Friday, 22 December 2017

Staying Together

Many years ago, as a new social worker in a large hospital, an elderly couple came in together with two different issues and were admitted to my floor. They had been married well over 60 years and had never spent time apart. The husband had dementia but knew his wife. In the day they found each other but they were in separate rooms and the staff were faced with a problem every night when he would wander the halls and climb into bed with other female patients. We realized that he was looking for his wife at bedtime. I began to advocate to allow them to share a room and was faced with opposition as this was not something the hospital had ever done or entertained. Unfortunately, they each had different medical issues and could not return home.
I was reminded of this story this week when I read of the New Brunswick couple, separated after 69 years of marriage because his dementia had worsened and he was deemed to need a level of care not offered in the home he and his wife lived in. 
My story had a bittersweet ending - after many calls and much advocacy, I found a place that would take our couple on the same day. They would be in different areas of the residence but staff would do their best to bring them together as often as possible so they could visit. Not ideal but at least an understanding that for whatever time they had left, they needed to be together as much as possible. 
For the New Brunswick couple, this understanding was clearly not there. Separated this week, the family resorted to calling the press to share their story. 
I am sad that this many years later, with more couples aging together, we don't have a proper mechanism in place to ensure that at this last stage of their lives, they remain under the same roof regardless of differing care needs. As our health care system continues to evolve, this is definitely something that should be added to the list of 'must haves'. We need to find ways to allow couples at different levels of care to stay together and live out the remainder of their days in each other's company. 

Friday, 8 December 2017

Hiring Help

For most people 'there is no place like home' and so, for many who have difficulty managing at home, prior to considering relocation, they consider/investigate hiring extra help in the home. For some, adequate help can be found through their local LHIN where costs are covered by OHIP. For others, if funds permit and the care available through the LHIN is not enough for them to feel safe, they investigate hiring through a private agency. As with any private care service for a vulnerable population, one is wise to do their homework prior to hiring anyone. Senior care is the new up and coming field with many new companies who may or may not have adequate training and experience. One needs to ensure that whomever they hire is reliable, trustworthy and able to provide exactly what they promise. As with any private service it is always best to contact more than one company and interview both the agency and the care providers before they begin working for you. It would be best if you have a written list of questions to ask each company/provider prior to speaking with them. As well, ask to see a copy of the client contract in advance and ask if they can provide references.
Some suggested questions to consider when interviewing an agency to purchase services from include:
• How long have they been in business?
• What sort of memberships/licenses/accreditation do they have?
• What qualifications do employees have?
• Do they do background/criminal checks and reference checks for all new staff?
• Are staff trained to manage cognitive impairment, behavioral issues, vision issues and hearing issues?
• How do they monitor their staff & track hours?
• Are there surprise visits by a supervisor?
• Are staff licensed, insured and bonded?
• Will the same staff person visit your loved one every time or will there be different people providing service?
• What is the cost of services required?
• Is there a minimum number of hours required for a client to commit to?
• How often do they increase fees & how much notice do they give you before an increase?
• Are staff protected by the Workplace Safety and Insurance Board (WSIB)?
• What is the procedure if a caregiver is sick?
If there are specific needs your loved one has, do include that in your list of questions as well as anything else you think is important to know when you hire someone to provide care.