……..Baby Boomers Aren’t Getting Older We’re Getting Wiser!

A good friend turned 80 this past February and we had a great celebratory week of parties. She never says “getting older” it’s always “getting wiser.” I think it’s a great idea. Words do matter!

When you see Penny around our RV Park you see this slim, strong woman in sweats and long-sleeved t-shirts walking, biking, golfing or on the pickle ball courts. She always has a big smile on her face and a kind word for everyone. The next season we will see her with her newest family addition – a golden retreiver.

Just like the rest of us Penny is fed up with COVID. It has certainly changed the way we conduct our daily lives. We understand that as retirees we are in a group who doesn’t have the pressures of the younger generation. We don’t have to make a decision about whether or not our children attend school, whether or not we will maintain our income or how to carry on if one family member becomes ill. As “the wise” generation our focus is to remain positive and not ‘awfulize’ the situation…..we don’t want to add pressure to those around us.

Penny and I have been talking and here are our 12 tips as you become “wiser.”

  1. Remember that each day when you open your eyes you have two choices- to be happy or to be sad. Make a conscious choice.
  2. Look for new experiences and cultivate a variety of friends. Penny thought about each decade of her life and focused on a different activity-such as triathlons, polo, traveling in a motor home and taking up pickle ball. Any chance she got, she would travel to other countries. While our travel is now limited, there is lots to explore within your own community.
  3. Set your kids free and allow them to be self-sufficient. The same with adult grandchildren. Allow them to live with their choices.
  4. Eat well. Limit processed foods and use lots of brightly coloured fruits and vegetables. Penny has recently become a vegan and feels her pain from inflammation is much better. (I have noticed she hasn’t given up her nightly scotch or me my wine.)
  5. Allow yourself quiet time daily such as reading, listening to music or simply watching the world go by. Get enough sleep each night.
  6. Do whatever exercise you can each day. Walking, golfing, pickle ball, swimming etc. Just because you aren’t as good as you used to be, enjoy the experience. Be kind to yourself.
  7. Accept invitations. Socialization is great for your mental health. A change of scenery and a different conversation improves mental health. With careful thought, you can be sociable and social-distance.
  8. Do not be obsessive, be knowledgeable not judgemental as you stay current with the daily news. Limit your viewing time.
  9. Focus on today. We can’t change the past and have no control on the future.
  10. Pain and discomfort do not always accompany “getting wiser.” Rather than accept it, go to a health professional (physician, physical therapist, dentist, chiropractor, nutritionist etc.) Once you have their opinion, follow their advice.
  11. Respect the younger generation and value their opinions. Be supportive and encouraging. Do not judge.
  12. Laugh lots. Look for people, experiences and activities that make you smile.

How are you staying positive during COVID? What would your 12 rules be?

Urgent Action Needed to Reform Long-Term Care in Canada (Part Four)

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The Royal Society of Canada (RSC) published a report on July 2, 2020 that consists of 9 steps to solving the workforce crisis in nursing homes, all of which require a strong, coordinated leadership at the federal and provincial/territorial levels to implement.

It says” Our long-term care sector, particularly nursing homes, is in crisis now from far more than COVID-19. The pandemic just exposed long-standing, wide-spread and pervasive deficiencies in the sector.”

It implores the levels of government to:

  • listen to older adults especially those living with dementia and their caregivers
  • acknowledge profound inequities faced by elderly, especially poverty
  • develop and support management and leadership
  • build resilience and listen to workers in long term care (LTC) who do the direct care
  • establish standards for appropriate levels of regulated health workers

When I read ‘profound inequities’, need to establish ‘adequate levels’ and ‘establish standards’, I am frightened. Those of us who have had parents or friends in nursing homes or long-term care have long seen the inequities. We knew there were not enough staff and standards were as varied as the facility.

Many of us supplemented care and were vocal advocates so our loved-ones were well cared for. We were able to pay for the extras that were not provided such as vision, feet and eye care. We saw ernest staff, coping with residents who had dementia or were upset/depressed, and yet these caring staff had no support or training.

We’ve all heard of restraints of medication being used to calm someone. Or a resident calling out from their room in obvious distress. It broke my heart to go into my friend’s residence and hear the moans, the calls and smell the odours that meant there wasn’t adequate staff to care for all the complex needs.

How can we expect staff to have strategies to assist when there is no standard formal training? Or they simply cannot get to all the patients they are assigned? They aren’t lazy. They just don’t have the skills or the time to accomplish what is needed.

Older people are entering care facilities with far more complex needs than those who entered even 10 years ago. We are all living longer. We need more complex and higher levels of medical and social care. Therefore staff need to be better prepared.

I was shocked when I read that The Canada Health Act DOES NOT protect or ensure universal Long Term Care! Canada’s Long Term Care sector has it roots in the Elizabethan Poor Law of 1601! It’s time for an update.

The first step recommended by this report is to address the workforce crisis. Untrained care aids and personal support workers are injuring themselves, experiencing burnout and are the lowest paid in the health care sector. Since they do 90% of the direct care they need to be properly supported and have a voice in the care of the patients.

I believe we need to establish federal standards and have inspectors making monthly, unannounced visits to long-term care facilities and nursing homes to ensure standards are being met.

