Spotlight on a Human Tragedy: Long-term Care in Ontario

The current horrific circumstances resulting in thousands of deaths in our long-term care homes has been a virtual ticking time bomb that was waiting to explode. And now we have seen it explode into the public consciousness day after day. Into the aching hearts and minds of family members and friends of residents in long-term care. Into the consciousness of staff who have become numb to the poor quality of life of many they serve. And into the overwhelming sense of frustration and personal failure of those in leadership.

As of this writing there have been 2,781 deaths in Ontario long-term care homes and there are 207 homes in outbreak due to COVID-19.

Source: https://covid-19.ontario.ca/data/long-term-care-homes

A resident in a seniors community challenged me today. She felt my silence as a leader in my chosen field reflected a complicity with those who are responsible for the tragedy. She felt I had to do something.

My silence was not complicity, but rather my own feelings of helplessness and heartache.

Experience has taught us that media exposures accompanied by political posturing and threats of increased rules, inspections, and punishment, create an opportunity for grandiose commitments to effect permanent change but in fact serve only to delay and wait for the drama to settle and the situation to return to normal.

However, I was startled into painful distress and the need to do take whatever action I could  when faced with the following story.

A member of my extended family, admitted from hospital into long term care in Toronto on Christmas Day with a diagnosis of dementia and resulting difficult behavioural issues, was speedily administered an antipsychotic as a solution, rather than reaching out to family for assistance.

“Too busy!”; “Not enough staff!”; “The hospital did not tell us!“; “(We likely would not have admitted her if they had)”; “She was bothering other residents”; “We don’t have time for this”.

And so they rendered her helpless with something that is effectively a chemical restraint. No consideration appeared to be given to the horrendous trauma the gracious former school teacher, choir director community leader, and loving wife, mother, and grandmother was experiencing.

In the midst of a pandemic she had become just another terrible nuisance.

The next day, her fully engaged loving daughter realized something was seriously amiss in her mother’s condition. She had not been advised of the decision to administer these drugs, and challenged the nurse leader. Only her intervention changed the approach of those responsible. The chemical restraints were withdrawn but no assurance given that she will receive the care she needs. The future is bleak.

I do not agree that the primary issue is for-profit ownership of long term care homes.

I am convinced however that there is an underlying societal issue which permits this travesty of justice. Our cultural view of our Elders, especially those suffering dementia is that “they are lucky we care for them“ not “we are privileged to serve them”. It speaks of a lack of respect for folk at their time of greatest need. 

It is almost as though some have decided that their long lifespan renders considerations of their quality of life as moot.

As a society we have become more conversant with and accepting of mental illness — this is very significant progress — however the same cannot be said of dementia affecting our elders. Dementia is understood as an inevitable part of aging. It is not.

And so in that unfortunate dynamic, horrific behaviours are permitted to occur.

How dare the management company exacerbate the pain felt by anxious relatives by not answering the phone?

How dare they not allow relatives to visit their loved ones?

How dare they pay dividends to shareholders when staff and supplies are woefully inadequate?

How dare they expect four bed wards to be acceptable accommodation?

How dare they hide behind the mantras of “every dollar we receive is spent as directed” when in fact the profits (surpluses in the not-for-profit sector) are still being realized and the return on investment insisted upon, regardless of the needs of the people they serve?

They dare because the general public accepts the service, albeit reluctantly, rather than insisting there is a better way. They dare because the political leaders posture impotently without the unrelenting commitment needed to make change happen.

Commissions, studies, public posturing, and more money! With no end in sight.

And so the drama continues to unfold. The senior who challenged me suggested a letter writing campaign, “The ‘prisoners’ in long term care need to know there is someone out there advocating on their behalf”. 

The daughter committed herself anew to hold the organization accountable for the care of her mother.

And I will do my part by advocating whenever and wherever I can, to effect permanent change.

We are privileged to care for those who have gone before us. The potential losses we may face in our own functioning capacity do not change our history. And even if our history is not notable, those who have accepted responsibly for our care need to be taught respect, by word and deed. 

We have an obligation to change the culture of care, not just turn away and hope it will all be ok. There is indeed a “better way”. And if it is my turn for care, may that better way be underway.

12 thoughts on “Spotlight on a Human Tragedy: Long-term Care in Ontario

  1. Ann Peachman Stewart January 3, 2021 / 5:36 pm

    This is me standing and cheering! This is such an important post and should be shared everywhere!

    Like

  2. Dorothy Janes January 4, 2021 / 6:00 pm

    Thank you Grace for this very timely post!
    My sister is facing a very similar situation as your relative, with her husband who spent nearly three weeks in hospital only to come home worse than when he entered . And now it is so very challenging and costly to find regular home care but she was unable to be at peace leaving him there. They immediately changed his meds, diagnosed him without tests, placed him in a dementia ward where he became a different person. One of the first questions a doctor asked her was about their personal care wishes. We feel that he has many better days ahead given the right attention.

    Like

    • Grace Sweatman January 4, 2021 / 6:07 pm

      So sorry. He is a gracious beautiful man. Will be a serious strain on the whole family. My heart goes out to you.

      Like

  3. Dawn Irwin January 5, 2021 / 11:24 am

    Such a great post! It is indeed a very sad time for those living in LTC and some retirement homes. I am grateful for my experience working in LTC as it provided me an opportunity to see what really happens and confirmed that there are many many gaps that need to be fixed.
    There is definitely a “better way”, however it really does start with the leaders and for the most part those individuals are not in the homes they oversee, on a day to day basis.
    I am going to share this as one voice is often all that needs to be heard.
    Thank you

    Like

  4. Grace January 5, 2021 / 12:18 pm

    Thank you Dawn. May we lead the way in
    the change which is no doubt emerging

    Like

  5. Madeleine Van Wouw January 6, 2021 / 1:14 pm

    A long overdue post Mrs. Sweatman. – thank you kindly for stating the truth.

    The lack of insufficient and well trained staffers in long term care has always been a major concern for me. While I personally tried very hard to keep my mom from long term care, I had no choice in the last six months of her life, so made the difficult decision then to quit my job so I could visit her daily to ensure proper care and support. It was the only way I could justify sending my wonderful mom to the nursing home. Clearly, I should not have felt so guilty in doing this!

    It’s time we all lend our voice to the unacceptable elder care practices in nursing homes. Thank you again Mrs. Sweatman for a very articulate and truthful post.

    Like

    • Grace Sweatman January 6, 2021 / 1:29 pm

      Thank you Madeleine. A challenging time for sure but I remain hopeful there will be better days ahead.

      Like

  6. Bonnie Oliver January 7, 2021 / 9:07 am

    Spot on!! Unfortunately this is the sad reality for many seniors and their families. Thank you for this post.

    Like

  7. Chaplain John Duyck January 7, 2021 / 1:21 pm

    The ultimate preciousness of every individual human, no matter one’s size, age, ability or disability, weakness or strength – this fundamental belief is eroding at the edges these days. The tragic actions (or inactions) observed in some elders’ facilities during this pandemic are rooted in something deeper. Actions emerge from values – and values, from beliefs. Do we hold a utilitarian belief – that what gives a person value is his/her usefulness to us? Or do we believe that every human in his/her essence bears the image of God? Philosophical and religious beliefs result finally in actions. Thank you, Mrs. Sweatman, for championing beliefs, values, and actions that in the end enhance the dignity of us all!

    Like

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