Thursday, 20 August 2015 11:17

Swift Current resident has concerns about long-term care facility

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Open letter to Premier Wall; The Saskatchewan Health Minister; The Opposition Leader, Cam Broten; and all Members of The Legislature; The Swift Current Health Region., and the residents of Swift Current.

I am a retired Saskatchewan Registered Nurse, who worked at the Swift Current Care Centre, from 1985 to 1995. The setting of the home in a quiet area adjacent to the Chinook Golf Course and the improved and then well-kept grounds, gave much pleasure to the residents. Although the layout of the building is not the best design (such as double rooms, shared bathroom facilities and small access doorways for wheel chairs) the daily care provided by the nurses aides and charge nurses was excellent. The residents there were always given individual care. The staff followed  their accustomed daily routines as much as possible, such as breakfast in their rooms if requested, and  staggered bedtime hours. They were given help with eating their meals.
Well thought-out activities, including daily tasks similar to those they did at home were incorporated for those more mobile, such as cooking, under the supervision of the activity director and her assistant in a separate room, where family could also eat with their relatives.
Entertainment was and still is provided by many volunteer groups. Some were taken out to shop for personal items.
Charlene Baron was one of the first activity directors to follow the Eden concept of care in the province.
I have toured the set-up of the new Care Home Pods and have seen the many great features of this new facility, but I have many safety concerns. My prime concern is adequate staffing.
There should be a minimum of two trained caregivers in each unit of 10 people, under the supervision of a Registered Nurse, for each shift. I believe the original quota of staffing by one aide has now been revised to include a Licenced Practical Nurse and a trained care aide for each unit, plus a float aide when necessary. Student apprentices from the high school should always work alongside an experienced worker.
The most important aspect of care for the older citizens of our district for those who need Level 4 care (especially those confined to their beds or wheelchairs) is interaction with familiar, friendly people; those who give daily physical care; those who come into their room to do housekeeping and chat; those who come to encourage participation in activities, both physical and mental; and those who give spiritual care. To feel ‘at home’ these are the main requirements. Extra people can also be invaluable in reporting accidents and confrontations to the regular staff.
Appliances, such as an oven for cooking in each pod, are an unnecessary expense and a potential danger. A toaster-oven and /or microwave, which can be safely unplugged and locked away, could be used to heat cinnamon buns for breakfast, and perhaps a soup pot for supper, are all that is required in each unit. To furnish each  pod with a large fridge/ freezer is also unnecessary when raw meat for example can be stored and handled in the hospital.
Many confused residents wander and, thinking they are still at home, try to use appliances. The hospital kitchen staff, well-trained in food management, special diets, etc. could provide the main meal, as they do for meal-on-wheels. The statement that people appreciate the aroma of cooking is not necessarily true, for many as they age, lose their sense of smell, or for some the cooking of meat, fish and vegetables can make them feel nauseous.
Many long-term care aides do not wish to cook and do not feel qualified to prepare special diets, such as diabetic, gluten-free and salt-free dinners, and cater to those with allergies to a variety of foods.
Staff at times may have to prepare 10 separate menus. Their main concern is taking enough time to prepare residents for meals. Some will need their meat cut up or minced as they may not be able to chew well. Many residents may need help and encouragement to eat and drink enough fluids. Many will need or wish to have their meals in their rooms.
There have been any examples throughout the province lately of mishaps and even fatal accidents in long-term care facilities (See newspaper articles in The Leader Post in 2014/15). Most of these are due to inadequate staffing. Therefore I will stress the measures that should be put in place to help prevent such accidents.
1. At least two trained staff should man each pod for each shift, with a  Registered Nurse and float aide, that  can be called on to help when necessary. Health care administrators should be prepared to work on the floor in emergencies, including fire, accidents, outbreaks of illness in staff and residents, and other potential hazards. They should keep in touch with the running of each unit by working alongside a nurse on each shift at least every three months to assess care.
2. Revise plans for oven placement in each pod. Those giving bodily care should not be expected to prepare and cook a main meal. This is work they are not trained for and do not have the time for. It cuts into their ability to give basic daily care, such as changing sheets, helping residents prepare for meals, use the toilet, and wash their hands. There is always the possibility of infection. As people age their immune system is easily compromised. In the 10 years I worked at the Swift Current Care Centre not one resident suffered from a bedsore which indicates the good basic care provided. Residents value the individual interaction with staff, such as conversations about their families, and staff should have the time to learn each resident’s background. This aids in their ability to calm down anxious and aggressive residents.
3. A special separate pod or pods should house residents with advanced dementia, who need specialized care, and staff with experience in this field of care.
4. Recognize that many seniors are now able to live longer in their own homes, but need more home care nurses to help them out. Those living in the new facility, by definition, can no longer manage without nursing care and many will be bedridden. There  should always be two care givers present when a lift is required (as students are taught in their training at the Great Plains College).
5. Extra cleaning staff can add to the residents comfort by their friendly interactions as they do their work.
6. The activity director should have a separate kitchenette for birthday parties and family meals with residents (perhaps some cooking for selected seniors, and extra help for outdoor activities).   
7. As I approach my 86th year I know my main concerns of having to have full-time care and battling depression in the future, is enjoying the cheerful interaction with family, especially children, and friends, and being able to count caregivers in that category. I would like to continue to exercise my mind as well as my body as much as I can by participating in any task and hobby that I am capable of doing, such as making my own bed, dusting and tidying my room, writing, painting, and even helping plant flowers and vegetables. A combined community garden adjacent to the new facility could be tended by school children and teachers. They could be supervised by interested residents, who could give much useful advice, even from a  wheelchair. Raised beds such as were planted at the Swift Current Care Centre could add to the seniors’ interest.
I hope some of my concerns will be addressed before the Integrated Facility opens and other citizens of Swift Current will voice their opinions, so we can give seniors a truly pleasant and safe place to live when their health fails.   
Anthea Loran, Swift Current

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