Ask the Chaplain: The Truth about Long-Term Care and Why It Needs to Change Now

Author: Memory Lane Home Living Inc. | | Categories: Community , Dementia Care , Dementia Care Home , Dementia Day Program , Dementia Program , Memory Home For Women , Person Centred Care , Respite Care

Assisted Living Home Richmond Hill

Adult children are busy. Parents are getting older.

Chores are becoming more and more difficult for Mom to do independently. She does not remember things like before. She may forget the stove turned on after having cooked or forget to turn the tap off in the sink. Her hearing has diminished considerably, and she can’t hear the water running. Her forgetfulness is impeding her from doing the things she used to do on her own, independently, and even worse is placing her in real danger (e.g., fire or flood). What to do?

The first thought arises,

Why don’t I place Mom in a Long-Term Care home?

The second thought quickly follows,

I’ll put her in Bellevue Home.* It has been around a long time, looks incredibly attractive with its view of a river and rolling hills, some of her friends are there, and there’s even a waiting list. It must be a good place.

As a chaplain who works in such a home, I can tell you that clients are well taken care of physically but are often incredibly bored and lonely. This is because there are far too many clients, not enough chaplains and the quality of spiritual care is superficial—it only scratches the surface of what is really needed. That’s because I cannot spend as much time with a client as I would like to, because other parts of the home will be without a chaplain. And so I move, from client to client, section to section, a greeting here, a smile there, and a short prayer said in between, always mindful of the insufficiency of time and the overabundance of need.

Residents are placed in long lines to be toileted and given showers. I wonder what the adult children of my clients would think if they could see what’s happening ‘behind the scenes.’ For the most part, my clients’ children come, spend an hour or two with their loved one and leave. They’re busy and have to get on with their lives. Or do they?

I was particularly struck by how one man’s wife came, danced with her husband during a program and never returned. Why?

In addition to a deficiency in chaplaincy support services, there are not enough health care aides (HCAs) to ensure clients’ safety. This means that clients are grouped together near the nursing station during the day, so that they can be observed. Clients can only enjoy the privacy of their rooms at night, when sleeping, or during outbreaks (e.g., Covid-19 which is occurring at this writing), when they’re required to isolate.

Any idea of meaningful socialization amongst clients is precluded. Often times when clients gather for religious programming, they don’t know who their neighbours are—even though they’ve been living together for years! This goes beyond cognitive impairment; this touches at the root of the problem in LTC: anonymity and isolation. In my opinion, psychological isolation can be just as damaging as physical isolation.

During a window visit—a visit where an adult child of a client came to see her mother through the home’s window in order to respect physical distancing on account of Covid-19—the adult child, May, started to cry at the end of the visit. Her mother couldn’t hear what her daughter was saying, even though I’d placed the mobile telephone next to her ear. She kept asking me, ‘Who is that?’ pointing to her daughter on the other side of the window. ‘That’s your daughter, May,’ I would reply loudly, my mouth inches from her ear, protected by a surgical mask and a transparent, plastic face shield.

I think that May cried because of how much her mother had declined since she’d last seen her—only a few, short weeks ago. I also sensed that she cried because of guilt—represented by an all-encompassing wave of sadness at the realization of the situation and its inherent separation—both physical and emotional.

It doesn’t have to be like this. LTC can change. In fact, LTC needs to change without a moment’s delay.

What we need are small, cozy homes like Memory Lane Home Living so that we can ensure that our parents are in ‘soul-enriching’ environments that promote togetherness and include us, their adult children, in the decisions that affect their lives.

*Names and details in this blog post were altered to protect privacy. The author chooses to remain anonymous.