Let me reiterate by saying that I am a resident of RK MacDonald Nursing Home, in Antigonish, Nova Scotia, Canada. The home has approximately 136 residents. Let’s just say that nobody wants to live in a hospital type of environment but since I have no choice I might as well make the best of it, at least until I win four million in the lottery. The four million will cover private home care! I am lucky to have a private room in the new section of the home, which, though small, when you have a big wheelchair, will be cute when I decorate it.
We have a great group of occupational and recreational therapists offering everything from physical therapy to organizing events like making cookies, singing, art and more. I can’t imagine anything that I would need that any one of them would not be happy to do for me with a smile. The staff always have the home very nicely decorated, seasonally, as well. Another very important item to mention is that administrative staff, as busy as they are, are always willing to hear our concerns.
Generally speaking, I think that there are far less people in the home with good cognitive ability, as most residents have varying degrees of dementia. I enjoy speaking with everybody, and I appreciate that it sometimes takes me a bit of time to know which category somebody falls under.
Since I moved to the RK we have enjoyed excellent nursing service from two registered nurses who split the 12 hour day shifts. In addition to excellent nursing care, they provided continuity which is vital to long term care. They knew each resident inside and out. When the doctors arrived, these women facilitated each doctor visit, giving the various doctors a short rundown of the patients well-being since their last visit and would also bring up medical issues that the patient forgot to mention. This was a recipe for success and so valuable.
But somebody or something screwed this up. Within the past year, everything flopped. This is, truly, the very strong opinion of many people! I have not been able to figure it out or see anything positive come out of the changing shifts and administrative staff, and I’ve tried very hard. I do know there are less RN’s and more LPN’s and casuals. Most importantly, for me, is that since i have such a large range of medical issues, I miss the support that the two former day-shift nurses provided at doctor visits, because this support doesn’t and cannot exist now because there are too many different nurses involved.
Please understand that these casuals are great nurses and wonderful people. This situation is not their fault but residents have expressed concerns to me about things like getting medications 2-3 hours late on occasions and also I have had 3 prescriptions lost/misplaced or never found. I have, a couple of times, after staff have left my room, called them back to tell them they forgot my insulin. I had a casual nurse tell me I told her that I was at the mall and up on James Street by myself, but she thought I was just confused. Within a few days she saw me at the mall. Another casual told me that it was too bad that I wasted six years of my life. “Hello? Did I have a choice to have brain damage etc?”
It’s very difficult to build patient knowledge, good care and continuity among this disorder. Today I asked two different nurses to tell me which antihistamine I was put on three weeks ago. Neither could find this record, but I knew it was there someplace. But the nurse on today, who worked our day shifts before things fell apart, quickly found the order and called my family doctor immediately. I plan to meet with our CEO shortly to get some answers.
The housekeeping staff here are amazing and some have become my friends. They do a lot more than clean and will often take a minute to cheer you up on a bad day. I look forward to seeing them.
I made a very conscious decision to write about the RK from the totally personal view of a resident, before speaking to administration. Later I will write from an informed administrative point of view, as I know they will want to address some of my concerns. I thoroughly hope the nursing schedule/staff changes were a government decision and not an in-house one because my guess is that it’s not about to change. Please note that I’ve been asked by RK administration not to mention any staff names, and I agreed. But it does make me a little sad not to be able to acknowledge those who go the extra mile to do a great job. What really makes me, giggle though, is that this old, half dead woman, is still too professional not to do what they requested!
Also, hindsight is 20/20, and I realized that I should have gone to administration earlier with some of my concerns, but I really didn’t because I didn’t have any time. Sounds weird though because until July all I really had was time. I only got my brain working in July, after bouts of Tonic Clonic seizures (blog # 1). In August I helped plan our daughters wedding and in September, my father died.Then in October I got a new iPad that I had great difficulties using, and still do. Without a thought and not having read or typed a word in almost 6 years, I found myself writing like a crazy. I think this might have been enough reasons for not making it to administration with my concerns. So I accept some blame here.
I am very upset about the pharmacy arrangement that the RK has set up with a local drugstore. At this time I will not name the drugstore, I will give three months to do better. Here is how it works: I think this drugstore pays the home for a monopolistic arrangement whereby all residents must have all of their prescriptions filled only by this drugstore. This is profitable for the nursing home as well as the drugstore, as they have no competition. My issue is that residents get very poor service. Since July I have waited a full week for two different prescriptions. Prescriptions that were ordered for me on Friday morning have not arrived yet and today is Monday. This seems a bit ridiculous, since these are common drugs like prednisone, for example, or a skin cream. This lack of service has cost me additional pain and discomfort, which I do not need. I am going to ask the RK to request 24 hour standard delivery time.
