The elder care system isn’t the problem
Misconduct at city-run nursing homes shows failure of character, work culture
So, inevitably perhaps, we are going to have an outside investigation into “systemic” failures at Ottawa’s four municipally-run nursing homes.
Why? Can someone tell me what kind of “system” prevents a personal care worker from asking a disabled woman, 85, with memory problems: “Why is it taking you so long to die?”
Human beings are capable of monstrous behaviour, even those, evidently, trained to be care workers for the vulnerable. What kind of “system” would weed out a worker with a lack of empathy? How does a “system” know when the compassion reserves are empty for the month, or for all time? How does a “system” know when a passionate, fresh-faced care provider has grown into an embittered, late-career, sack of anger?
These are not holes in a system, these are failures of the heart. How do you “train” someone not to think, let alone utter, hideous things? (Let us not be as gloomy as a recent Twitter chirper who said “humans are garbage” is the explanation for about half the world’s worst problems, like mass ethnic cleansing.)
Firing the worst offender — who seemed to taunt the family by sneering into the camera — was undoubtedly the right thing to do. You do wonder, however, what kind of tone set by superiors would permit this brazen act of disrespect to so casually take place. Nor was it as isolated as we first hoped: patients punched, found bleeding on the floor, taunted and mocked — where does it end at city-operated homes?
I dislike the word “culture” to describe a work environment, like PSWs were a lost tribe with their own customs. We already know this about “culture” in every workplace: the climate is set at the top and pours down, like raindrops. Some of these bosses better get out of their comfy chairs and into patient rooms to make sure the public’s expectations are being met, because there is an undercurrent this behaviour has, for years, been tolerated.
Does anyone believe this was the first time the worker said a terrible thing to a resident? Good Lord, imagine what the camera hasn’t captured. As for the failure of two others to report the misdeeds, is there a danger of creating a “snitch culture” that will just make the environment that much more toxic?
Here’s what worries me about an “outside investigation.” It will mean hiring a company, at considerable expense, involve weeks of interviews or hearings, it may mean battling with the unions, it may mean lawyer upon lawyer, and it will result in a bunch of recommendations, or more rules, to fix a system already loaded with regulations. (And God save us from a “funding shortage” excuse.)
In other words, we don’t need a bulldozer to fix this. The right broom would probably clean up the mess.
Lest we get too high on our horse, something to keep in mind: Elder abuse is a serious problem in Ontario but the bulk of it is perpetrated by loved ones, like spouses, children and grandchildren, with “service providers” well down the list.
A massive study published in 2015 found that about eight per cent of older people, some 700,000, suffer some form of abuse or mistreatment in this country every year. Of the physical abuse, almost two-thirds was perpetrated by spouses, ex-spouses, children or grandchildren, with paid caregivers responsible for about seven per cent.
And these are often people suffering in silence, without anyone to turn to. Where’s the “investigation” for them?
There may be calls for cameras in every room. This is a bad idea. The privacy of residents is fundamental, too important to have their every move viewed in some giant control centre. Even prison inmates aren’t monitored in this way.
Increasing the salaries of personal support workers — to attract better candidates — may well be part of the answer, but no magic wand, as first-hand experience informs.
At a certain age, you will deal repeatedly with the health care system as it manages aging parents. Some of the (well-paid) nurses and doctors seem born to do the work: attentive, compassionate and professional; others look as though they’re just punching the clock, the patient a widget on an assembly-line shift.
And all of them seem preoccupied with the record-keeping that consumes modern health care. (Observe a nursing station: it’s all typing, filing and updating, as call-bells go ding-ding.)
So, more rules, another system, more oversight? It cannot be — is the better way not already inside us all? To contact Kelly Egan, please call 613-726-5896 or email kegan@ postmedia.com Twitter.com/ kellyegancolumn