Care model must change
Want to move into a nursing home? Raise your hands
I live in a nursing home. It was not my choice to move into a nursing home but no other options were available. I have Parkinson’s disease and as it progresses, I require support in a number of different areas – personal care, meds management, meal prep, mobility, physio, etc. I fully admit I need support, but I am not a child, and I do not need someone to look after me like a child.
However, the nursing home model we have here on P.E.I. (and in most of Canada) seems to be based on a parent-child relationship. We residents have very few choices in how we live our lives in a nursing home. To start with, if you do not have sufficient income to pay for nursing care, then you have to share a (small) room with a complete stranger because government does not subsidize private rooms. It is the nursing home that decides when we get up, eat our meals, take our meds, go to bed, what activities we do, and how often.
Don’t get me wrong, the staff in my nursing home are great and try their best (although I could do with a few less dears and honeys) but they must work within the nursing home model just as residents must live in it.
It is a very outdated and paternalistic model. Rules, regulations and order take priority over a resident’s right to make their own choices, where they can. I often feel that long-term care residents are less valued and respected as adults who bring with them a lifetime of experience.
This model is broken. It has been broken for a long time, but the pandemic has highlighted just how broken it is. COVID19 has presented many serious challenges for people in care but it has also provided us with an opportunity to refocus the direction of care.
Stats Canada has revealed in the 2021 census that seniors, especially in the Atlantic region, are the largest growing demographic. So it is an ideal time to rethink how we want to treat our “older” citizens who will require more support as they age. And the good news is that the new, improved model will be more cost effective than our current one.
We can definitely learn from Denmark’s model (CBC The Current April 27, 2022). They are putting their resources into public homecare, not into institutions. Two-thirds of their resources go towards homecare, while one-third goes toward nursing homes (and even there they build smaller homes and not large institutions). In Canada, the opposite is true, two-thirds of our resources go to nursing homes while only one-third go into homecare. I do not know the ratio on P.E.I. but I suspect the ratio is even higher towards nursing homes vis-à-vis homecare support.
The recent decision by the P.E.I. government to provide free tuition for RCWS is a great start. But we need more than that. The care model needs a complete overhaul. The focus needs to be on dignity, respect; and the lived experience of the person requiring care. The level of homecare also needs to be expanded. At the moment, public home care support workers can only provide personal care to their clients often only once or twice a week. In Denmark, the needs and dignity of those requiring care are at the forefront. Personal support workers will come to a person’s home as often as six to eight times a day over 10 hours if that is what is required. And they provide all kinds of support services – personal care, meal prep, cleaning, meds management, physio, company, etc.
We need a model like that and we need it now. If Denmark can do it, so can we. We just need the political will to get it done.
So does anyone want to move into a nursing home? A Marketplace survey indicated that 100 per cent of those over 65 said an emphatic "no". We want to stay in our homes for as long as possible, and receive the support we need which is our right. It may be too late for me but for those coming after me, it is time to stand up and be counted!