Resident’s general needs in the home are taken care of by CCA’s (Continuing Care Assistants). Formerly known as Personal Care Workers, these people have a very tough and sometimes thankless job, worked in 12 hour shifts. They do our bathing, wash our hair, dress us, change diapers, which I call pampers (they call them ”systems” but I expect nobody would know what I was talking abou) they bring our meal trays, feed some people, cut food for others, wash dishes and clean our ward kitchen, pick up things we drop, open windows, change our beds daily, wash our clothes, get us drinks, take temperatures and blood pressures, weigh us etc. They are, on the whole, amazing. I would never have had the physical ability to do what they do in a shift.
Before my stroke I had many nightmares about my white, perfectly straight, cavity free teeth falling out, and about 3 years ago they did, probably due to prescription drug reactions. In addition to this I am unable to wear false teeth, then I lost 95% of my taste buds, followed by losing 90% of my sense of smell. One of my favourite joys in life was food, and all this was nearly my undoing, once again. The food at the nursing home isn’t great, but, I hope, getting better. One of the contributing factors for this is, that we have good cooks, but no professional chef to lead.
I freely admit that I was very fussy. For years my wonderful husband sustained/supplemented my need for what I liked/could eat, by arriving with takeout treats from my favourite restaurants.
One day a nice lady arrived, knocking on my door, introducing herself as the Director of Food Services at the RK. She said that her job was to design a menu specific to my needs. Since I had all the above problems and only one hand to eat with, I think she has her hands full. I feel that she, and the kitchen staff are working very hard for me and will soon get their gold stars for success. Tonight I really enjoyed a nice supper of whipped potatoes and a bowl of sweet and sour chicken with everything cut very finely. I have come to love her as a sister for her sweetness, patience and perseverance with my dietary issues.
I have just been told by one of my favourite nurses here that at least 50% of residents living at this home are lonesome. I was already writing on the topic when I asked the question, but the high percentage was very unexpected and caused me to think about this more. We live in this beautiful small town and my thought was that we all take care of our own in this town. My definition of “our own” is family, friends, or neighbours, people on our street, “town characters,” somebody you heard about that was in trouble, giving monetary donations to a family trying to overcome a catastrophic disease like cancer etc. But for some very important reasons I think we have “dropped the ball a bit” perhaps by necessity.
I believe that societal changes have caused most of the issues for isolated seniors, whether they live in a nursing home or alone in their own home. If you need nursing home care and there are no empty beds in your community, you will be placed in a home within a hundred kilometres of your community, where/when a room is available. Although I don’t like this ruling, I see it as a viable political/financial decision for many reasons.
Not too many years ago, we would find many family members all living in the same community maybe even the same house, supporting and caring for each other. Another factor would be that with both family partners working in order to financially survive, they are most likely not able to care for their parents or other senior family members, they may also not have the time or energy to even visit often. Mostly due to economic conditions again, many families are scattered around the globe. This only allows family members, if they can afford it, to visit their loved one maybe once a year. Older residents may have outlived their family or maybe never had children.The result is that for these and many other reasons a lot of seniors get minimal or no family visits and are very lonely. Nothing I have written on this subject is new to you, I’m sure. But my hope is that seeing it all together in one paragraph might provoke you to think about this and find the kindness in your heart to devote one hour a week to visit and chat with someone in need. If you are a little nervous about your first visit, come and chat with me and I will take you on a tour and meet a new friend. I have already decided that my winter project will be to make two new senior resident friends.
The RK’s budget was cut by 1% last year. This may not seem like much to you, but to the home, it’s a good chunk. The home seems understaffed.The nurses and CCA’s are very overworked, in my opinion. My biggest issue with their being overworked (and stressed) is that, because they are so busy it can take them about 30 – 60 minutes to get me back in bed from my chair, although I do see marked improvement lately for some reason. This moving process takes about 5 minutes. The issue is not that I am impatient, but that I have a lot of stroke, muscle, arthritic pain, and exhaustion most of the time I am in my wheelchair. Once I am back in bed my pain will slowly almost disappear because I’m able to move around a bit.
I have never once been allowed outside after supper, to enjoy an hour of summer evening beauty and to smell the wonderful gardens here at the home because there is no staff-time available, I am told. I am also unable to attend many events in the home for the same reasons. I am penalized because I need a wheelchair! If I could walk I could attend bingo, art etc. and get back in bed when I am tired and in pain. This all makes me more sad than cranky. We need to fight for sufficient funding for senior homes now, or it will be far worse for those ending up here in the future. Who are those very intelligent and resourceful people who organized Antigonish Community Transit? Again, we need your services desperately. Can we get something going in fundraising for this inadequately funded home? Anyone have any funding ideas, please let me know. I will be more than happy to help as well! Maybe we could look at substantially increasing the funds we raise from our yearly December ”Lights of Love” campaign?
I appreciate that I am lucky to live in my own community, in probably one of the better nursing homes in the province. Thank you to all the people working here who care enough to take the extra little step to make make our days are little nicer.