health care | From The Heart

COVID-19: What I’ve Learned from Outbreaks at Mom’s Personal Care Homes

It’s no secret that personal care homes have been severely affected by the COVID-19 pandemic. News stories from across the country highlighted significant flaws in the care and management of nursing homes in the early stages of the pandemic. This resulted in numerous outbreaks in several homes throughout the country with tragic outcomes.

Since the news first broke about the inadequate care in PCHs that led to the widespread outbreaks in many homes in 2020, there has been a very guarded and cautious approach at almost all long-term care centres to make sure these tragedies don’t happen again.

As the world opens and society goes back to pre-pandemic normalcy, long term care facilities keep many restrictions in place in an attempt to protect the residents.

For-Profit Care Home COVID-19 Restrictions

In the first, for profit care centre Mom was admitted to, the administrator proudly boasted their facility had the strictest COVID-19 protocols in the province. When mom first arrived at the centre, she was quarantined for 14 days, a standard practice with nursing homes. After the quarantine period, Mom was only allowed two designated visitors, my brother and I, to visit her. We had to take the home’s mandatory COVID-19 training session to see her. If we didn’t attend this session, we were not allowed in the building. Visitation was only allowed every second day Monday to Friday between the hours of 11:30 am to 1pm and 4:30 to 6:30 pm. We were screened upon entrance and forced to wear masks and face shields during our visit. If we didn’t follow the protocols, we were not allowed into the building. Her stay at this for-profit place was not during a public outbreak. In fact, public case counts were on the decline and society had already eased almost all of the public restrictions.

After the first month, she was allowed to see other friends and family. Visitors had to book an appointment and were restricted to visiting Mom in a room on the main floor. Staff monitored closely, often walking into the room during the 30-minute visit to ensure all visitors kept their face shields and masks on. Visitors who didn’t follow the rules were not allowed back into the building.

Despite the overly strict protocols in place at the profitable PCH, they had two separate COVID-19 outbreaks among patients and staff during the six weeks Mom stayed there. Sadly, one patient died during the second outbreak.

Government Run Centre’s COVID-19 Protocols

The government run facility my mom and sister are currently residing in now also has strict policies in place. Two people are allowed to visit at a time between 11 am to 7 pm weekdays and 9 am to 5 pm weekends. Visitors can only visit with their loved ones in their rooms or outside in the home’s enclosed garden. Visitors are screened upon entering the facility to make sure they are not symptomatic, exposed to COVID, travelled recently out of country or told to isolate. Masks are mandatory.

Three weeks ago, two residents on one of the three units started to display COVID symptoms. The PCH went into immediate lockdown while they tested the residents. Family, friends, and outsiders were not allowed to visit the facility and residents were isolated to their units and rooms only. It was soon confirmed that the two individuals had COVID and the facility has been under lockdown ever since.

Despite the strict lockdown policies put in place immediately, the virus spread. So far, eight people have contracted the virus from two different units.

Mom has COVID

Mom is one of the eight. She started displaying symptoms a week ago and was tested immediately. The second test confirmed she was COVID positive.

We worried about her having the virus because she is older and has comorbidities. COVID is one of those viruses that is unpredictable. We’ve had COVID in my house and know friends, family, and coworkers who have had COVID. While there are standard symptoms of the virus, everyone reacts differently so you don’t know from one person to the next how the virus is going to affect them in the short and long term.

Mom received excellent care and after a few days of severe symptoms, started feeling better. It’s been a week now since her first symptoms and while she’s still weak and has minimal appetite, the worst of the symptoms have passed.

Closure and Spread of the Virus

Despite the closure of the government run PCH to the public, the virus has spread to two separate units. It has gone from two possible cases to eight confirmed and two possible cases. The PCH has less than 80 people residing there so, while the case counts seem low, the population is also lower than most facilities.

COVID and My Sister

My sister, who resides in the same home on a different unit, has not contracted COVID-19 thankfully. It has not made its way to her ward to date. With her severe health issues, we worry about how the virus would affect her.

A Few Observations About COVID-19 Protocols

Despite the strict COVID-19 protocols that personal care homes have, both facilities have experienced outbreaks. While my mom and sister were not in a nursing home during the height of the pandemic, my sister was in and out of hospitals since March 2020. The difference in restrictions between hospitals and nursing homes is noticeable. While personal protective equipment and screening were still in place, visitation rules were not as strict.

