Chaplain's Corner

As you well know, I spend half of my working day in a Personal Care Home. Bethesda Place has 60 residents ranging in age from 48 – 99 all needing 24/7 nursing care. When people find out I work in a personal care home they often reply, “I sure hope I never end up in one of those”. Surprisingly the chances are that you won’t.

Recently I sat in on a presentation made by David Driedger, CEO of haven Group, an organization in the city of Steinbach that provides a number of levels of senior’s housing for the community. He shared some interesting statistics relevant to our area. About 1 in 10 people over the age of 75 will spend the end of their life in a personal care home. The average age of those admitted to personal care homes presently is 83 and the average time a person lives in a personal care home is 2 years. Now of course those are averages. That means there are younger people as well as older people coming into personal care homes and that some live after admission less than a week and others will live 6-7 years. We all know how averages work.

But what was interesting is that in our area there are 5 different kinds of care given to our older adults, fitted to their need and the supports that they have available to them. I found this very helpful because I have a hard time keeping things straight in my mind when terms like assisted living and supportive housing and elderly person’s housing are being talked about. David Driedger broke these down going from independence living to personal care homes. I think this information will be helpful to many of us who have to think about these matters, either for ourselves or for loved ones. So here goes.

Independence when it comes to housing is well understood by all of us. It means that the individual is responsible for looking after all the needs that they have in regards to living: choosing where they will live, accepting responsibility for things like maintenance taxes and all the things that go with property ownership if that is the choice. As a person ages, many times there are health care needs that arise that can be managed well in the independent living situation. In Manitoba this is done through Home Care, one of the wonder proactive programs provided by Manitoba Health that enable people to manage their health care needs outside of facilities like hospitals. However, as we all know there are times when the needs become greater than the resources that Home Care can provide in the independent living situation. Then decisions must be made.

For many the next decision that is made is to move into Elderly Person’s housing. Many of these complexes are called 55+ but according to David Driedger, the new 55 is 75. Most residents in EPH are 75+. In an EPH a person no longer has to be concerned at all about maintenance, lawn care, snow removal as these are provided by the management of the EPH. Many EPH’s provide congregate meals services once a day (generally the noon meal). The congregate meal program is a fee for service program that allows the elderly person to enjoy eating a good nutritious hot meal in the company of other residents, ensuring that the residents that chose to enroll in the program socialize and interact with others on a regular basis. In many EPHs Home Care has an office and staff in the building and they provided serviced as determined by the Case Coordinator. In our area the EPHs that you may be familiar with are Woodhaven and Fernwood.

Once a person’s needs exceed the support that an EHP is able to provide there is the alternative of assisted living. In assisted living the cost includes  rent and  a service package which generally includes two meals a day (lunch and supper), light housekeeping and a variety of activities. Home Care continues to provide services in Assisted Living facilities as determined by the case Coordinator. This is an option that can be quite pricy and there will always be a sector of the population of elderly persons in a community that cannot afford this option. In Steinbach Bridgepark Manor is an Assisted Living facility.

The levels mentioned thus far do not require that a person be paneled to be admitted to the facility. Paneling sometimes seems like a mysterious thing. The “panel” is a group of members of Southern Health’s/Santé Sud staff from various programs. This panel receives applications for paneling from Home Care Case Coordinators who believe their clients require higher levels of support. The panel meets monthly and the Case Coordinators then defend their applications to the panel and the panel decides whether the application meets the criteria. If the application is rejected, the person is not eligible for supportive housing or personal care home admission. If the application is accepted, the person’s name is added to the waiting list at a supportive housing facility or a personal care home of the person’s choice.

What is supportive housing? In Steinbach this would be Cedarwood, in Grunthal there is Greendale and there may be others in the area. In Supportive living, the operator of the facility provides three meals and snacks daily, housekeeping services, safety and security, as well as some programming. The rates vary from one facility to the other.

The final level of housing and care for elderly persons is the personal care home. Some of these are owned and operated by Southern Health/Santé Sud, others are owned and operated privately and work under a contractual agreement with Southern Health/Santé Sud. The contractual agreement allows for government subsidized care to be provided whether the facility is owned by Southern Health/Santé Sud or not. Personal care homes provide 24/7 nursing care, room board, medications, staffing such as social work, recreation and sometimes spiritual care. Residents pay a per-diem (per day) rate based on their income. Presently the rate starts at $34.00 a day and goes as high as 74.00 a day, depending on the person’s income. No one is ever rejected from personal care because their income is too low. Even people on Employment and Income Assistance or Old Age Security are accepted.

As a person grows older and finds it necessary to move through the various kinds of seniors housing options, rarely does anyone move through each of these options. Some people will go straight from their home to a personal care home. Others will go from their home to Assisted living with no other moves. The point is there are these five different ways that elderly folks are supported as they age and knowing just a bit about them may be helpful for many of us.

The transition depends pretty much on the attitude of each person. Some move smoothly through a number of living arrangements with very little struggle. Others fight every time a change is needed. Maybe what we can do most to prepare ourselves for the possibilities of needing to move from independence into some form of seniors housing is to simply develop an attitude that enables us to embrace change as one of the necessary eventualities of life. I know that is something I am actively working on.