I reflect frequently on my conversation earlier this year, with a Care Partner at Christie Gardens, our well-known “campus of care”. 

Sarah was on her lunch break and often sat for a few moments in the quiet of the 10th floor library. I was there that day and welcomed her to join me. I knew I would enjoy our conversation.

Sarah’s daily work assignment was to visit and provide needed care for Independent Living residents in their suites. This support program is called Assisted Living. 

Assisted Living can be the key to the resident remaining “at home” safely and with dignity, in spite of health challenges and personal losses. In some cases the resident might be suffering the onset of dementia and participating in the Assisted Living program, while waiting for a move to The Courtyard, our full care home on the first floor.

Sarah was a highly respected employee. She had been working full time as a Care Partner for over ten years. Throughout her work shift she might spend time with a dozen residents. Her duties were primarily to assist them with activities of daily living as needed. The majority of her residents knew her well and were very happy for her kind attention.

At times, however, she might encounter resistance and on occasion aggressive personal insult from a resident. There was no doubt she knew fatigue and sometimes pain as she fulfilled her duties.

I inquired about her day and her relationship to the residents she was currently supporting. I had heard of one particularly challenging lady, a Mrs. Jones, who may have caused Sarah grief. I had heard of Mrs. Jones’ unpleasant responses and of her frequent insults aimed at those who attempted to provide her with much needed support.  

I raised this subject with Sarah. She spoke of really enjoying both assisting and becoming a friend to the residents. When I inquired specifically about Mrs. Jones she was uncertain how to respond. And so, I attempted to encourage her by sharing my vision for respectful care of our Elders, using Mrs. Jones’ history and current behaviour as an example.

Mrs. Jones was a former professor. She was a high-achiever, and life-long social activist but recently had driven away those who attempted to be close to her or help her in any way. Mrs. Jones’ responses, including personal insults to the team, were no doubt driven by her dementia, frustration, and fear. 

I shared my vision that we might all consider the following philosophy of care. Our perspective should be clear. Not that Mrs. Jones was “lucky to have us care for her but rather that we were privileged to assist her especially at this time of her greatest need.”

I acknowledged that getting that message beyond our doors was proving difficult for me. Sometimes it felt simplistic in the face of complex situations. I acknowledged that I often felt I should just give up trying to share it with others in our field of service, and retire.  

However, I remained convinced that the quality of Mrs. Jones’ life would be directly impacted by Sarah’s attitude and responses toward her, no matter how Mrs. Jones behaved. And that in turn Sarah would also benefit, as would we all.

We then digressed into more personal matters like how long it took her to travel to work by public transportation. That her daughter was a nurse and really needed the family car to get to her work and that what her daughter did was more important. And so she travelled daily to the heart of the city from north Mississauga.

Our brief but meaningful conversation ended. Sarah stood to leave, took a deep breath, and turned to me with her recap of our discussion.

“I am on my way to see Mrs. Jones now. When I get to her door, before I knock I will pause and say to myself I am privileged to assist you”. Then with a radiant smile she went on her way.

She could, and I have no doubt would, brighten Mrs. Jones’ corner of fear and loss.

And so, I was once again encouraged to continue to share my message. Large group or small, or conversations with individuals, the message is clear. The ripple effect is difficult to measure but I remain convinced that we can “change the culture of Eldercare”.

And so, front line workers, and all who support you in the daily challenge of caring for our Elders, please remember it is our privilege to assist them and be their friend.

Brighten the corner where you are.  

I leave you with this hymn written by Ina Mae Duley Ogden and Charles H. Gabriel in 1913, and performed here by Ella Fitzgerald in 1967.

Who could have ever imagined the sight? Chairs outside each doorway on Floors 2 to 10 of the 10-storey building, where three hundred forty of the city’s finest Elders live. The remaining eighty residents of this remarkable community live in The Courtyard, our full care home on the ground floor, a critical service in our Continuing Care Community. A “Campus of Care” as it is now described. (See my previous post)

From the beginning of the COVID-19 pandemic, Christie Gardens residents have exhibited exemplary responses to the ever changing rules and restrictions.

Those in Independent Living faced limitations on their movement they could never have envisioned. Those serving them could not have anticipated the day to day disruptions and ever-changing guidelines.

Residents in the Courtyard who had isolated to their rooms during the first wave of the virus faced the most challenging losses.

Once again the staff teams showed their true colours. 

There were no staff shortages; Care Partners worked double shifts to ease the workload for their colleagues; Nineteen staff members from all departments chose several weeks of accommodation nearby in order to keep their residents and families safe.

Team leaders met twice and sometimes three times daily to stay fully apprised of and respond to the changing situation. The sense of concerned gentle care permeated the whole community.

For some members of the Directors Team, twelve long days over the holidays with no time off to be certain residents were served well and community life was rich.

Endless decisions and regular communication to residents and families. Unrelenting determination to keep residents safe and see the crisis through.

