Abuse in Nursing Homes

In todays Vancouver Province, there was an article by Peter Clough about Judy Sellin, whose father was in a nursing home. concerned about abuse, she put a hidden camera in the room, and filmed some powerful evidence that some B.C. seniors are neglected and even abused in an overburdened system."

In my book, Nurisng Homes: The Family's Journey, I spend quite a bit of time talking about abuse. I couldn't decide, when I was writing the book, if I should put it in, because it frightened people, but then I thought, better they should be forewarned."

Building up trust in a nursing home or care facility is hard anyway--it means leaving your loved one with people you don't know. It is harder still because of the emotions of guilt, shame, regeret, grief that accompany the decision. These feelings can colour what we think and feel.

First however, understand that most staff are caring and professional people doing a hard job in a difficult situation. They would no more abuse your mother, father, husband, wife, etc, than they would their own. Mostly, they spend their own money, work overtime, burn out on caring. Support them, and you will have supportive staff.

However----------- it makes sense to be aware. It makes sense to know that staff really are stressed out and stretched out.'Understand that the care aides have had their pay and benefits cut.

But-------know the signs of abuse. Know what good care is about. Go visit at different times. Talk to residents and other family members. Make sure the staff know you are around. Understand how nursing homes work. Learn about aging. Trust your intuition--but temper it with looking at your self. Use a hidden camera if you wish

In my lectures to the public, and to business, I always stress that the "job "of family members is to be an advocate and to be a nexpert on care.

Is That A dollar Under A Liberal Tongue?

Okay, Gordon Campbell, the election is over, congratulations on getting four more years......Now you have your chance to show us how and if you will provide the care and resources for the elderly that you promised....... If you want any advice, you know where to find me...

Now that I think of it, I wonder how many politicians are caregivers and/or have loved ones who are elderly?.....What was it like when it was your family? How did you, or will you, deal when the resources for them and to support you aren't there the way they should be? Or did you or will you be able to hire someone from the private sector (like me) to be there for you?

One thing you don't have to worry about. The thing about most of us who work in health care, private, non-profit, or governement funded, is our compassion doesn't have a political colour, I think we just care. We will be there for you and yours.

Final Wishes

Every day this week I waited for someone to die, and hoped it would be quick. I was called in to help figure out what to do, after she'd had a stroke, couldn't speak for herself, and had no Representation Agreement ( British Columbia's form of Living Will.). I dug through the information I was provided with, talked to her friends, and her lawyer and accountant, and Trust Official. I emerged with a picture of a 90 year old woman who would not have wanted to be kept alive in the condition she was in; would not have wanted anything more than to go gracefully and with love. I looked into her clear blue eyes--they must have held a sparkle once--and talked to her, but she couldn't focus or answer enough to guide me. Nor her friends. So it was decided to let her go the way everyone hoped she would have wanted. In a couple of days she declined rapidly, then was unconscious, and then a day more, and she was gone.

I wsa only a health care worker who was called in to consult. But I think of her, of the picture I saw of a grandmotherly lady in a garden of roses, with a hat blown in the wind and a shy impish smile, and think, "if only you had told someone what you would have wanted."

The Real Reason There Are No Long Waits for Care

In the Vancouver Sun today, there was an article in which Clay Adams, Director of issues management for the Vancouver Coastal Health authority told the reporter that "there is no longer a long waiting list for residential care beds, so the health authority is focussing on assisted living, which is in greater demand (Quotes are re the article)"

Well, Mr. Clay the reason there are no long waiting lists is because the government made a policy that anyone who wants to go into a nursing home and manages to qualify must be willing to go in within three months. So of course there are no long waitlists.

Once people agrees to go into care, they are only allowed to choose a preference. If their preference is not available, they have to go to the first bed that is available, which can mean a long trek across the city for an elderly spouse who wants to go visit.

So if you want to go to one specific place, you may be out of luck. The committee responsible for placement will do their best to get you in where you wish, but if they can't they don't.

And woe to you if you are going to be discharged from hospital. With the pressure to get you out of hospital (where you will become a "bed-blocker"), there is even less latitude for you to go where you or your family, wants you to go.

Once the hospital says you are ready for discharge, you can be out the next day. Or when a bed comes up somewhere, you are gone as soon as it is ready. No preparation, no planning for you.

That includes discharging you if you are palliative, no matter what kind of room is available. I would think that somewhere there would be at least the compassion to find someone who is dying a single room. Silly me for thinking compassion could be a higher priotity than numbers.

By the way, there is something called relocation trauma. It means that elderly people especially are at risk when they are moved. At risk for death. Adequate preparation can help mitigate the risk.

New Beds, Old Beds, and the Election

When the liberals came in, they promised 5000 new long term care beds. Then it somehow seemed to change so that they could close some beds, and open others. Anyway, they never came near to what they promised. They also never came near to the assisted living beds that were supposed to be around.

There are not enough residential care beds. The hospitals are getting blocked up at times. People have to be pretty frail to even qualify for residential care. At the same time, home care--that is services available to help people stay at home- has been cut over the years.

What does that mean?

It means that increasingly, the burden of care is on families. So if you are working, or live out of town, and you have an elderly parent you bettter have some money or a lot of time, because there isn't a whole lot of help available.

By the way, incase you are confused, here is a bit of an explanation about the terminology.

Assited living facilities are pme wjere there is no, or minimal nursing care. People are provided with some help for their personal needs, such as washing, bathing, medication reminders, etc. There are usually recreation programmes, alert systems in rooms, and weekly housekeeping. Beyond that, people are supposed to be independent

Nursing Homes/Complex Care facilities/Extended care facilities, means that they have all of the services of assisted living, plus twenty four hour nursing.

There is another term we don't hear much of in British Columbia, usually called Congregate care. That is where there is no personal care provided. That is what a lot of the private seniors housing is, the new luxury places, and the older seniors apartments. If you want personal care you either have to pay for it, or if you are too needy, you will have to move.

The second category is where all of the bed closures have been, and these have been closed by the hundreds (Remember St. Vincent's Hospital? Gone the way of the dodo bird) They have not been replaced by any thing nearthe numbers promised or needed.