“There’s a desperate, desperate need for more
hours of care for people in nursing homes,” said Ann Dube, who has an 85-year-mother with
Alzheimer’s living in a Windsor home, where workers are so overloaded they
don’t have time — five minutes — to coax her to go to the bathroom. As a
result, she refuses, she wets herself, and Dube arrives to find her mother
soaked from her back to her heels.
It’s just one example
of frail, elderly people suffering indignities because there’s not enough staff
to provide the care they need, said Dube. “If you go for a tour, everything’s
hunky-dory — the rooms are clean, the place is beautiful. But when it
comes to actual care, it’s shocking.”
She blames
the rapidly increasing acuity of patients in long-term care, as elderly
people stay in their homes longer (thanks to home care) and only end up in
long-term care at an older age with much more complex needs.
Most residents are in
wheelchairs and most have some form of dementia, she said. “These people
require heavy care. They’re not people who can walk on their own, dress
themselves, shower themselves, toilet themselves.”
Since her mother went
into the home in March, she’s witnessed three nearby residents worsen to
the point they now must be fed by a personal support worker. “It’s
deteriorating rapidly and there’s no change to the care being provided to
them,” said Dube. “So it’s totally unacceptable.”
Evelyn Nevin, whose
husband Fred moved into the region’s newest long-term care home, the Villages
at St. Clair, in February, said the facility is “magnificent.” But she
believes understaffing contributes to missed baths, meals and recreational
activities, and increases the risk of medication and treatment errors.
“It is like
warehousing, there’s no other word for it, that’s what it is.”
She’s been bringing
the petition to the home and local seniors centres. “Everybody’s signing
it,” she said, suggesting that families are simply trying to get what
customers of child day cares already have: a legislated ratio of staff to
residents.
There’s no legislated requirement that nursing homes provide a certain
number of hours of care. Ten years ago, they provided about four hours, but
that number has probably dropped to 2.5 hours while the need for care has
risen, said Tom Carrothers, who chairs the advocacy committee of the Family
Council Network for long-term care homes in the region around Hamilton and is
one of the architects of the petition campaign. Email him at tom@tjc-chem.ca to get a copy
of the petition.
“It means that they
are in a wet diaper for a whole lot longer than they should be, that no one’s
there to help them walk so they’re put in a wheelchair instead,” said
Carrothers, who had a mother and mother-in-law in long-term care until their
deaths.
When residents don’t
get help walking they lose their mobility. When they aren’t helped to the
washroom and are left in a diaper they become incontinent, he said,
recounting a recent letter from a woman upset over the lack of care for
her husband. When she arrives to see him, he’s crying, unshaven, in a wet
diaper.
“This man was a very
proud person, a very good person, but his self respect has fallen apart because
he’s been treated this way,” Carrothers said.
He also noted that
some families are paying $25 an hour for extra help from outside agencies
that send personal support workers into long-term care homes. But many people
can’t afford that, he said, resulting in one resident receiving the care he
needs, while the resident beside him doesn’t.
The four-hour
requirement is the main focus of a private member’s bill re-introduced this
fall by Ontario NDP health critic France Gelinas. “I want it enshrined, I want
it written down,” so families can demand improved care from long-term care
homes, she said. She estimated residents currently receive about three hours a
day.
Talk to the families
of people residing in long-term care, she said. “Their No. 1 concern is there
isn’t enough time for staff to care for their loved ones.”
Ontario Long Term
Care Home Association CEO Candace Chartier agrees there’s been a problem
with staffing to cope with a dramatic rise in patient acuity. For example,
while 62 per cent of the province’s long-term care residents had dementia
two years ago, today that number is as high as 87 per cent. However,
Chartier contends that imposing a four-hour care requirement wouldn’t help
much.
“You’re not solving
the problem that you’re looking after a very different population and you need
more specialized investment,” Chartier said, suggesting a better solution is
devoting dollars to initiatives that individually address behaviour problems
(primarily by dementia patients) and find solutions.
The four-hour rule
would cost $1.2 billion, a 30 per cent increase to the current government
budget for long-term care, Chartier said. “That’s crazy. That money could be
put towards specialized staff to look after that 87 out of 100 (dementia
patients) who need that specialized approach.”
Since 2003, the
government has almost doubled funding for long-term care, to $4 billion
annually, according to a statement from Health Minister Eric Hoskins.
Staffing has increased by 4,600 since 2008, and those new personal support
workers and nurses have helped improve patient care, it said.
“All licensed
long-term care homes are responsible for providing appropriate levels of
staffing at all times based on the unique needs of each resident,” Hoskins
said. “I fully expect long-term care homes to provide residents with
the quality of care that Ontarians expect their loved ones to receive.”
But Shelley Smith, a
personal support worker at a Windsor area home for 31 years, said long-term
care residents are not being treated with dignity, “at all.” Though the
mostly female workers are nurturing and do their very best, they’re
burdened by a heavier workload, often working short staffed, she said. They
work through breaks and past the end of their shifts.
“The residents get
care, but it isn’t the care they deserve,” she said, citing as an example a
woman with dementia who has forgotten where “her babies” are. If you don’t help
her by looking for her babies, it only adds to the woman’s
frustration. But you don’t have the time, Smith said.
“Everything seems
like a production line.”
Elderly residents
require time, she said. You can’t rush them. If you do, it causes bad
behaviours.
“I feel they need to
be taken care of properly, 100 per cent, and I think the owners (of long-term
care homes) need to be looked at, the profits they’re making off these
residents,” she said.
“They’re allowed to
maintain all this profit, profit, profit, and I don’t see it coming back to the
home.”
Retired CAW national
president Ken Lewenza regularly visits long term care homes to visit retirees
and sees first-hand how PSWs and nurses “do not stop, do not stop.”
He sees patients
sitting in a chair alone for five or six hours and it all has to do with lack
of staffing, he said.
“I think the problem
is nobody every thinks about long-term care until they have a family member in
there, and it’s a real problem.
SOURCE: Windsor Star,
Brian Cross
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