Amazing responses from Independent Living residents …

Several left to be with families but were soon asking to come back to Christie Gardens. They would handle the restrictions, they just wanted to be home.They face each challenge as it occurred and trusted Christie Gardens staff to care for them.

And the reaction of The 340 residents on Floors 2 to 10 faced with the directives from Public Health and guidelines from our team.

Dining rooms closed?

No problem.We will order from the menus provided and enjoy the “bagged” take out meals delivered from the Dining Services department.

No fitness classes?  

No problem  We will sit on the chairs provided outside each suite door and encourage each other in the exercises led by the personal trainer going from floor to floor and calling out to them with the help of a portable sound system.

Toronto Public Health says we can’t go for a walk?

Now that’s a problem. I am going for a walk. I will be screened each time I return.

Need groceries?

Not a problem. I will pick them up on my walk and will shop for others is they need my help. You can see why I must go for that walk.

Staff Care Fund established?  

Do whatever you can for them. Here is my donation toward the cost of accommodation so they can be safe. Over $90,000 raised to cover the extraordinary expenses,

No group gatherings?

I will learn to “Zoom” and take part in whatever Is offered. And learn they did, with frequent interventions from the IT specialist to see them through it. The chairs are not needed in the halls any longer.

Would you like meals delivered to your suite?

Great, when you come to my door I will pass you my plates so it will feel like normal. I will wash them after and save you the work.

The store is open every day and you offer delivery?

Great, I can get most of what I need right here. You won’t have to worry about me going out.

You want me to be tested for the virus? Again?

Of course I will sign the consent form. We need to be safe.

And now the long wait is over! The big day is here!  

Of course I will get the vaccination. I can hardly wait! What do you want me to sign? Where do you want me to go, and when?

The Mt. Sinai Health Team arrived with five hundred doses of the Moderna vaccine. All residents and staff who had not yet been vaccinated had been invited to participate. Consent forms had been signed by all and many questions answered.

Many hours of planning had been undertaken. Plans for staff support for the residents’ floor by floor groups. Safe distancing on the elevators at carefully prescribed times so the residents could travel safely to the Maple Dining Room for their turn. The excitement was palpable.  Support staff teams equipped with full PPE had been instructed regarding their roles in assisting the Mt. Sinai team. 

However, in the midst of the best made plans, late in the day before the big event, a fresh perspective was introduced.  From the leader of the Mt. Sinai team assigned to Christie Gardens came the vital comment and question: “It can be challenging for all the residents to have to come to a central location. Based on our experience at other homes, how would you feel if we go to each of their suites instead?”

How would we feel? Delighted. To their doors? No elevator congestion. No concerns about stresses for some of the very frail elderly persons living in our community. Wonderful suggestion.

And so, with the same capacity for quick decision making, the community was immediately informed of this highly desirable option. Overnight, chairs were placed beside each door, with careful spacing in the halls for medical carts and social distancing. The house simply “buzzed” with good will and excitement. Felt like a Canada Day celebration.

And the Doctors would be making house calls.

What a day. Inspiring and motivational. Residents visiting with each other, from a safe distance, staff cheering them on. 

All residents in The Courtyard were first on the list to be vaccinated. Care partners each assisted their residents.  

Essential Visitors, family members and friends chosen by residents as their approved guests, were almost giddy with relief to see what was happening. They had previously been offered the opportunity to receive vaccinations at a nearby hospital clinic.  Over 150 of them had responded with only a day’s notice and could now help if they were needed. Indeed some of them had come to assist in this important event.

The team from Mt. Sinai arrived on time and were extraordinary. 

It is apparent an excellent new partnership has emerged in the midst of this crisis. Cheerful, optimistic, and well prepared with their invaluable cargo ready.

Immediately following the visit to The Courtyard, they made their way with Christie Gardens staff in full PPE assisting them in introductions and record keeping.

A thank you email from a resident said it well: “I can only imagine the enormous effort and skill needed to see this project through. And to make the last minute switch to house calls which, of course was so much easier for us. Thank you. So glad to be a part of this community.”

Changing the Culture of Care

Over arching the whole experience from February of last year with the intrusion of COVID-19 into our lives, until today with whole house vaccinations, has been the active and unrelenting expressions of RESPECT from all serving, to all receiving that service.

We have worked diligently for many years to change the culture of Eldercare care, from: “you are lucky to be living here”; to: “we are privileged to serve you”. ThIs sometimes overwhelming pandemic has tested our resolve and ultimately strengthened all of us. We are so grateful to experience first hand strong evidence of the success of our Culture Change ideals.

We are indeed privileged to serve the finest group of our Elders we could have ever met. And who are they? Those who have gone before us, setting the standard for a just Canadian society and worthy of our Respect. Those who have faced the traumas and losses of life and still wanted to actively engage with others. Those who are gifted and continuing to make meaningful societal contributions. Those who will help their neighbours, express their appreciation and challenge us when changes are needed.

And the doctors and their team have joined us in that Respect. So grateful for their meaningful contribution.

THE DOCTORS MADE HOUSE CALLS. And the future is brighter!