My mom has dementia and is living in a nursing home. I’m her advocate. I’m there five times a week for at least two hours per visit plus I have a companion visit three times a week for two or three hours. Without all these visits I know her care would not be what it is. The level of care that our governments require nursing homes to provide for seniors is below what I would consider a minimum level of care. From there it is up to the nursing home provider to provide any other care.
The health care aides in my mom’s facility have next to zero time to spend just being a senior’s friend. My mom was left in a soiled, very stinky diaper for at least one hour and 15 minutes. I concluded that the staff found her like this at the end of a shift so they opened her window and left her with cold air blowing on her for the evening shift to clean up. I came in and found her in this state and it was 20 minutes before I could find someone to come clean her.
If a staff member calls in sick a senior may miss their bath. Mom’s home provides baths twice a week; however, I have been told that the Alberta government only mandates one bath a week! That is horrible. If a health care aide calls in sick the residents will be given a bed bath, but that means my mom will go over one week without getting a full bath and having her hair washed. The facility’s managers say all residents are to get baths two times a week except if they are sick and confined to bed, but workers tell me if they are short-staffed on a given night not all residents who are supposed to have a bath that night will get one because of time constraints.
Mom’s teeth and mouth have become a mess, so I have had to put up a sign asking the staff to brush her teeth at least twice per day. I recognize that Mom make this difficult, but even 30 seconds of brushing is better than nothing.
We need to provide dental care in all nursing homes. I have found a dental hygienist who will come in and clean the teeth of wheelchair-bound residents. If Mom needed more serious dental work, however, she would have to go by HandiBus [a transportation service for people with physical and cognitive disabilities] to a dental office that will treat people in wheelchairs. This would be over-the-top scary for a person with dementia — first you are taking them out of their familiar environment then you have to do a dental extraction or something else. I have my mom on comfort care so she is not to go to the hospital, but if a tooth becomes rotten because of bad dental care she will have to leave the facility to have it removed or I will have to let it fester in her mouth.
I have found that if a resident is difficult the staff will avoid providing basic care. Now that I’m retired I drop in way more than I used to, and I have found that the morning staff have not been looking after my mom as well as the evening staff because I used to stop in after work all the time so got to know the evening staff. If you are an advocate, family member or companion you need to be at the nursing home frequently to ensure your loved one gets the best possible care and to ensure that they are receiving the care that is mandated. Treating the staff with respect, care and friendliness goes a long way toward ensuring they look after your loved one well. Make the staff part of your family and circle for your loved one’s care.
Family members also need to speak up when they are unhappy about something. Don’t attack the staff; rather, talk to them in a calm, respectful way about your concerns. I take the time to bring up my concerns to the care managers and registered nurses because these are the people who direct the care that the health care aides provide. If health care aides are not happy about something they can complain to their managers but if a family member complains about the same issue there is a better chance that things will change.
I have never worked in the health care industry, but after having my mom in three facilities in Calgary and two in Ottawa I have seen the good and the bad at various levels of care in the last 7.5 years.
There needs to be more funding to upgrade our nursing homes, provide more staff, combine child care centres with nursing homes on the same site, and make the nursing homes feel more like a home rather than an institution. Nursing homes should have couches and chairs for visits all over the place, including hallways, and there should be games, books and puzzles at tables for visitors and residents to enjoy. There should be many secure garden areas for residents to enjoy the outdoors. These areas should be shaded and should be protected from the wind. Nursing homes should also have wide hallways so people can walk to get residents out of their rooms more. There should be lots of common activity areas, and music should be played in different areas of the facility.