Ottawa Citizen

Called to serve

Personal support workers make it their mission to treat dementia patients with love and respect — right till the end


Charles Best has a generous spirit and a moral outlook on life, qualities that define who he is and how he does his job as a personal support worker at long- term care facilities in Pembroke and Deep River.

Many of the elderly residents he cares for have Alzheimer’s disease or other dementias. To him, the job is a calling.

“ They need love,” he says. “ They need to be made aware that they still have value.”

Personal support workers such as Mr. Best form the backbone of Ontario’s long- term care system. They do much of the heavy lifting, literally, when it comes to caring for dementia patients at home and in institutio­ns.

Although not highly paid — the average wage for a PSWin Ontario is $ 15 an hour — the job can be physically and psychologi­cally taxing. Advanced dementia patients are often unable to communicat­e and they sometimes lash out if they’re not understood.

It’s a PSW’s job to interpret their patients’ needs and moods while assisting them with the everyday tasks of dressing, bathing, toileting and eating.

In his experience, Mr. Best says, Alzheimer’s patients and others with dementia respond to gentle care.

“ You walk into a room, and when somebody is locked in their mind or in their body and they can’t speak — there’s something in the eyes you can’t miss. There’s communicat­ion there, I find. A warm touch of a hand or just rolling someone over gently when you’re caring for them, as opposed to just dropping them or pushing them. It speaks volumes.

Each year about 80 PSW students graduate from Algonquin College, the only institutio­n that provides the course in the Ottawa area. The updated course, which replaced the college’s former home- support program, has been offered since 1997.

There are about 100,000 PSWs in Ontario. Although they are not regulated as a health care profession in any province or territory, the Health Profession­s Regulatory Advisory Council is considerin­g whether PSWs should be regulated and is expected to make recommenda­tions to Health Minister George Smitherman this fall.

Sheila Clarke, a registered nurse and senior professor in Algonquin’s PSWprogram, always gets puzzled looks when she tells her students that there is no cash payment for the most rewarding part of being a personal support worker.

But, like Mr. Best, most discover what she means once they’re on the job. Recently, one of her students had one of those revelatory moments.

“ She came up to me and said, ‘ I just got paid like you said,’” says Ms. Clarke. After nearly six months of not speaking, a resident for whom the student was caring had finally said: “ Thank you.”

Laura Faught, 32, has been working as a PSW at the Miramichi Lodge in Pembroke since mid- June, having graduated from the Algonquin course in April.

In her previous job as a bank teller, Ms. Faught found that she enjoyed helping seniors, many of whom came in looking for assistance with their accounts. “ I realized that when I helped them with something simple or something big, they would be happy because it was a worry off their mind,” she said. “ I realized I wanted to do something to be more involved with their lives.”

So far, the job has exceeded Ms. Faught’s expectatio­ns. She finds particular satisfacti­on in caring for residents with dementia. ated with PSWjobs: “ I believe it is coming.”

The PSW program has steadily evolved since Ms. Clarke began teaching it at Algonquin in 1987. In August 2005, the course became a full two- semester program running 32 weeks.

The program attracts a range of students “ from right out of high school to women in their 50s,” says Ms. Clarke. Some are former nurses who stopped to raise their children and don’t want to go back to that same level of care, she says. Others take the course simply because they enjoy working with seniors.

PSW students are taught how to provide basic personal care — bathing, dressing, hair and nail care. Essentiall­y, “ anything a person requires to function in their daily life,” says Ms. Clarke.

“ It requires a huge amount of patience. But very often the client may be able, with direction, to accomplish some of the tasks. And it’s so important to teach the students to let them do, for as long as possible, what they can.”

Lab practice and clinical experience in community long- term care facilities are crucial elements of the course. Role- playing and demonstrat­ions teach students patience.

In one role- playing exercise, students feed each other and take turns playing a client with dementia. “ People with Alzheimer’s cannot tolerate clutter. We teach the students that if you’re going to give them a meal, you give them a glass of juice. When they finish the juice, you take it away. Then you put down the plate and a spoon. Because if you put everything in front of them, they don’t know where to start. They’re likely to push it all away and just walk away.”

One primary lesson for the students is that clients must be treated with dignity and respect.

“ If the client is upset with you and throws a plate, you take it away, and come back in five minutes. And their whole attitude may be different. There may have been something — the approach the person took was too fast, or came from behind and startled them.”

Some who take the course find they’re not cut out for it, says Ms. Clarke. “ The ones who do stick it out almost have a calling for it. We see how they adapt and fit right in.”

Frequently, caregivers also find themselves providing support for the families of clients with Alzheimer’s, says Ms. Clarke. “ The family is as big a victim of Alzheimer’s as the person who actually has it. I think one of the hardest things for the family is when the spouse comes in and the person doesn’t know them anymore; it’s almost as if they have left already.”

After 15 months on the job, Mr. Best has learned that empathy and humour are essential. “ Being empathetic, putting yourself in their position, is the most important thing, I think. And everything flows from there. When you really put yourself in their position, all these other barriers are knocked down.”

Being so intimately involved in a person’s care means that the PSWs and their patients form close bonds and build deep relationsh­ips — for life. Most of the people living in long- term care homes end up dying there, Mr. Best says, and it is up to personal support workers to honour them right to the end.

“ I may be the last person they ever see. After I go home, they may pass on in the night. It’s important that the last person they touch in this world has given them love, given them care, showed them dignity and respect.”

 ??  ?? Nurse Sheila Clarke ( foreground), a teacher in Algonquin College’s PSW program, tells her students that the most rewarding part of the job is not financial, but personal and emotional. Recent graduates Charles Best, 49, and Laura Faught, 32, pictured...
Nurse Sheila Clarke ( foreground), a teacher in Algonquin College’s PSW program, tells her students that the most rewarding part of the job is not financial, but personal and emotional. Recent graduates Charles Best, 49, and Laura Faught, 32, pictured...

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