While I agree that residents in personal care homes must be protected, I wonder how effective the strict restrictions are in actually keeping the virus out. In both facilities, it was not family and friends that spread the virus. The public was banned from visiting the nursing home three weeks ago as soon as the first two residents showed symptoms of COVID. Yet, despite the lockdown, the virus has spread to two out of three units. Eight residents out of 80 have contracted the virus and two were symptomatic as of three days ago.

It’s hard not to question the effectiveness of the policies since the virus is still getting into the facility and spreading despite strict restrictions and lockdown policies. If personal care homes want to protect their residents from this and other viruses, I would like the care centre to re-evaluate their policies and create guidelines that protect those residing in the homes without isolating and segregating them from their loved ones.

When Mom first contracted COVID, she commented how, even once she’s better, she won’t be going home. That was heartbreaking to hear. Like many residents, she mourns the life and home she has lost. For those of us who have never been forced from our homes, it’s hard to understand the grief that comes with moving into a healthcare facility. We take our life for granted without truly realizing how easily and quickly we can lose it.

After Mom’s test confirmed she had COVID, her roommate was moved to another room almost immediately to protect her from the virus. While understandable, I question why the nursing home staff reacted so quickly to protect a resident from the virus but did not take the same response to protect my mom from abuse.

As I wrote in my last blog, my mom was verbally and physically abused by a roommate in both care homes she stayed at. In both situations, staff heard and saw the abuse but did not do anything until my brother and I threatened to call the police. Despite zero tolerance policies in place at personal care homes, staff did not respond in either situation to protect Mom until we threatened police involvement. Yet they quickly and strategically protect residents from the COVID-19 virus. I find the difference in their response between a virus and abuse shocking and inexcusable. I’ve tried contacting the home’s social worker to further discuss this but so far have not spoken to her.

Closing Thoughts

I have observed firsthand how personal care homes respond to COVID-19 through my family’s own personal experiences and those experiences shared by friends and colleagues who have loved ones in care homes throughout the city and country. I appreciate and respect the attempts to protect adults residing in personal care homes from the COVID-19 virus, but, after seeing how easily and quickly the virus gets into care homes and spreads, despite the rigid policies, I question how effective those restrictions really are.

Not only has the virus spread despite the lockdown, but the restrictions also affect the mental, emotional, and physical health of the residents. Aside from being separated from their loved ones, residents are not allowed to leave their rooms so they can’t visit with each other. Because they can’t leave their room, they are not allowed a weekly bath or shower nor do not get their physiotherapy or reactional activities. They just sit alone in their room. Mom has a TV and phone, and my sister has her phone. That helps break the monotony of the day. However, many residents don’t have devices, so they just sit. I don’t need a degree to recognize how unhealthy that is.

I’ve also noticed the stark difference in the type of care residents receive in homes. I’m grateful for the immediate and aggressive medical care Mom received when she was first diagnosed. It made a significant difference in how she felt during the worst days and her recovery. I have seen this not only when my mom got COVID, but also in my sister’s ongoing care since she has moved into this personal care centre. Without question, the medical care is fantastic. But the same cannot be said for their rehabilitative care response to their own policies around abuse. As both places have stated, they do anything unless family get involved and say something. That’s not acceptable.

Mom never contracted COVID living in her own home. She had control over where and when she went out, so she could control her own level of risk and exposure. She has no control over the risk factors in the nursing home.

As someone who believes that not all senior’s should be automatically panelled into a personal care home when they lose their ability to live independently, I believe that this is yet another reason why we as a society need to develop strategies of care so senior’s can remain in their homes and communities for as long as possible.

Getting older should not be a life sentence into an institution. Other countries have implemented changes in housing and home care so seniors can stay in their home and community for as long as possible. There are proven benefits to keeping people in their homes and out of care centres.

My province is working on implementing change. I will continue to do my part to advocate for change in our current system for our aging population.

Thanksgiving: Finding New Ways to Celebrate When Your Loved Ones Reside in a Personal Care Home

Posted on October 10 by Admin

It’s Thanksgiving weekend in Canada. Traditionally, we would gather as a family for a turkey dinner today (Sunday) at Mom’s. But that hasn’t happened in three years. The COVID-19 pandemic restricted family gatherings during the last two Thanksgiving celebrations.

This weekend we don’t have to worry about COVID-19. Now that all the restrictions are gone, life as we know is back to a more normal routine. But while many families are happily getting together for their holiday dinners, our family won’t be. My sister is not well enough to leave the personal care home. Due to her failing health, she has spent every major holiday and once-in-a-lifetime event in the hospital since March 2020.

