We Need to Put the TLC Back Into Long Term Care

The old woman sat in her wheelchair looking out the window at the perfectly manicured garden. It had a fountain, where she loved watching the birds frolicking on hot summer days like this one. She held her useless left wrist with her right hand for a moment, then gently laid it by her side. The woman did this by habit; she didn't want people seeing what the stroke had done to the hand that used to knead the shortbread that she once made for her grandchildren.

"Hi Elsie," I said softly, and sat down in the chair beside here. "Do you want to come out for the sing-a-long?"

She looked up at me with rheumy blue eyes, and shook her head.

"Not today, dear," she said in her soft Scottish accent. "I'm not feeling up to it."

"Come on, now," I said. "It will do you good. Singing always makes you feel better."

She shrugged and gave me a wave her hand, as if showing the white flag. She knew there was no point arguing with me. I was her favourite, and she didn't want to disappoint me. 

Minutes later, I was passing out song sheets, and the atrium was filled with squeaky little voices, and booming baritones, all singing war time favourites. Silver Threats Among the Gold. It's a Long Way to Tipperary. And then my personal fave: The Maple Leaf Forever.

As we began to chime together, we could always count on one voice to drown out the rest. It was Margaret, a 90-year-old with advanced dementia, a woman who could not speak most of the time. But sing a few bars of her song, and suddenly she was wailing like an old blues mama. 

The Maple EEF, my emblem dear/

The Maple EEF forever/ 

God save our Queen and heaven bless/

The Maple EEF forever!

I'm getting older, with my silver threads hidden by an expensive dye job, but I still love to sing these songs I learned so long ago as part of my job at a long term care facility. I used to sing them to my granddaughter when she was a baby, and she would squeal with delight when I imitated Margaret and massacred the Maple Leaf. 

These songs give me comfort now, as they did for the residents I worked with more than 40 years ago. They remind me of warm cookies, and lukewarm Orange Pekoe that had a faint metallic taste from the stainless steel tea pots it was served in. 

I drank a lot of tea and played a lot of Bingo that summer. But mostly, I spent my time wandering around, holding hands with the likes of Elsie. Like many of the residents, she cried often, and it made me sad to watch this wonderful woman sitting in the corner, waiting for company that rarely came. It was my job to cheer her up, and make her laugh -- and I took that job seriously, teasing and cajoling her, and getting her to see that her life wasn't so bad -- even though I knew the melancholy would return as soon as I walked out of the lounge.

For Elsie, old age was a cruel practical joke, a terrible ending for a life well lived.

I used to visit David, too. He was a crusty veteran who lived his life on a hamster wheel. He was only 18 when he dove into shallow water as a navy diver, and broke his neck. He was 40 when I met him, cooped up on a dementia floor, helplessly fending off wandering patients who would come into his room and say crazy things. David didn't like me at first, but he couldn't resist the charm of an 18-year-old with long hair and short skirts. I spent a lot of time with David, and I used to visit him in subsequent summers between university semesters, and at Christmas. I heard a few years later that he had moved in with his niece, paid for a nice house, and was living a more normal life. I hope I helped him get his mind around that. 

I had many grannies and grampas that summer. It was more than a job for me. I felt that I had won a secret lottery, that paid me just to be kind to people. 

I tried to make each and every one of the residents feel special, and loved, even though their own families rarely visited them. There were occasional grannies and grampas who had doting sons and daughters, but most of them spent their days alone sitting in the dark in their rooms, or lined up in the lounge watching Jeopardy.

We, the staff, were their only lifelines. We weren't perfect, and some were better than others, that's for sure. We often heard about other facilities where the seniors were forced to sit in shitty diapers for hours, or lay in bed at the mercy of bedsores. But this didn't happen at my place of employment. At our home, the seniors were loved, cared for, and respected.

This is the kind of facility I want to go to, if it's my time.  I want to be in a place where I'm surrounded by people who see caring for the elderly as a calling, not a job. It's not easy being a caregiver who is paid so little that she has to take another job, or two, to make ends meet.

Seniors can be loving, but they can also be challenging. Some have lost their minds, but remain strong. I know of one nurse's aide who had her ribs broken by a little old lady who thought she was back in the war. Some will scream, and kick, and curse the staff even when are doing their level best to attend to the needs of their patients. 

The staff aren't perfect, either. It's like any job. One bad apple can spoil the whole bunch.

But it's not fair to say that all long term care facilities are terrible. A lot of them have simply lost sight of their mission. They are supposed to be CARE GIVERS, not just MONEY TAKERS.

People who live in these facilities need to know they are safe, but they also need to know they matter.

So maybe, in addition to adhering to safety concerns and regulation, facility owners also need to value their staff, pay them well and stop abusing them. Abuse is learned behaviour, so if the staff are abusing their patients it's because they themselves are being abused and disrespected.

And another thing, while I am on my high horse. The families need to do better. They shouldn't be allowed to write cheques and just leave their mums and dads in a strange place, and never visit.

It's not asking a lot to visit not just at Christmas. They wouldn't just drop their kids off at daycare and not care how well they are treated, or if they are fed or changed, or talked to.

In a perfect world....

There's a lot we can do, as a community to help our seniors in long term care. Government has a responsibility to keep them safe, but maybe the job, Mr. Ford, should be more than just sending in inspectors with their notepads, and spreadsheets. Maybe there's a more human way to approach the issues in LTC. 

Did I tell you that my summer job was paid for by Premier Bill Davis and the Ontario government?

I didn't do a dish, or wipe a butt, or put in a feeding tube.

I just got paid to sing songs, play bingo, and just listen. But if I saw something, say, a senior sitting in shitty diapers, or one calling out, I would help them. If I saw abuse, I would report it. 

Maybe the government could hire summer students, or older people, to do what I did that summer so long ago. Maybe government needs to do more than regulate. Maybe it needs to show seniors that we care.