Retired RN ‘horrified’ over senior care in B.C.
System in desperate need of major reform
The stories are horrific enough that a rational person might conclude that the only solution is to not grow old.
At Evergreen Care Centre at Lion’s Gate Hospital, seniors live four to a room with no privacy and often with roommates whose cognitive and physical abilities are often widely different from their own.
At that facility — the province’s largest complex care facility — the bathtubs have been taken out.
“Residents are essentially taken on a rubberized bath stretcher and hosed off in the ‘tub room,’” says Judi Georgetti, who retired last spring from Capilano University after a decade of teaching in the health care assistant program and four decades as a registered nurse.
The reason for the change, she was told, is that it took too much time to fill the tub, bathe the resident, then clean and disinfect the tub.
“I was so horrified that I told my director that I could never supervise students in such a place because it was antithetical to all that I had been taught and all that I believed.”
A spokesman from Vancouver Coastal Health confirmed that the bathtubs were removed a number of years ago and were replaced with walk-in showers, chairs and hand-held shower heads as a safety precaution so residents can’t slip and caregivers don’t injure their backs lifting them.
At another facility, a woman told me that her husband must wear diapers because care aides aren’t available to get them to the toilet in time.
He has Parkinson’s. To keep his limbs mobile, he does a lot of walking, stretching and muscle building. He sweats a lot. Yet he gets help showering only once a week unless he pays an extra $28 for a second one.
“When I pick him up on Saturdays to bring him home for dinner, he smells so bad sometimes I can hardly stand it. The first thing I do at home is help him shower.”
She asked that I not use their names and she refused to name the facility. She fears retaliation against her husband.
Another family initially offered to share photos of what they described as the filthy conditions at the facility where their matriarch is living. After several email exchanges, they decided not to. They, too, feared that the staff might make the woman’s already bleak life worse.
Their stories add flesh to numbers in a survey released recently by the B.C. Seniors Advocate that quantified the views of 9,605 residents and 9,604 family members connected to 292 of the province’s nursing homes.
Half the residents rated their overall care as poor to good, while 67 per cent of their families rated it as good or excellent.
But where too many are failing is in the provision of personal care. Nearly two-thirds of residents and 71 per cent of their relatives say the residents never or rarely bathe or shower as often as they want.
One in four never, rarely or only sometimes get to the toilet when needed.
Overwhelmingly, families told me that fear was precisely why they didn’t want their names used.
But the majority surveyed said they felt they could complain without fear of retaliation. Of course, almost half said they only sometimes, rarely or never complained.
Ivan Rubcic offered a reality check. His aunt, a wheelchairbound widow with no children, has been living in care for four years. The government pays 80 per cent of her costs.
What would enhance her life most is something the government or care aides can’t provide — more visits from her extended family.
While it’s easy to criticize the care homes, he says, “For poor people, the care homes work. There is a vast amount of improvements that could be implemented. But where is the money going to come from?”
Rubcic raised the pragmatic, problematic reality. Over the past few years, the average age of residents has risen to 88. The acuity levels of those suffering from dementia/Alzheimer’s is much higher than it used to be. There are more people with multiple health issues. And many people’s expectations about the kind of care that our loved ones get or what we deserve are much higher than before.
The Health Ministry has set 3.36 hours of direct care a day as a guideline for all nursing homes, regardless of whether they are owned and operated by government, a non-profit or a company — 70 per cent of residential care is delivered by the private sector under contract with the government through the health authorities. But data compiled by the B.C. Care Providers Association from the health authorities’ report indicates that 178 nongovernment care homes and 66 government ones failed to meet the guideline.
The direct-care hours range from a low of the 2.68 hours per person in Vancouver Coastal Health’s private facilities to a high of 4.02 hours in government-owned facilities in Northern Health.
To meet the 3.36-hours-aday standard, the association figures that would require hiring another 1,500 staff.
Where would caring, qualified workers come from since many care homes already have trouble finding staff ? Where would the money come from? And what happens in the coming years now that Canadians over 65 already outnumber those under 15?
Answering those questions might require some exceptional, out-of-the-box thinking — like in Japan. There, the demographics skew even older than in Canada and they are experimenting with robots.
Here, thoughtful people have been making recommendations and suggesting innovations for more than a decade. What we need is action because if the situation is critical now, it will only get worse as the tsunami of elderly arrive in full force.