Our governments need to see this as a priority. We need to let them know it is important. As the report says there is ample sound evidence on how to achieve this. While the pandemic exposed the crisis, it is long-standing, wide spread and pervasive. The deficiencies in the sector are deplorable.

Write to The Federal Minister of Health The Honourable Patty Hajdu as well as the Federal Minister of Seniors, The Honourable Deb Schulte. Also send letters to your provincial ministers. Let them all know it is priority. Our voice will make a difference.

We need to speak up for those who cannot.

To read the report RESTORING TRUST: COVID-19 AND THE FUTURE OF LONG-TERM CARE go to:

https://rsc-src.ca/en/restoring-trust-covid-19-and-future-long-term-care

Home Care for the Vulnerable (Part Three)

Over and over we hear that it is best to age in place. Or if you have a medical condition that requires support from others it is again best to have the help come into your home.

While in theory it sounds like a perfect solution in practise it does not work, unless you have a large bank account.

Both my parents and my in-laws accessed home care at various points. My parents only qualified for it after my mom was released from the hospital with a cracked pelvis. The Home Care worker came in twice a week to help her bath. My mom liked to bathe every other day so on those days she would do it by herself. I tried to make the 30 minute drive out to help because I didn’t want her to fall.

Later on when I was worn out from grocery shopping every few days for them, we hired a lady to come and help out. It cost $25 per hour and she came for three hours once a week. I still supplemented picking up medication and groceries……

If they had a medical appointment, my brother or I would drive them. At their particular age taking a taxi wasn’t in their plans. My in-laws also refused to take taxis so my husband or I would drive them to and from appointments.

We also hired a cleaning lady so that was another cost. Another person was hired for foot care and they purchased meals on wheels.

My in-laws qualified for bathing twice a week, so we hired a cleaning lady and they had meals on wheels. They refused to hire a foot care person.

In our experience Home Care people were often different. How could any sort of trust be gained when different people arrived to do this intimate care?

One my friend’s mothers refused to let a ‘stranger’ in her house. She had mild dementia and was afraid to allow this Home Care Worker she hadn’t seen before come in. Makes sense to me.

When my friend phoned to see why her mother wasn’t bathed she was told her mother refused. While I understand the Home Care Worker could not force herself in, it highlights an issue with Home Care.

Home Care staff were also always rushed as there were time limits set for each ‘service’ they offered. When dealing with people who are vulnerable, as in elderly or medically fragile, trying to rush them only adds to the confusion and stress.

A good friend has a sister who is confined to a wheel chair and requires daily home support, even though she lives in an assisted living facility.

The sister qualifies for three showers each week and is allowed one hour per shower. Because she is incontinent this is not really enough. She copes.

She needs exercises so Home Hare provided a physiotherapist twice a week. As soon as the pandemic started this was stopped. Her sister had to hire a private physiotherapist and can only afford her once a week. This in not helping her to maintain her independence.

The sister has limited use of her hands and Home Care comes in once a week for two hours to assist with laundry, homemaking and cleaning. Even in a small apartment there is no way everything gets done. During the pandemic this limited help was gone. It fell to my friend and later on, to the sister was able to hire a lady to help out. Again this was a financial burden.

As far as meals go, within the assisted living place where the sister resides, meals were provided but because of the pandemic, she is now charged $5 if she asks that they bring the tray up to her room.

Can you imagine someone with limited hand and arm strength opening her door to go out in the hall, wheel herself down the hall, enter an elevator, pick up her food tray and then make the reverse trip. How can this be safe?

So my friend makes meals to freeze that can be warmed up in the microwave. Her sister is getting limited social interaction and my friend is taking on another job.

When Home Care does come, part of the service is meal preparation. The reality is that they are only allowed to make toast, salads or sandwiches. If we care about nutrition this is simply not enough.

The sister requires medication twice a day and Home Care does come in to administer the drugs. Again there is a time limit to these visits so it is quick.

What I have noticed in the condo where my parents resided and now our condo is there are many different Home Care staff arriving at different times of the day to assist people who need help.

I wonder if those visits couldn’t be better coordinated so it was always the same three or four staff who visited a building. Wouldn’t that make more sense, be a better use of time and be easier on those who need the help?

For my parents, in-laws and other friend’s parents and siblings, we step up and help when needed, sometimes at our expense.

For caregivers this can become a full time job and many are wearing out, stressed and financially burdened. We are aging too.

What happens to the vulnerable who have no one? How about those who don’t have the bank account to be able to hire extra help. It is frightening to think of their fate.

I hear arguments about cost and certainly this needs to be considered. Let’s sit down and talk about what could work better? If there a different way that is more humane?

I understand that moving the vulnerable into institutions isn’t popular, especially after we see what is happening in many, and yet for us as caregivers it was reassuring to know that qualified staff was on site 24/7.
Also most residents get more social stimulation which is so necessary to their physical and mental health.

In it’s present state, Home Care is not enough to keep our vulnerable in the best safe spot we would expect for our loved ones.

Seniors and those living with degenerative diseases deserve the respect and care we give to children. We need more doctors, nurse practitioners and trained staff who specialize in this care.