Six years ago, we moved my mother into a nursing home. It was a good home. It was expensive. But she refused to go, and we had to have her declared incompetent. Six months after we moved her, she died there. It was a sad story. But, as I have been reading the news from Quebec -- particularly the news out of Dorval -- I give thanks that she will not have to live there in this crisis.
My wife used to work in nursing homes -- and the weaknesses in the system have always been glaring. Bruce Arthur writes:
The weaknesses in the system have been apparent for over a decade. The SARS report in 2003 mandated nurses should work in one facility only, but many long-term care workers — as many as 50 per cent — work in multiple facilities. B.C. banned the practice on March 27, over two weeks ahead of Ontario and Alberta. Facilities heavily rely on personal support workers, or PSWs, who are not medically trained, and start at $15 an hour. You can say they should be paid more, which is true.
The system, though, often stretches those PSWs, and doesn’t include enough medical supervision and care. In the face of COVID-19 — which stresses actual hospitals — and with either limited personal protective equipment or limited training in how to use it, is it any wonder that someone making $15 per hour would, faced with the nightmare of a sudden sea of feverish and deathly ill residents, simply walk away?
“Think about how quickly the patients will go downhill, and they absolutely know that they aren’t equipped to look after them, and (if) the hospitals won’t take them, then they have to look after them in place with no skills at all,” says Joy Parsons-Nicota, who has 45 years of experience as a registered nurse, a nurse practitioner, and as a nurse-educator at the University of Ottawa, specializing in geriatrics, and who also recently spent three years working part-time at a Kingston long-term care home. “You wouldn’t treat animals like that. No pain medication, no IVs when they’re dehydrated.
The coronavirus has exposed a lot of our weaknesses. One of the ugliest is the way we deal with our elderly. We can no longer rationalize the way we have organized their last years.
Image: Business Insider
8 comments:
Well put.
My mother spent her last four years in Northwood in Halifax (ending six years ago) now undergoing a nasty Covid-19 outbreak, actually mentioned on national news. Northwood are far, far better than the average seniors' home -- had a real RN on duty 24/7 on my Mum's floor in charge of the PSWs, and a doctor for the entire place, a gerontologist of no particular merit, but qualified. So, much better staffed than those Fly By Night outfits in Quebec and Ontario, and any other NS facility to my knowledge for that matter.
They had an obvious Achilles Heel, however. What got my goat was discovering that there was no requirement that all staff members got the annual flu shot. The "inmates" as my mother jocularly called herself and the others even as she suffered dementia following many small strokes, got their flu shots religiously. Public Health showed up and injected the lot. The staff could have had the shot, but many declined. I complained to the RN and then management when I found out, but was told it was a personal choice.
It should have been a condition of employment.
Other than that, the place is competent in my view. But that's a glaring loophole even for a better place. And the chicken's come home to roost, unfortunately. A bit too lax around the edges.
BM
The way we treat seniors reflects the way our current capitalist system works. Seniors are no longer working, so extracting wealth from them is difficult, particularly in these days of uncertain corporate pensions.
Since seniors are on fixed incomes, executive bonuses and shareholder dividends must be made on the backs of workers. Skilled RNs are replaced with unskilled PSWs, who are churned out after a couple of months by sketchy private colleges. The PSWs get minimum wage and part-time hours so they don't qualify for benefits. Part-time hours means they work in multiple locations to make ends meet. This in turn makes them a vector for spreading disease from one facility to another, which we've seen during this Covid-19 pandemic.
All of this is facilitated by neoliberal governments and lax regulation. We could have an old-style economy, where executives made a little less money, but workers had the dignity of being valued for their skills and paid decent wages with benefits and pension plans. Or we can continue the devaluation of people and skills in today's gig economy to make a few people obscenely rich. The choice is ours.
Cap
We were pleased with the staff at my mother's nursing home, BM. With the exception of my disabled brother -- who lives at a group home in Montreal -- we were all at a distance. The staff, however, kept us informed and my mother comfortable. Nonetheless, it's difficult to see someone's body outlive her mind. During this crisis, my mother would not have understood what was happening and she would have been terrified.
Precisely, Cap. We are at an inflection point. The choice is ours.
Owen, the impression I have had ever since Reagan, Thatcher and Mulroney is that the choice is definitely not ours. The rich and powerful have control and will do anything and everything to make sure we don't have a choice.
Point well taken, Toby. If there is a silver lining in this situation, it might be that ordinary folks will cashier the very people who have put them in this spot.
.. I have no standing.. yet I take grave issue with anyone who mistreats our most vulnerable Canadians.. So I guess I take 'standing'.. My older sister and I grew up without a mom or dad.. They both had two families each.. after we had come along.. late 40's & early 50's. I began to get clues when I was mid 20's. So mom died in Van.. of MS.. well loved by Hubby #3. Dad went in my mid 50's, suddenly. He left behind Wife #3 and kids. Hell, we got half bro's & sis's scattered across North America it seems.. Adoption was big and seems there's siblings that surface only because of DNA testing.. whew! But bottom line, I never had to make those tough tough decisions.. though the Boss did. Her dad went through a shockingly fast cascade of health issues. He was a very big muscular man and as life deteriorated and he began to fall.. he required two skilled people just to leave his wheelchair. The small town extended care he received was excellent, and his wife, Boss's mom was a saint.. every day spending 4-6 hours feeding & looking after him in the secure retirement home.. maybe a five minute drive from home. Local firefighters had always come to pick him up at first.. no 911.. they just gave her the private station number. But the cascade that had followed hip replacement included, dementia, deafness, late onset diabetes & related issues.. He had two pensions & had managed his affairs competently.. so was not a financial burden whatsoever.. he fit into the system well, but needed exceptional care.
Now I try to imagine what was already incredibly complicated.. but with layers of contagion wrapped into the situation.. and/or any other complication.. and it would likely have required immediate reaction. Job one - get him out of there. Then muster a drastic temporary solution at home plus immediate effort to relocate him in a professional setting.. even a hospital. But what I'm hearing has happened in Canada is shocking.. the scope is dreadful ! We should have seen this coming too ! I almost wonder if this requires involving the military.. as the muscle.. and rock solid healthcare pros the brains. Those Seniors homes need to be vacated and sterilized - room by room plus every space.. thus the residents need extraction to a safe, isolation facility of some sort.. I really have to get my head around the staggering logistics involved !! This is a rescue mission.. !
One of the problems, sal, is that many nursing homes have rooms with two or three residents. In a case like this, the virus spreads like wildfire.
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