This is the first Thanksgiving weekend since Mom had her stroke and was admitted into a PCH. While I’m more than happy to plan a dinner at my place, Mom can’t get into my wheelchair inaccessible home. I suggested going to a restaurant for Thanksgiving dinner instead, but Mom declined. It’s not as easy for her to go from place to place the way she used to.

Living in a senior’s care home, she doesn’t have the independence and freedom to up and leave whenever she wants like she did in her own home. Staff have to be informed, extra personal, medical and transportation arrangements must be made and the place we are going to must be wheelchair accessible. All that work and preparation makes going out uncomfortable for Mom. She doesn’t like the hassle as she calls it, so she chose to stay in the care home this weekend.

While most of the world has resumed normal activities, senior’s homes haven’t. Pre COVID, families could book time in a designated family to enjoy holiday and special occasion gatherings with their loved ones. The number of people allowed at these events were based on room size. But today, most personal care homes still follow strict COVID-19 protocols that impact who can visit, how many visitors each resident can have at one time and where outside visitors can meet with their loved ones in the facility. Masks are still mandatory so eating and other activities that require masks to be removed are also not allowed.

So, this Thanksgiving, we’re not gathering for our traditional family dinner. It definitely doesn’t feel the same. It’s strange, it’s sad, and it doesn’t feel like a holiday weekend. We all feel the loss. Commercials, news stories, social media posts and store advertisements further emphasize the fact that our family will not be together this holiday season.

As difficult as it is for us, her children, spouses, and grandchildren, it’s equally if not more difficult for Mom. She never thought she would spend her senior years in a personal care home. She never wanted to lose her house. Spending the holidays in a senior’s home is difficult for her. She misses cooking, baking, and being in her apartment. Holidays highlight what has been lost.

My sister has missed more special events than she cares to remember. This Thanksgiving is another holiday she cannot celebrate with her family. She misses the gatherings, the meals and the life she once took for granted.

Rather than focus on the negative, we are choosing to find ways to celebrate the holiday separately but together. It’s not only important for us as a family, but it is essential for Mom and my sister’s mental health and well being. This holiday should feel special regardless of where they reside. After all, there is still a lot to be thankful for and most importantly, we are very grateful that our mom and sister are still with us. While we can’t gather as one large group, we can still spend time with our loved ones. Whether it is a smaller dinner in our own home and immediate family or a visit at the seniors care home, we are together during this Thanksgiving weekend. And for that, despite feeling the loss of what can no longer be, I, along with my family, are very thankful for what we still have.

9 Key Issues Discussed in a Focus Group on Seniors’ Community and Personal Care Home Care

Posted on October 1 by Admin

Last week I had the pleasure of participating in a focus group organized on behalf of the provincial government to discuss seniors’ care. The provincial government has created a new Seniors and Long-Term Care department to address the current care system of our aging population and develop new strategies to enable seniors to remain in their own home and community for as long as possible.

I received the invitation through my mom’s PCH and was delighted to attend. As an advocate for seniors’ care, I was looking forward to offering my feedback, but I was also interested in hearing what others had to say.

Our current system forces seniors who can no longer live an independently into institutionalized facilities where they are likely to share a room with another resident. While I appreciate the value and need for personal care home facilities, I believe panelling and placing people into a care home should be based on their health care needs, not age based.

There were 11 of us in total, including the two facilitators. Those who attended ranged from directors of senior’s organizations, managers of an assisted living centre, former healthcare professionals and family members of residents who resided in PCHs. We discussed many issues with the current long-term community and facility care system as well as ideas we believed would help in the future planning for seniors’ care in my province.

Currently, our province has an all or nothing approach to aging. If you can live independently, you can stay in your own home, but if you can’t, you are institutionalized into a personal care home. Seniors, with the help of their family members can choose one place to call their permanent place. However, due to long waiting lists, seniors are placed in what is referred to as an interim home while waiting for a room in their permanent place. The individual does not have a choice where they go. They are admitted into the first place that has a bed available. This approach doesn’t work for numerous reasons.

Concerns Addressed

As a group, we shared many similar concerns and what we saw as problems with the current system. They can be broken into 2 categories and include:

Personal Care Homes:
- For-profit homecare facilities that prioritize profit over quality care
- Improperly trained staff
- Lack of beds to meet the needs, room sharing
- Government standards that are not enforced in for profit care homes
Community:
- Inadequate homecare servicesLack of community based transportation servicesNegative societal approach to agingLack of resources in rural areas, for example, medical services, home care, housing
- Lack our resources and support systems to help seniors maintain their social, physical and personal needs

For-Profit Care Homes

Private, for-profit care homes were a serious concern for all of us. Because provincial and territorial governments regulate how much seniors are charged to live in personal care homes, for-profit places cannot set their own fees. This means, they have to find other ways to make a profit at the expense of the staff and residents.

