Opinion/Editorial submitted by Fran Millar
Everyone watched in horror as COVID-19 ravaged senior citizen homes. Although a large number of deaths occurred in Ontario and Quebec, it exposed a problem that could occur right across this country. It took the military, a group of people that is not motivated by politics or greed, to expose the shortfalls within the senior resident home system. Not only did many homes not have adequate staff in place to begin with, there was no one available to replace those who became ill. Residents were left in deplorable conditions; sometimes not getting properly fed or cleaned up for days.
That said, what are we going to do about it? Over the years privatization has become a priority of recent governments. The truth is that senior care is very expensive. Governments seem motivated to turn this expense over to the private sector. With less government involvement there is less money being directed towards necessities such as inspectors, which means fewer people keeping tabs on the facilities and its services.
Profit motivates. The whole idea of taking on a venture is to make a profit. In order to make a profit, an increase in the number of clientele may be needed. Add to that less staff, fewer supplies, poorer quality of food, and the list goes on. The bottom line is to make money. In the end it is our seniors who pay the price.
I have personally experienced putting a family member in a seniors’ home. When I first learned where she was being placed, I will admit that I had a negative attitude. The building seemed old, the hallways cluttered, and the people crammed together. However, the experience was something that I did not expect. Any inquiries and concerns that I had were dealt with in a timely and appropriate manner. I cannot say enough about the wonderful, caring staff. While it is true that my family member sometimes had to wait a long time to have her needs met, I soon came to realize that this was not a lack of caring on behalf of staff. She was always met with an apology and a smile.
The problem was a shortage of staff. One person can only do so much in a day. Yes, it costs a lot of money for staff, but who is paying the bill? The seniors and the taxpayers. It is only right that a certain level of care should be experienced.
I am not writing about Senior Retirement Villages where people choose to live. Residents there are aware of the costs and the services that are delivered. I’m writing about residential care homes that house level three and level four clients. At this level, complete care is required. Often people are placed here after being assessed by a home care professional.
It is a fact that at both ends of our life cycle, we require more help. There is no problem fighting for younger children. Daycares meet quotas per the needs of the children that are in their care. To my knowledge, there are no such quotas for senior care. The demands for care are just as important — sometimes more. That leaves care homes to struggle to give quality care with very few staff. It was my experience that the staff that cared for my relative were loving and caring. They did the best they could to meet her needs. I could see, too, that on any given day an incident could occur that would delay services to my relative. This was not the fault of the staff, but rather the shortage of staff.
Here is a scenario that may play out in a residential home: Let’s say there are 40 clients that live on one wing. There are two clients to each room, and all the clients are level three or level four. Most days, this is staffed with one nurse and two nurses’ aides. A report, which is information that is exchanged between shifts, is given. The day begins, the nurse goes about her tasks; dispensing meds; doing treatments; doing rounds with doctors; dealing with relatives; charting; ordering any necessary medication; filling out incident reports if someone falls, chokes, or somehow goes missing; to name just a few of her tasks.
The nurses’ aides go about their jobs, assisting people to get up, getting clients to breakfast, feeding those who need to be fed, and assisting others who need a little help, then returning clients to their rooms if needed. Next, there are the five or six clients that are scheduled to be bathed, along with the many calls for help from the clients. When lunch time approaches the meal routine is repeated. Once everyone is settled in their rooms, the aides begin to answer the many calls for help from clients. Somewhere in the day’s routine, staff are supposed to get one coffee break and a lunch break.
With two people expected to do all of this, sometimes the best services are not being provided. How can they be? You end up with clients having to sit in soiled clothing for long periods of time, (even during a meal,) and other clients get fed cold meals. Luckily, in some homes family members and volunteers help with meals.
Now, for the sake of argument, let’s throw in the pandemic. We have one nurse and two aides doing everything without the help of relatives or volunteers. Clients are confined to their rooms with little or no contact with anyone but their roommate. Meals are delivered to their rooms to minimize contact. So, there they sit all day long, in a space sometimes smaller than your bathroom. The staff are expected to deal with the additional loneliness and fear, along with everything else they do. I can see that the endless, time-consuming paperwork that is required daily will go by the wayside. Really, this is not a problem; a lot of it is a way of proving to management that you are doing a good job. The time taken to fill out endless paperwork (which could be streamlined) only takes away from client care. Client satisfaction speaks much louder than the paperwork.
We have a tendency to think of the clients that are in these homes as “the elderly.” “The elderly.” That’s all. Stop right there! These are the teachers, rail workers, farmers, doctors, musicians, and homemakers, to name a few, that built this country. It is because of these pioneers that we have the quality of life that we enjoy today!
Governments and residential home operators are often blinded by the cost of care rather than focusing on the level of care that is being delivered. What we are seeing exposed, due mostly to the pandemic, has simply been caused by governmental indifference. It is not a problem if you don’t see it, right? Crying foul and vowing to do whatever is necessary is too little, too late. People who work in the industry have been complaining about the myriad of problems for years.
As for governments who have been silent because the situation in their respective provinces has not yet been exposed: Shame on you. This is a national problem and it will take teamwork to fix it.
So what is the solution? We need to put in place the following, immediately:
- Long-term care should be placed under the arm of Medicare.
- Most homes require training in care. It must be made mandatory for all care homes.
- Professional development courses need to be put in place.
- Make surprise inspections of all care homes mandatory.
- Establish quotas for staff to client ratios — How many people can one person care for safely? Keep in mind the rules to prevent injury to both clients and staff. Is the person a one-person lift, or a two-person lift, etc? Is mechanical aid available to help the staff?
Finally, if the profit generated is being siphoned by private care home owners into other provinces or countries, then we need to find a way to reinvest it back into senior home care improvements such as increased staffing levels. We demand single room accommodation and larger courtyards. We must rethink our treatment of our senior population. Their contribution to our comfortable way of life has been and is still invaluable. It’s simply time for those of us who benefit to pay it forward.
The views and opinions expressed in this article are those of the author, and do not necessarily reflect the position of this publication.
