January 30, 2012

Once again, over the last few days, the conditions reserved for the elderly with loss of autonomy have hit the headlines twice. Two new examples of the direct consequences of the dehumanization of care caused by the State’s unloading of its responsibilities for a group of citizens who are among the most disadvantaged.

The first case concerns the publication of a report from the Ombudsperson on the events that contributed to the premature death of eighteen elderly people at the Centre multivocationnel Claude-David. A disaster bound to happen, and which could have been, and should have been avoided.

The next day, it was a private residence for the elderly which had operated illegally for a year. And directly under the nose of the agence de la santé de Montréal. Once again, to no one’s surprise. The rules and the resources governing the certification process of private residences for the elderly are clearly insufficient for ensuring the safety and adequate living conditions for those who live there.

If, tomorrow morning, another viaduct would collapse, resulting in the death of ten people, all of Quebec, including the political class, would be outraged, mobilized and demand immediate action, and with good reason.

If more people knew what the daily lives of these elderly people were like, maybe things would change more quickly…

An elderly person whose state of health requires a presence and care which can no longer be provided at home finds herself in a CHSLD or in a private intermediate resource facility, without having chosen it, and, with a few exceptions, without the hope of one day returning to her home. From one day to the next, it is expected that she get used to a strange environment and that she open up to people that she has never met before. She has to adapt to the system.

Staff for whom time is of the essence and acts must take place at an accelerated pace in rapid succession, concentrate on what is essential. No time for a patient who is lonely and who is looking for someone to talk to for a few minutes. No time either to help another patient dress herself because, despite the desire to help, it would take too long. She must be dressed quickly, performance requires…

And if, by chance, the administration considers that a care unit is under performing, cuts are made to the staff in order to attain the cost-reduction target. A target that is not set by the nursing administration, in theory responsible for the quality of the care delivered. Instead, efforts are made, by whatever means, so that the care delivered corresponds to the resources determined according to the numbers written on an Excel spreadsheet.

This unloading of responsibilities for our elderly is a matter resolved by contract, a good deal, at a good price for the Ministry of Health and Social Services.

But sooner or later, someone has to agree to look at things as they stand now. The MSSS cannot continue to herd the elderly into care or residential environments which cannot or do not want to take care of them in all respects, with the attention and humanity to which they are entitled. The MSSS cannot expect the healthcare professionals to treat human beings as common mechanical parts on an assembly line.

The healthcare professionals, who have made the choice to practice with the elderly love their work, but realize that the profession is more and more difficult to practice under these conditions. They cannot, nor do they want to, close their eyes: their patients can live a better life.

In the mean time, licensed practical nurses, nurses and respiratory therapists are doing the impossible with what they are given in order to keep a human side to a system which has less and less of one.

Things must change, and quickly.