“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.
“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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