As someone in her late twenties, long term care should be something at the very back of my mind, something I find myself unconcerned with. However, it is something that all young people should be concerned about, as our parents, grandparents, great grandparents if we are so lucky to have them, and even ourselves deserve better than what currently exists. And it is going to take time to fix this, because our system is so, so broken. I spent several years working as a health care aide in assisted living, long term care and home care environments and I can honestly tell you that there is no one, singular fix for the crisis in senior care. And it isn’t because the health care aides and nurses don’t work hard enough or care enough. It is not because the recreational staff and volunteers do not do enough. It is so much bigger and more complicated than this. I do not have all the answers, but I hope that by showing you a couple of glimpses inside the walls of care homes, I can help make it clear as to why advocacy and change is needed.
To this day, years after I switched jobs, I still have nightmares about the mornings we would show up for work (at 6 or 7 am) and be expected to get dozens and dozens of residents up and ready for the day within a few hours. Due to the minimal staffing levels, achieving this goal, the end result being that our residents made it to breakfast on time, meant treating our caregiving for the seniors as you would an assembly line. Of course, you are kind and try to allow the seniors to have an active role in their preparations for the day, but ultimately, you are expected to complete a job quickly, and failure to do so means failing the resident you’re with, your other residents and your coworkers. As part of this daily “assembly line”, we could not give our seniors much in the way of options to suit their preferences for when they wanted to get up. We would try to skip over someone who preferred a later start and come back once everyone else was up, but it really wasn’t much in the way of sleeping.
After breakfast, seniors would be parked in hallways and common areas, theoretically to participate in recreational activities or to converse, but often, they would fall asleep in their chairs. Theoretically, this would be a perfect time to spend time with the residents, asking how they would like to spend the day or having a cup of tea and a nice conversation. Unfortunately, as HCA’s, we were not able to spend quality time with the seniors because we had a list of other residents of whom each day was their designated “bath day”. Yes, one bath day a week (maybe two if the family paid extra). And because of staffing limits, bath day did not mean a relaxed soak for as long as the residents chose, it meant, yet again, tasks that needed to be completed as quickly as possible so as not to fail anyone else.
Those of us who were not bathing residents were changing linens, making up rooms and responding to call bells. Although we tried to respond quickly to call bells, the limited number of staff were really stretched thin during these parts of the day. Any staff with residents in the tub couldn’t leave them, for obvious safety reasons. Any staff already assisting residents couldn’t leave them. This left few if any staff to respond to bells in an immediate fashion. Many times, particularly in long term care, our residents required two person assists, whether physically or with machines in order to safely move a resident. Even if I was next door when someone hit her call bell to use the bathroom, I was not allowed, and safely could not, assist her until another staff member arrived to help.
So, what changes do I think are necessary for improving the lives of our seniors? Isn’t that the million-dollar question.
Increased staffing. I know, it isn’t so simple, the money has to come from somewhere. But this is non-negotiable for keeping staff and residents safe and for ensuring staff do not become burnt out by the overwhelming needs of their jobs.
Increased choice. Choice is so important, and the absence of it has been demonstrated to be detrimental to humans and even to animals. I can’t imagine how heartbreaking and demoralizing it must be to have an entire life of experiences and learning behind you, and in what are meant to be your golden years, to have any and all aspects of autonomy stripped away from you. Why can’t we ask residents what time they would like to get up in the morning? Why can’t we have breakfast options available throughout the day so even if they get up past breakfast time, they can still eat? Why can’t we ask them what they would like to do with their days and attempt to design recreational programs around this? Why can’t we ask them what their passions and interests are and see how we can continue to support and develop these?
Increased personalization and humanization. Every human is unique and has experienced and lived their own distinct life where they have grown and changed and developed into who they are today. Seniors are especially unique in that they have had so many more experiences, so much more time to develop into the person they have become. Our seniors deserve so much better than being forced to give up all aspects of individualism and assimilate to the industrialism of care homes.
Increased advocacy. SCAS exists to advocate for seniors who have no one to do it for them as well as to assist families who are not sure how to advocate for their loved ones. As an organization separate from the care homes, SCAS volunteers are able to focus on resident needs and wants outside of the basic aspects of care that staff provide. SCAS volunteers are able to ask residents what would improve their day and brighten their lives. Sometimes these are relatively simple matters and sometimes they are more complex, but they are all worth it to provide seniors with more joy in their days. SCAS volunteers are also able to guide families through the process of how best to advocate for their loved ones and their needs.
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