Sherisse Tucker thinks problems are caused by a lack of workers in facilities
Concerning Care is a series on CBC that looks more closely at home and respite care in Newfoundland and Labrador, which has the oldest population in Canada. It talks about a lack of workers, the emotional and financial costs of family members taking care of other family members, and problems home-care workers face.
Frank Tucker’s life has changed in many ways.
One is that his favorite candy bar is a Wunderbar. The other is that Sherisse Tucker, his daughter, loves him.
Sitting on a black leather couch in her parents’ living room in Mount Pearl in late February, she thinks back to when things were easier.
She said, “My dad is the most funny person you’d ever want to meet.” “He is amusing. He is kind. His life was all about his family.”
Frank’s life was turned upside down when, at age 61, he was told he had Alzheimer’s.
Medication slowed down the disease for five years, but then Frank had trouble finding reliable home care and kept running away. In October 2021, they had to move into long-term care.
His family reluctantly hoped that his new home in St. John’s, Pleasant View Towers, would be the safest place for him.
Now, after more than a year, Tucker thinks that her mother’s death on January 30 from Hodgkin’s lymphoma was caused in part by her constant worry about Frank’s care there.
Tucker said, “It’s ruined our family completely.”
“It was a lot. She wasn’t worried about how she felt. She didn’t feel well, and all she could think about was Dad. So, she didn’t do anything about it until it was too late.”
Karen, Frank’s wife of 47 years, his daughters, and other family members made sure he was stimulated, entertained, and rarely alone from the moment he was admitted.
But in July 2022, Frank signed a contract with COVID-19 and changed.
“He was always nice. And he just got mean, ” said Tucker. “His actions would get worse. And things would get worse until he might push someone or get in their face and yell at them.”
Tucker says that the staff started putting Frank to sleep and relied more and more on his family to calm him down.
She said, “It got to the point where they called us every single day.””When we got there, it was easy to calm him down most of the time. It was a lot of trouble.”
A lot of the time, giving Frank his favorite treat worked.
Tucker said that some staff members were able to use the family’s advice about how to deal with Frank (“you pull out a Wunderbar”), but others were not. She thinks that there is a “huge gap in communication” between the floor staff and the management.
More and more problems started to come up with sedation. Tucker and her sister would sometimes help Frank by giving him the shot until they were told to stop. Sometimes, there was no one on staff who knew how to calm or restrain a person.
In the end, police and paramedics were called to help calm down Frank, who was upset, and he was taken to the Health Sciences Centre. There, Tucker had to wait eight hours before she could see her father.
Tucker said, “They didn’t have the staff to deal with him.” “So they kind of threw their hands up in the air and said, ‘You know what? This is the decision we’re going to make.'”
Tucker said that it was later found that Frank’s behavior was caused by a psychosis brought on by COVID. The medicine was changed, but the calls to the family kept coming. So, in December, Tucker told Eastern Health what was going on.
“They called us and said, “Well, we can’t find his shoe” or “He needs to be changed, but he won’t get changed.” I mean, that’s what the family, the government, and the province are paying for, ” said Tucker.
“That’s the most important thing for us: they made us feel like we had to take care of everything.”
At a meeting with facility and unit managers, as well as the recreational therapist, promises were made to make changes and questions about sedation were answered. Tucker was told that nurses are trained to give injections, but not to restrain, and that security is only there on weekdays to help.
For Tucker, it all comes down to staffing issues. She said that 30 to 35 people on her father’s unit are cared for by six people.
“Patients who are trying to get away, who can’t go to the bathroom on their own, or who need help trying to eat. There aren’t enough people there, ” said Tucker. “It’s clear that the workers are tired.”
She said that having a lot of part-time staff isn’t good for Alzheimer’s patients who need consistency. It also means that they haven’t seen how residents act before.
She also said that Frank’s unit’s recreation program “doesn’t work.” Instead, the radio or TV is turned on in the dining hall.
Tucker said, “All he does all day is sit in a chair and have nothing to do.”
Yvette Coffey, president of the Registered Nurses’ Union, said that it’s hard to do that when you’re taking care of anywhere from 40 to 110 people at once on several different units.
“Because of the critical lack of staff, we’ve had some nurses cover more than 110 at times,” she said.
You can’t open the beds if you don’t have the staff
The most recent numbers that the union has seen show that more than 240 long-term care beds in the province are closed. Two new facilities in the central health region and one in the western health region can’t open to their full capacity, and one in Gander isn’t taking any new patients.
Coffey said that the government is aware of these problems, but there needs to be a long-term plan to keep workers.
She said, “We will never be able to open up all those long-term care beds if we don’t keep every single nurse we have in long-term care.”
On March 27, Health Minister Tom Osborne said that if this goal was met, staff could get bonuses of up to $3,000 and new staff could get up to $8,000. The provincial Dementia Care Action Plan, which came out Thursday, also wants to help health care workers learn more about dementia.
Eastern Health turned down CBC News’s request for an interview, but they did answer a list of questions sent by email.
The facility has a total of 460 beds, but Eastern Health says that only 404 are open right now. There are 481 nurses working in the facility. Judy O’Keefe, vice president of clinical services at Eastern Health, said recently that there are about 150 open positions at the facility.
Even though the ratio of staff to residents depends on many things, the statement says that Eastern Health tries to have a full staff working every day.
“For example, on average, for the week of March 1–7, 2023, about 31% of RNs and about 47% of LPNs and PCAs who worked daily shifts at [Pleasant View Towers] were casual (or temporary call-in for NAPE) employees.”
Even though there were staffing problems before the pandemic, NAPE president Jerry Earle said that fewer graduates, retirements, job changes, and burnout are likely to have made things worse.
“I don’t think there’s a long-term care facility that isn’t affected,” he said, adding that the College of the North Atlantic’s efforts to increase the number of seats in its LPN and PCA programs will take time to show results.
NAPE represents about 4,000 LPNs and PCAs, of which about 75% work in long-term care.
Earle hopes that the government’s review of long-term care homes will include a new look at the ratio of staff to residents.
Earle said, “Because of the level of care and the complexity of care, their staffing ratios, which were set more than a decade ago, just don’t meet the needs of residents today.”
“Staff feel like they go into a room, take care of what needs to be taken care of, and then leave the room.”
‘It’s just not there
Sherisse Tucker wants more for her father and the other people who live there.
“He has nothing to live for. It’s wrong, ” said Tucker.
“People have an idea of what long-term care is like, and they think of personal care homes with all kinds of activities and stuff, but that’s just not the case…. If you don’t check on a loved one in long-term care, they might not be getting what they need.”
Concerning Care tells the stories of these and other people on a number of different platforms, such as Here & Now, CBC Newfoundland’s website, and the radio.
If you have a story to tell, you can get in touch with us at[email protected].
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