On TV, in the news, on Facebook and Twitter – those poignant scenes of families blowing kisses through windows, glimpses of a frail silhouette, horror stories of multiple illness and death in long-term care homes all over the country. Politicians, and even doctors, boldly stated, ‘if you have family in long-term care, get them out!’ Who could resist this heartbreaking appeal?
Before making this emotional decision, please take a minute to read further…
Care Needs of a Long-term Care Resident
Your dad was admitted to long-term care after a careful application and vetting process, and probably inched his way up a crowded waiting list. In the application, his care needs were documented, such as assistance with activities of daily living, or ADLs; bathing, toileting, dressing, getting around by rollator or wheelchair, and for cognitive issues such as memory loss or behavioural issues caused by neurological conditions like dementia.
Chronic conditions like Parkinson’s Disease, arthritis, diabetes, hypertension or COPD would have also been noted. All of these conditions would have been the basis for the Plan of Care created for your dad when he was admitted, the basis for all care routines and medication delivered to him.
Both physical and cognitive issues would have been addressed in the Plan of Care and enlisted services such as physiotherapy, occupational therapy, social work, geriatricians, respirologists and many other specialty services, all ordered and managed by the home and subsidized by the provincial ministry of health. The staff doctor would be available once a week, registered staff during the day and personal support workers 24/7.
Social needs such as shared meals, scheduled and informal activities, religious services and visits by family and friends would all be accommodated through the nursing home.
Various assistive devices may have been part of his care routine. A cane, walker, rollator or wheelchair for ambulation; a shower bench or hoist for the shower, a raised toilet seat or commode for the bathroom.
Medication requirements, including the prescribing, type, dosage, timing, route and combination of all medications, would have been managed as per the law, by registered staff. The home would be able to order and safely secure the medication for all its residents.
Who will Care?
Looking at this list, who is qualified in your home to provide this array of care and services?
Family will be wanting to provide as much care as possible, but be realistic. Your dad was in the home because he needed full care, so care will have to be dedicated and may require more hours and effort than you realized. You can’t do it alone!
Caregiving is a science; special techniques are required to safely move, wash and transfer bodies from bed to a wheelchair. Additional care can be provided by a personal support worker (PSW), hired privately or through an agency at $25-$30/hour. Other special services may be provided by the local community health authority, however the allotted time will be limited; if hired privately, these services can easily be $100+/hour.
There are several longer-term ramifications of this decision:
– When the pandemic eases and you go back to work, who will provide care? Who fund that care?
– When you left the home, your dad’s bed would have been re-assigned, and he is no longer the staff doctor’s patient
– In order to re-enter a nursing home, he must complete the long-term care application process. He’ll have to join waiting lists – which will be at an all-time high – all over again
Back to the nursing home?
How will you all wait out the waiting list this time? The nursing home monthly cost of $2,500 or so could be $6,000 in a retirement home, assuming they have space and can accept his level of care. Additional private care may be required.
Alternatives to Bringing Dad Home
Even if a home is in lockdown, private professional caregivers are allowed – it’s part of the Resident Bill of Rights. Consider hiring 1-on-1 care for part of the day, ideally in the morning to get him ready for his day, have some activation, lunch and be settled for the afternoon. The regular staff can help him for the remainder of the day.
Assess what the shortfalls really are and address them specifically. Is it ADL’s?- hire a PSW. Is it emotional?- set up a telephone or Facetime roster and mail him cards and letters. Are there cognitive issues? Perhaps they’re from isolation, so the 1-on-1 care can help here too.
I hope these ideas will help you think through a successful decision. Good luck!