New Perspectives: A Senior Moment – “OUR MOST VULNERABLE”

The true measure of any society can be found

In how it treats its most vulnerable members—–Gandhi

More than 75,000 frail, elderly Ontarians are cared for in the Province’s 626 licenced long-term care facilities. Over a seven year period ending in 2014, nurse Elizabeth Wettlaufer callously murdered nine of them. Three years later, she pled guilty to these crimes and other counts and was sentenced to life in prison with no eligibility for parole for 25 years.

This week, Commissioner Eileen E. Gillese’s public inquiry into these deaths issued its massive 1,441 page report. From subsequent news reports, the main thrust of her 91 recommendations is to ensure better oversight of nursing homes so that no other “health care killer” will inflict a similar horror on these most vulnerable members of our society. Recommendations include closer monitoring of medications, especially insulin, (Wettlaufer’s weapon of choice), coroner-led investigations of unexpected deaths, a system of staff reporting around any colleague’s suspicious behavior and spot checks to determine compliance with Provincial guidelines of care.

As valid as these ideas were, another key recommendation caught my attention; the Commissioner mandated checks on staffing levels in these facilities with a report-back due in one year.

One component of a clergy’s responsibilities is to provide pastoral care to his or her church members living out their final years in nursing homes. During my years serving as a local pastor, I made regular visits to seven long-term care facilities on Owen Sound, and others in Walkerton, Wiarton, Chesley, Kincardine, Hanover and Southampton. Some nursing homes are privately run, others operate as not-for-profit and some are administered by municipalities.

In general, my own impressions have been mixed. Some facilities are in obvious and immediate need of physical upgrading and the needs of residents look overwhelming. In my mind I can still hear the incessant, simultaneous ringing of bells from multiple patients’ bedsides, where they are calling for nursing assistance. Some are incontinent, some are needing help with dressing or other personal care and some, I suspect, are lonely or confused and simply need personal reassurance.

I was impressed with the skills of administrative, supervisory and support staff as well as chaplains. And I greatly admired the front-line workers. It is no coincidence that front-line nursing staffs typically wear running shoes. Most days, they can be run off their feet. And they quickly became my heroes.

Most hands-on staff are not registered nurses and are therefore paid much less than their university-trained counterparts. Yet, unlike Elizabeth Wettlaufer, the work they do is of immeasurable importance. They must balance their innate compassion for these elderly residents with the practical demands of providing physical care. When they would like to stop and spend more time per patient, duty is soon calling to the next room. And so the day goes.

In my brief encounters with these women and men, I have frequently told them: if I were in charge of the world, I would transfer money from overpaid athletes and movie stars and use this windfall to provide much higher salaries to nursing home staffs. While my comments did nothing to change their reality, I think these front-line workers appreciated my intentions.

Who are these residents of nursing homes? According to the 2011 Canadian census, they are the parents of the Baby Boomer Generation, born between 1919 and 1940. They are 3.1 million in number and constitute 9% of Canada’s population. I prefer to designate them as “The Greatest Generation,” that segment of our society who stoically coped with the Depression, fought bravely through six war years or served on the home front to keep Canada’s war-time families, farms and industries flourishing. Then they built the economic power house which was post-war Canada.

Now those who remain are old and frail. As explained in a 2019 report of the Long-Term Care Association, the Ontario Government has shifted its planning for care of the elderly. As home care provisions have increased to enable relatively healthy seniors to remain longer in their own houses, admissions to nursing homes are increasingly the older and more frail members of this age group. The report notes that about 90% have some cognitive impairment while 86% require extensive daily help.

And now the Wettlaufer Report will surely discover over this next year that nursing homes are understaffed; the classic case of being overworked and underpaid. As a society we can respond by supporting legislation—and taxes— that will enable additional staffing and more training for front-line positions.

While I won’t be around to see it, I can safely predict that once the influential and much larger (9.6 million or 29% of our population) Baby Boomer Generation (1946-1965) becomes elderly, they will insist on high quality residential care for themselves. Should we not insist that their parents deserve just as much?