According to one participant, profit earning care homes are also not regulated or monitored by the same standards as government run homes are so many problems that occur in profitable facilities, happen because the standards are lower.

Lack of Beds and Space

There are more seniors panelled for care homes than there are beds available. This means there are long wait periods to get into a facility and, when a senior is finally moved into to PCH, it’s usually not the place of choice and they are often forced to share a room. Those living in the community, whether urban or rural, face longer wait times because hospital patients have first priority. For those living in the community who do need 24-hour medical care, the extended wait times can create unsafe situations for the senior and increase stress for the families.

Trained and Qualified Staff

Another concern raised was improperly trained and paid staff. Again, profit-making companies were targeted for not hiring enough properly trained staff and paying their employees lower wages. During my years working for personal care homes and home care agencies, I also noticed salaries for profit care home staff were considerably lower than salaries for the same position in government run homes. I saw firsthand how properly trained and paid staff made a significant difference in the type of care seniors received.

Ageism

One of the first issues I brought up was how society views of aging and seniors. Historically, getting older has always been viewed negatively and older people have less value in society than younger people. This ageist opinion has been the foundation for many services, opportunities, healthcare, and resources developed for older adults. There is a clear difference in the type of services and care offered to seniors when they are treated as valued members of the community as opposed to when they are not. There are many organizations and housing projects opening that recognize, value, and cater to seniors but we need more.

Rural Concerns

Two participants live in rural communities. They voiced many concerns about lack of housing, transportation, and health care services available to seniors. This creates many challenges and problems for aging adults who left in dire situations or have to leave their community to access the services and housing they need. It also affects family who must travel further distances to see their loved ones. The two focus group members want to see more services in rural areas, so health care and housing are more accessible.

Community-Based Transportation Services

Before the pandemic, many housing and community-based agencies offered transportation services to seniors to they could shop, run errands and attend social functions. When Mom lived in her apartment, she enjoyed taking the weekly van to the nearby grocery store. Not only was it convenient and affordable, but it also allowed her to maintain her independence. The transportation services also created a regular social event for its riders. Mom and the other residents in her building enjoyed the weekly chats and developed friendships during their travels.

When the pandemic started, transportation operations stopped. Many have never resumed, creating challenges for many seniors who must find alternative ways to go from place to place. In rural areas, this becomes even more challenging because there are less public transportation options available.

Lack of Community Based Resources and Supports for Seniors

As a group, it was collectively agreed that communities still lack supports and organizations to help seniors live independently while ensuring their daily needs are met. This continues to create many barriers for older adults to stay in their own homes and communities. In this province community-based supports are available for many vulnerable populations, so they are not institutionalized, but it is still lacking significantly for seniors.

Inadequate Community Based Home Care Services

While there is home care available, services are limited to a maximum four visits per day. Staff shortages, lack of resources, high community needs, weather and absenteeism creates a very unreliable system that doesn’t adequately meet seniors’ needs and puts a lot of pressure on families to fill in when home care doesn’t arrive or provide the needed services.

There are many non-profit organizations to provide 24-hour care and health services for other vulnerable populations in their home and community, there are no similar services for seniors in this province. Having similar services to cater to senior’s needs would reduce the strain on the government run system and allow more seniors to live in their own home and community.

Positive Qualities of the Current System

It was easy as a group to find multiple problems with the community-based and personal care home-based care services that are currently in place for seniors. The issues we all raised were similar, abundant, and affected all areas of seniors healthy living in their own homes and community. When asked, it was difficult for any of us to find positive factors to the current system. When asked, no one could find an answer.

Final Thoughts

I was happy to be invited to participate in this group. Not only did I had a chance to voice my concerns and views of the current system, I enjoyed listening to what others had to say. All the points discussed were valued concerns that will hopefully be used to create a better community-based health and home care system so our aging relatives can continue to live productive and valued lives in their own homes and communities for as long as possible.

I’ll cover each issue in its own blog post in the coming days and weeks. I would also like to hear from you, my readers. What concerns do you have regarding your area’s current services for seniors? Are there any positive features to the services offered? What changes, if any, would you like to see?