Meet three residents living in Ontario’s long-term care homes.
Meet three residents living in Ontario’s long-term care homes.
These stories, while composites created through consultations, highlight the range of individual needs and preferences – personal, clinical, emotion, social, spiritual and cultural – of those in long-term care.
Their stories also show how long-term care homes and their staff teams struggle against systemic challenges to focus on residents, their needs, and their preferences.
Yu-Mei is 91 and has always believed she needs to remain as active as possible. Yet a recent fall in her family home sent her to hospital, causing her family to realize that her needs were beyond their abilities. Her fall and hospital stay also revealed that Yu-Mei’s dementia was more progressed than they had realized.
When Yu-Mei moved into a long-term care home in Scarborough, the family shared their concerns with the staff about her growing loss of vitality. They felt that Yu-Mei needed to regain her failing strength and mental abilities through activity and good nutrition.
A nutritional assessment by the home’s registered dietitian confirmed that Yu-Mei needed to increase her daily calorie intake.
The home then worked to learn more about Yu-Mei’s lived experience. Through discussions with her and her family, the care team learned about the family’s immigrant experience – at a time when anti-Asian prejudice meant many employment opportunities were not available. Yu-Mei and her husband instead opened a restaurant to give them their start in their new country.
The care team learned that food preparation skills and activities were important to Yu-Mei, so they encouraged her to join the home’s daily meal preparation. By helping her to focus on familiar skills and memories, Yu-Mei became interested in meals, resulting in her appetite improving and her vitality increasing, despite her frailty and advancing dementia.
Empowering long-term care homes to provide care that is responsive to individual preferences, needs, and values is what resident-focused care is all about – and what is generating positive outcomes for Yu-Mei.
Barry suffered a severe stroke at 73 and moved into a long-term care home after waiting in hospital for 18 months. His stroke was too severe for rehabilitation and after his prolonged hospital stay, Barry found he was living with further deconditioning.
Barry was an educator in his rural community, and was one of the longest-serving principals at his local school board. He shared his love of the outdoors with his students, friends, and family and until his sudden stroke, spent his retirement hiking, fishing, and hunting. The stroke left him paralyzed on the right side, easy to tire, often confused, and increasingly depressed – which was devastating to him and his family.
Barry requires a lot of care from his long-term care team to help restore him to a more stable state. For example, to help support his mental health, the home’s recreation therapist has set up virtual sessions to bring the outdoors in and to re-connect Barry to his love of nature.
Barry and his family say they appreciate not only the medical and nursing care that Barry receives to address his physical needs, but the emotional and social care he receives too. They share how grateful they are with the home’s staff quickly recognizing his love of nature and finding ways he could still embrace the outdoors and experience joy. They say this personal connection has made the world of difference to Barry.
More people are coming to long-term care with higher acuity needs. While long-term care teams are experts in caring for people, they require multi-disciplinary staffing models – like the one that Barry is experiencing – to deliver high-quality, responsive care.
Jocelyn is Franco-Ontarienne and communicates best in French, her first language. Her diabetes has progressed to the point where she is dependent on dialysis, and she relied heavily on her eldest son and caregiver to help navigate her health care needs. When he passed away last year, Jocelyn began to feel isolated. She found it increasingly hard to travel three times a week to and from the hospital for dialysis, and she often could not find the support she needed.
Since moving into a long-term care home, which is part of the province’s renal network, Jocelyn can receive dialysis at the home. The care team has helped Jocelyn manage her diabetes, but she still struggles with isolation as most staff at the home do not speak French.
Jocelyn has poor sight due to diabetes and can no longer read her beloved detective novels on her own. Her joy of “crime-solving” through books is only possible when someone can sit and read with her in French. But, it is a challenge for staff to find the time to read with Jocelyn.
Her long-term care home is in community near Windsor that has significant staffing vacancies for reasons that are systemic across the long-term care sector – including significant health human resource shortages across the health sector and long-term care staff finding more attractive pay in hospitals.
Jocelyn’s home is working hard to recruit new staff – especially bilingual staff – and is trying avenues such as reaching out to local colleges to explore student placement opportunities. In the meantime, the home has found a local French community group who volunteer their time to read with Jocelyn and the other residents in the home who speak French.
More comprehensive health human resource solutions in long-term care homes are vitally needed so that residents like Jocelyn not only get the care they need that meets their cultural needs, but also continue to experience the things that give them joy.