Tuesday, July 29, 2008
CBC Story: "Nursing Homes"
What is interesting about this story is that reporters are covering issues that are far more complex than that which can be covered in a webpage. This article, based on my research, provides much good information but until you talk to someone who has been through this, you might not understand all that is required of caregivers and family members, like myself, who become alternate decision makers. Comments on the web sites can be trite or inaccurate, journalists may be uniformed - but that is another story.
There are some misconceptions out there in the public. For one, we don't call them nursing homes any more. There are very few 'nurses' actually in them! They are called Long-Term Care homes and are regulated in Ontario by the government.
Most of the care is provided by Personal Support Workers (PSW) who have taken the course in a college. Of course, this certificate is not mandatory, and not all institutions have this requirement. They are staffed with physiotherapists, and dieticians. But the PSWs are in an unregulated profession. Some LTC homes do not require certificates. Many PSWs are phenomenal people, but all should be trained. I never met a PSW who was incompetent, but as a family member who visited regularly, they came to know and respect me. I, in turn, demontrated respect for them. It is a difficult job with remuneration befitting those with only some college courses, and one which ought to have much more training and support to ensure higher standards across the province.
There is a lack of PSW staff in most areas, as with all people involved in health care in Ontario. The best staff can move to profit or non-profit LTC and they draw nurses and physicians. Geriatricians are the lowest paid doctors, yet they deliver services to the most complex cases: our frail seniors.
The big issue regarding violence in LTC, arises from lack of staff. There are frustrations in caring for too many seniors with too few staff members. In addition, those seniors who used to be cared for in mental health institutions, are now on the street, or in hospital waiting to be discharged to a LTC home. Those with dementia are angry and violent and require secure facilities. Those with mental health issues, e.g., schizophrenia, or biploar disorder, or depression, do not fit in with frail seniors who posess all their faculties.