Nursing home puts ‘care’ in health care
Administrator Jessica Altenor comforts Inga Cherry at Malton Village.
The headline on the front page of Thursday’s Star read “The power of love.” The story, by investigative journalist Moira Welsh, is that rare thing — good news, carefully reported and revealed in depth.
If you haven’t read it — the series continues through the weekend in print, and the whole story is available online — I’d encourage you to go do it. I can wait here while you do.
If you’ve just come back from reading it, I can give you another minute to wipe the tears from your eyes. In short, it’s about how a nursing home in Peel Region transformed the end-oflife care they provide to patients with dementia by treating them like human beings, worthy of affection and kindness and of some agency, and their surroundings being treated — and decorated — like a home. The result, after a year of experimental transformation based on the advice of a consultant who’s supervised similar “Butterfly” homes around the world, was happier patients, relieved families and more satisfied staff.
It feels a bit like a miracle. The frustration that runs under the story is how exceptional it is to expect a decent life in such an institution. Every per- son who has considered eldercare options, anyone with any experience of the system or who has read about it, knows that expecting anything like “caring” in these places has seemed unrealistic.
We fear, and too often see, that nursing facilities resemble warehouses more than homes, with patients too often treated more as a series of tasks to be completed than as human beings.
It isn’t necessarily the fault of those who work in them, or even those who run them. It is in some respects how our entire health-care system has been set up — to maximize the efficiency of doctors’ time above all else, and then to ensure safety and standardization alongside it.
In doing so, we place a lot of difficult demands on nurses and other staff to juggle tasks and conform to procedures. We have translated the need for routines and accountability into a subordination of everything to the checklist. We have translated the need for sterility into an absence of comfort or warmth.
We have built institutions, and anyone who has visited an emergency room will be familiar with the sense of being institutionalized — turned into another damaged product on a repair assembly line, to be herded from one bin to another, discussed but only occasionally addressed. Even in a short visit, even while being happy to be cured of whatever ails you, you can leave feeling disregarded, ever-so-slightly dehumanized.
To face life like that — permanently, in circumstances where care is even more challenging and your mental and physical state make you all but helpless to effectively complain — is a nightmare all too vivid for most of us.
Which is not to suggest the experience has been universal — most of us have encountered great, caring professionals in hospitals and institutions. But it is to observe that, both for those working in them and for those of us relying on them, the bureaucracy and institutions have produced some depressingly meat-grinder-like effects, and nowhere quite so acutely as in nursing homes.
That is why it is so inspiring to read about how a quick transformation is possible, one that improves care and results, and creates an environment in which we wouldn’t fear to immerse ourselves or loved ones. Especially when you see, as the story’s subheadline put it, “how simple it was to change.”
Not that it was easy — changing your whole approach to things never is. But with relatively few extra dollars and relatively uncomplicated changes, lives are transformed.
As a relative of one resident said, “Why can’t all facilities be like this?”
If there’s a sad undercurrent to reading the joyous piece, it is rooted in that question, and in the suspicion that our institutions — both in health care and in broader government — are so slow-moving, so resistant to change, so pennypinching that they will not seize the opportunity to transform all our facilities in similar ways. Or will not do so fast enough.
There is no excuse not to now. We know, pretty much all of us, how much we have dreaded the traditional model of nursing care. We know, now, how much better a different model can be, and how simply it can be implemented. If the word “care” in our system of health care means anything, we need to get on with it.
Edward Keenan is a columnist based in Toronto covering urban affairs. Follow him on Twitter: @thekeenanwire