What is Long Term Care Like? - The Other Side of the Story
- abissett22
- Jul 26, 2022
- 5 min read
When you think of long term care or assisted living facilities, what kind of images come to your mind? The media often portrays these environments as lonely, depressing, and confusing, such as in the movie "Away From Her" (Polley, 2016). News stories, especially during the Covid-19 pandemic, have often painted a picture of inadequate staffing, poor living conditions, and neglect. Care homes are often thought of as "old folks homes", despite 9% of residents in Alberta being under 65 years old (Government of Alberta, 2018). Working in long term care has sometimes been perceived by those who work in other areas as boring, slow, or a poor use of a clinician's skills. News stories during the pandemic have shown a different story of working in long term care: one of long hours, heartbreaking losses, and burnout.
Today, I want to tell another side of the story. While I do not deny that there are substantial challenges, and I have witnessed and experienced suffering, I want to share another perspective. I want to share why people like me choose to spend our careers in these settings. I want to tell you about some of the residents, families, volunteers, and staff who have impacted my life.
I remember:
A lady in her 50's who was often found beside the bird cage, singing "You Are My Sunshine" to the birds. When I was pregnant, this same lady gave me a dollar store teddy bear, and recommended saving pop cans for my baby's education fund.
A man in his 80's who got a power wheelchair after three years of being dependent on others to move around. He laughed and cried at his newfound freedom. I ran around the block with him while he tested out the fastest speed. Later, in a recreation program, he painted a picture of an elderly man, grinning ear to ear. He gave that painting to our team, and it stayed on our office wall for years.
A Harry Potter fan in her 80's. She was in the "pleasantly confused" state of dementia, and was often looking for the Gryffindor common room. She once looked in my eyes and solemnly stated "I don't care what anyone says, Dumbledore is the wisest man who ever lived".
The 40 year old leader of the resident council, who made an effort to welcome those new to the facility by giving them a tour from a resident's point of view and introducing them to other residents.
A family conference where I watched a husband hold the hand of a woman he had been married to for 40 years. She did not understand what was happening or recognize him, but he looked at her with incredible love and devotion. My young husband and I were dealing with our own health difficulties at the time, and this man's example inspired me to stay strong too.
A son who came to the facility every day to visit his mom and volunteer. He shared that he was only paying back all the love his mom had given him over the years.
A woman in her 40's with Multiple Sclerosis who had lived in the facility for 6 years. She found an apartment and developed her own plan to meet her care needs outside of long term care. Before she moved out, the facility staff donated used household items to get her started in her new home.
An Italian woman who invited her family to join her while I assessed whether she had recovered enough from her stroke to safely resume eating regular food. The audience for the assessment was a bit intimidating, but they were good-natured. When I informed her that I didn't recommend pureeing her food or thickening her fluids anymore, that big, loud family shouted for joy!
A man in his 40's who was hit by a drunk driver while crossing the street. He was unresponsive and receiving a tube feed when he was admitted, and we did not expect any recovery. It was discovered that he had hydrocephalus. A shunt was inserted, and his recovery began. The first staff member to notice small improvements advocated for the whole team to gather our resources and provide the most extensive rehab we could manage with our caseloads. He regained the ability to eat solid food and speak with his 12 year old son. He improved enough that we were able to refer him to an intensive brain injury program. After that program, he no longer needed long term care.
A volunteer in his 80's had his own woodworking shop, and created individualized items for the residents upon request.
A petting zoo that was brought to the facility for the residents, and staff were also welcome to bring their children to come see the animals. The resident's days were brightened by both the animals and the children.
A woman with complex medical conditions was in a significant amount of distress 24 hours per day. Our team had just gone through PIECES training (The Bethany Group, n.d.), so we put our new skills into practice. We did our first formalized Pro-Attention Plan and involved staff from all departments, family, and volunteers. She became much more calm and settled.
A dying man who was very distressed was rubbing his foot back and forth on the corner of a wall until it was breaking down his skin. The team was able to put strategies in place to promote comfort and a peaceful passing.
A summer carnival at the facility, where participants could donate $2 and throw a whip cream "pie" at a staff members face. One resident took so much joy in throwing "pies" at his favourite staff that he had photos taken and posted them in his room.
Watching a family gather to say goodbye to their loved one, then participating in an honour guard (The Vital Beat, 2019) to show respect for the resident and say goodbye to the family.
Being with a man in his 80's when he took his last breath during a terrible facility-wide COVID-19 outbreak. After taking a moment to cry, I changed my PPE and went to take care of the next resident. She brightened immediately when I entered the room, and sincerely gushed "My dear! What a lovely blue gown you have on! It brings out your beautiful brown eyes", reminding me that life is all about perspective.
A woman who was slouched forward and to the side in her wheelchair, and had a pressure injury on her spine that went down to the bone. We were able to set up customized wheelchair components for her, so she could sit in an upright position, facing forward. Her daughter said "You have no idea what it means to me to be able to look my mom in the eye, and feel that she's comfortable". Her wound healed a few months later.
The opportunity to mentor a newer therapist, who told me that because of the skills she learned from me, she was able to help the residents in her facility.
These stories, and countless others, are why I do what I do. Many of these stories could have taken place in any care setting. What I find unique about long term care and assisted living is the sense of community that can develop, when so many people are living, visiting, and working every day in one place. These are not easy places to live or work, but these are places where we can choose to find joy, meaning, and life.
I do not mean to downplay the challenges that exist in these care settings. There is certainly work to be done in improving the quality of care we can deliver, and the quality of life for those who receive these services. My hope for the upcoming years is that we will be able to take the lessons of COVID-19 and never again face such a terrible crisis in our care homes; that we will be able to make substantial improvements while holding on to the heart in our work.
References
Government of Alberta (2018). Long-term care resident profile.
Polley, S. (2016). Away from her. [film]
The Bethany Group (n.d.). PIECES. https://www.thebethanygroup.ca/education/outreach-
The Vital Beat (2019). Honour guard celebrates the life of the resident.
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