Chaplain's Corner

Personal care homes, nursing homes, long term care facilities, whatever you might want to call these facilities, the provide an extremely important function in a society that has for the most part taken the care of the very young and the frail elderly out of the hands of families. This isn’t to deny that children and elders are not being cared for in the homes of adult children with or without the supports of home care or private nursing, but conceptually, our society views the care of the frail elderly as the function of these health care institutions.

As you must know by now, I work in a personal care home. I serve the facility as spiritual care provider. I love this work; I love elderly folks and the people that give their lives to caring for them. As an insider, I would like to share with you a few thoughts that might help you understand the work done by those who serve our elders in personal care homes.

The housekeepers are the men and women who wash floors, empty trash cans, clean toilets, dust furniture on a never ending rotation. But it’s what they aren’t getting paid for that I want to mention. It is the kindness they show to the residents, the time they take to notice their needs and alert other staff, the conversations they have about resident’s families or concerns and the sensitivity with which they enter every day into the “homes” of the residents to do for them what they are unable to do for themselves. In my years working in a personal care home I have seen housekeeping staff members go way above and beyond what they get paid to do, to enhance the quality of life for the residents. We tend to look down our noses at housekeepers, whether they work in personal care homes, hotels and motels, or public buildings. Shame on us, I solute the housekeepers I work with and considered them valued partners in providing the kind of care you would want if your Mom or Dad were in a personal care home.

Then there is the maintenance staff. They have training in a trade and spend their days replacing light bulbs , unplugging toilets, changing furnace filters, repairing holes put in the wall, keeping snow cleared and the grass cut, as well as maintaining all the mechanical systems in the facility. But they do more than that. I have seen maintenance staff members take time to change a bearing in a noisy wheelchair or adjust wheelchair breaks that no longer worked or build a set of shelves that a resident bought for their room. But I have also seen the maintenance staff members invite a younger male resident to join them for coffee and the occasional bar-b-q they have in the summer. I have watched in amazement as they came in on their days off and helped bake pies with a female resident and I have watched them develop emotional attachments with residents over time.

Then there are the health care aids or nursing aids as they are sometimes called. These people, most of which are women, are the workhorses of personal care home, literally doing most of the heavy lifting that is part of caring for those who are no longer able to care for themselves. They work on round the clock shifts dressing, bathing, toileting, transferring, answering call bells. They make beds and adjust pillows, reposition residents who can not move themselves. They change those who are  incontinent, feed those who no longer have the strength or the cognitive ability to feed themselves and treat each person like a person of worth and dignity. In the midst of doing all thixs, they develop relationships with those they serve. They learn their likes an dislikes, the tailor their care to the preferences of the people they serve, they learn their families names and they listen to the stories of residents, the worry they have for a wayward grandson, or the excitement they feel over an upcoming great-grandchild being born.

Then of course there are the nurses. These dedicated professionals are often looked down on by their counter parts who work in acute care hospitals because the “only work with old folks”. I work with both long term care nurses and acute care nurses, they are all well trained specialist in the area of health care they serve. Geriatric nursing is a specialty. There are skill sets that a nurse must learn in geriatric nursing that are different than those needed in medicine, surgery, maternity or on a rehab unit. Unlike hospital nursing, nurses in a personal care home do not ever see their “patients” go home, for eventually each one dies. Geriatric nurses see the resident’s doctors once a week, they are the eyes and ears and make the assessments that are required to alert the doctor to a medical need. The resident’s doctor may actually see them only once or twice a year unless the nurses are on top of things and alert the doctor of a brewing problem. One of our retired nurses used to say, “After all these years I just tell the doctor what the resident needs and they order it.” That is how well our geriatric nurses get to know the medical needs of the residents. Oh and I mustn’t forget the increasing levels of paper work required by the RHA, Manitoba Health and Accreditation Canada.

We mustn’t forget the recreational workers. These dedicated people are responsible to provide life enriching activities in the morning, afternoon and evening so that the resident’s life consists of more than staring blankly at a TV or sitting alone in their rooms. They develop a rhythm for the life of the residents. Bingo every Tuesday afternoon, or “mind jogging” mornings at 9:30. They learn what each resident enjoys and seek to somehow accommodate that into their recreational program. They schedule singing groups to provide entertainment; they plan family activities often around the holidays to enable the resident’s family to join them for a special event. They organize trips to the ball park for Gold Eyes games, or shopping outings for the resident that still enjoys an outing to the mall. They recruit and support as many volunteers as possible, some who read to residents, others who come in regularly to visit those who have little or no family, others who support the regular activities with additional hands to place bingo chips or participating in baking with a resident who comes alive in the kitchen. The also decorate for Christmas and have special holiday parties as the seasons of the year roll along.

The dietary staff serve meals to the residents, learn what they like to eat and don’t like to eat and try hard not to give a resident porridge in the morning when they can’s stand porridge. The serve the meals, clean up the tables after the meals, they do the dishes and keep that unrelenting rotation of meals and snacks available for one of the few things most residents can still really enjoy: eating. They deal with complaints and have to develop tactful skills to deal with residents who can’t stand the chicken noodle soup they get served or can’t understand why the toast is always cold.

Then of course there are the administrative supports: the facility manager, the head nurse, the social worker, the administrative assistant and ward clerk (often the same person), occupational therapist and dietician (usually only in the facility a day a week at most) and in very rare cases (for most personal care homes do not have these) a chaplain. These folks not only provide services in their professional specialty, but they support the rest of the staff and the families of the residents as well as the residents themselves.

Are mistakes sometimes made that impact a resident? Yes. Do staff members sometimes have a bad day and aren’t as compassionate and caring as usual, Yes. Are there times when something happens that causes the morale of the staff to suffer? Sure. But having worked in a personal care home for over ten years now, I want to say just one thing – I thank God for the exceptionally caring people who find themselves by choice or necessity caring for your parents or grand parents in personal care homes. Their work is largely unseen, not generally lauded but for the most part they do it with joy and with the best interest of the residents in mind. I feel exceptionally blest to count myself among those who work in long term care