In August 2018 Barry Howie was admitted to Oakville Trafalgar hospital. By December, he had completed his rehabilitation but was still awaiting an assessment from Community Care Access Centres (CCAC) for admission to a long-term care (LTC) facility. That’s when his family was told that Barry had to vacate his hospital bed.
The family had wanted to move Barry into Post Inn Village. The not-for-profit LTC home is run by Halton Region. But without a CCAC assessment Barry could not move forward with the transition.
The family was told by hospital administration that there was an opening at Sunrise Retirement Home in Oakville. Revera Retirement Living owns a 65 per cent share of the for-profit facility.
There are a number of differences between LTC homes and retirement residences. Elders living in retirement residences tend to be more independent and can choose when they want to move into one of these facilities – no need for a referral from a doctor or CCAC.
Residents pay a set monthly fee for their unit and meals. Additional needs like administering medication, having your wheelchair pushed to the dining room, or your toe nails trimmed cost extra.
Long-term homes require a referral from a doctor or the CCAC, residents receive supervised care, and the individual pays part of the total cost while the rest is covered by the government.
For Barry, living at Sunrise meant paying $7,500 per month for a single room with meals plus ancillary fees for administering medications, bathing, and pushing his wheelchair to meals and activities.
His wife Mary Jane Howie told rabble.ca that the dining hall and all activities were located on the first floor. That meant Barry needed help to get from his third-floor room to the main floor several times a day.
Barry received his CCAC assessment the day he settled into Sunrise. A critical designation from CCAC, and the fact that Mary Jane listed only one LTC choice – Post Village Inn – meant Barry moved to the regional facility after only seven weeks.
Barry began paying $2,600 per month with no additional costs.
Older adults, including those in residences and LTC homes are at increased risk of experiencing social isolation and loneliness. The consequences of social isolation and loneliness are significant impacting dementia, physical and mental health.
While LTC and retirement facilities may be very nice, residents like Barry need opportunities to make friends and connections to avoid becoming bored.
Social events and programs may not be enough to prevent chronic loneliness. Research highlights the importance of creating connections to the larger community outside of these homes.
Barb Johns is one of Barry and Mary Jane’s four children. Both Barb and Mary Jane are Barry’s essential care givers. Barb agreed to speak with rabble.ca about the programming that was available for Barry at both facilities.
Barb found that there was more programming at Sunrise, but did emphasize that Post Inn Village does have great programming that Barry is able and willing to participate in.
According to Barb, “COVID threw everything off for everyone, but there was a disgusting lack of interaction available.”
Post Inn Village had no internet in the building and it was 18 months into the pandemic before it was installed. That meant family members had absolutely no access or interaction with Barry during lock downs.
The regional LTC facility had not outfitted residents’ rooms with phone jacks. That meant, the only way to reach Barry was to call the regional offices where reception would redirect the call to the Post Inn Village receptionist. The call was then redirected internally to the nursing station on Barry’s floor.
On weekends when the regional offices are closed there is no way to reach the LTC facility by phone unless you know the extension for the nursing station. Barb and Mary Jane know that extension, although other family members do not. However, if the nurse is away from the station no one answers the phone.
“Every time his floor got shut down because of an outbreak, or every time he got a sniffle and was in isolation, there was literally no contact that we could have with him which was just unacceptable,” shared Barb. “I think the decline was worse than it would have been had we been able to be there.”
When a senior with dementia and memory related issues goes for extended periods of time without any kind of interaction, the decline can be steep. COVID-19 meant up to six weeks at a time with no visitors due to self-isolating issues.
Barb did buy a cell phone for Barry but his dementia has him searching for a landline whenever he hears the ring tone. So, again, calls from the outside are often missed.
Post Inn Village finally purchased tablets once they got internet. But things did not really improve because there’s only one to two tablets per floor for roughly 100 elders.
That made scheduling face time virtually impossible. Barb was only able to use the tablet four times in six months.
Barb now uses her own phone and tablet to let Barry visit with his other kids, grandchildren, and great-grand child.
“COVID created huge challenges and maybe the [Post Inn Village] communication piece was low priority while they were struggling to get personal protection equipment and enough staff,” said Barb. “But the reality is there is dedicated staff who are the social program staff and they are excellent!”
Before COVID-19, Post Inn Village had social hours on Wednesday and Sunday afternoons. The main lobby area has a bar for residents and guests to have a glass of wine, beer or pop. People would sit around and chat. The social hours are not up and running again.
Without those central gathering spaces there was only so much the social programmers could do with residents secluded in their rooms.
Pre-COVID-19, Sunrise had trips to the mall or and indoor greenhouse using the Sunrise mini-bus. At night there was always the choice between a movie or some other activity. For a better idea check out A Day in the Life of Dorothy.
Post Inn Village has no field trips, not quite as much variety or as many options, and absolutely no programming on the weekend. Barb insists this is a resource issue and not a reflection of the staff’s abilities.
Barry’s floor has an exceptional social planner, Dana, who provides programming for about 100 residents.
Dana has even taken the time to phone Barb to see if Mary Jane was alright. Turns out, Barry told Dana that his wife hadn’t visited for a few days. What Barry forgot was that Mary Jane had been visiting and leaving before Dana’s shift started.
A friend of Barb’s moved her mother into Sunrise some years ago. The friend was under the assumption that her mother had two years left to live. Instead, the mother lived for over seven years.
The family home was sold for $1 million dollars to cover expenses at Sunrise which included $220 to $300 per month in ancillary costs. When that money was gone, Barb’s friend took out a mortgage on her own home to keep her mom at Sunrise until she passed away.
Barb believes, “Privately run retirement homes should be forced by the government to have ten per cent of their capacity dedicated to region-qualified patients.”
She also thinks there should be more social interaction, intellectual stimulation, and time spent outdoors. To that end, Barb and Mary Jane now play bridge with the residents each week.
Jean-Francois Pinsonnault, author of Aging Safely in the Home of Your Choice, finds the programing in these facilities too standard and lacking variation, new people and voices.
He points out that women do much better after retirement because they traditionally assume many roles and are usually the social programmers for their own families.
But even though women do better in retirement, Pinsonnault points out, “Seniors’ residences, and even long-term care, the majority of them are for-profit. People buy shares and are making money off of other peoples’ misery.”
This article first appeared on Small Change.
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