We are failing in our treatment of the elderly

The public system cries out for more compassion, common sense

Commission Castonguay

When she handed in her annual report yesterday, Quebec ombudsman Raymonde Saint-Germain noted a good part of the failings in the public care received by elderly people in long-term-care homes (CHSLDs) could be blamed on scarce resources as well as a lack of human touch and common sense.
Her remarks could apply to many situations where vulnerable people, including those with physical and/or mental handicaps, depend on social services, especially in public residences or publicly funded private ones.
The main failing in a number of CHSLDs and other residences is that services are not enough to provide what the Ministry of Health and Social Services calls a "substitute living environment."

This includes medical services as well as the quality of food, cleanliness, safety, respect, dignity, privacy and human relations.
Those who have experienced the system know that when a residence or a rehabilitation centre puts human care and compassion at the top of its list, the quality of care, even without optimal resources, usually improves.
It is perhaps the central weakness of the system: its tendency to tolerate failings in that philosophy in some residences because they fear losing those resources. If these values were at the centre of the training of its staff - administrative, direct care and those who run subsidized group homes - the message would be clear: Those who want to work here must share that approach.
When I did my training as a volunteer in palliative care, values of dignity and compassion were at the centre of everything we would be called on to do.
If that works for unpaid volunteers, why isn't it at the core of the training of people who do get paid? That's not to say that there aren't people in the system who do their work with compassion. There are. And it's not to say that working in direct care is easy. It's not.
But that's the point: Why should those who choose this work not be held to high standards? The danger is that they aren't because we think that "human nature" makes it impossible, that "bad things" will always happen when vulnerable people are mixed in with those in authority.
If the system's tolerance for undignified situations isn't changed rapidly, we're in trouble. We're an aging population. And we also face an unprecedented number of adults with intellectual or severe physical handicaps who have a longer life span.
That means that in the near future, there will be many elderly handicapped people whose parents or siblings are dead, or are too old, too sick, or otherwise unable to share the same home.
Many families faced with this prospect, including mine, have seen enough to fear the future unless the system is adapted to serve the people who need care, and unless the family is treated as the primary partner.
Is it normal that the government hands major subsidies to group homes but gives so little to families who now live with a handicapped person, or would like to if they had the adequate support? Group homes are necessary, but if families got proper help, we wouldn't need so many.
As for those aging handicapped people without family or money, who will take care of them with the dignity they deserve? We often can't do that today, even for able-bodied elderly in a number of CHSLDs.
The health minister says he will eventually present a new plan of action for services to handicapped people. We'll see if it will look at preparing for the care of aging and elderly handicapped Quebecers and their families.
Here's praying it does.

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