Another Point of View

As I got on the elevator to go back to the main floor, I realized a resident somehow wandered herself to the elevator, sitting in a wheelchair and holding tight to the handrail inside the elevator.  She couldn’t communicate verbally anymore but she was in some distress. She wanted to go down to the main floor.

“Jane, we want you to come out”, said one personal support worker caring for her.

Jane ignored the request. In fact, she was determined to go back to the main floor. Earlier in the day, her family came for a visit. But they have left. She might have thought they were still on the main floor. She wanted to go downstair.

Another personal support worker approached to try rolling her wheelchair out. But Jane held on so tightly that no one could move her.  Finally after few lame attempts, Brenda – the nurse came to the rescue.  Brenda knew Jane well. You could tell she was good to Jane. Jane’s face glowed for a minute when she saw Brenda.

“Jane, what seems to be the problem?”, asked Brenda.

Jane couldn’t tell Brenda verbally but her gesture suggested she wanted to go downstair.  Tears started coming out of her eyes. Brenda reached out to give her a big hug.  Jane felt better but she still wanted to go downstair.

“Jane, there is nothing downstair now. Your family is gone.”, Brenda tried to explain.

There was a total of four staff members, hovering around the elevator hoping to convince Jane to come out. This was around 5 o’clock when everyone was busy trying to set up for supper, medication administration and transferring residents to the dining room. They all had tasks to complete, jobs to do and many other responsibilities to attain to. Their schedule did not make time to deal with this crisis. But they did not rush Jane.  They did not ignore Jane. They did not impatiently push Jane off the elevator.

Finally, an activity coordinator said she would take Jane down for a walk.

The staff members treated Jane with love, dignity, respect and compassion.  But they would not be judged by how well they treated Jane. Instead, they would be assessed whether they have completed all the tasks assigned to them, such as bathing x number of residents, feeding x number of residents, administering meds to x number of residents. They would be measured if they have completed all required documentation and charting. They would be evaluated if they have made any errors or incidents that might become part of the performance review.

In fact if you read some of the inspection reports of this nursing home, it may include a complaint of resident neglect or abuse, critical incident of a resident falling resulting in fractures, or an inspection report detailing how wrong the home was to request family to pay for a fall prevention medical device.

These inspection reports are out of touch with reality.

Many long term care facilities are doing their best with the limited funding provided by the government. Many of them are struggling to ensure there is adequate staffing not to compromise on resident care.  Day after day, they have dedicated individual calling to ensure all work shifts are filled, to address any unexpected sick leave or emergencies, so that their residents can receive the daily care that they deserve.

No, they are not perfect. There is always room for improvement on communication, efficiency of services, education and many other areas.   But it seems no one recognizes the hard work they do everyday, especially to those front line workers who care for the residents, not to mention that they also get abused daily from residents with dementia, either from physical aggression to verbal intimidation.

Recently, there has been so much news coverage on the retired nurse working in a nursing home in Woodstock, who has allegedly murdered 7 residents while working there as a registered nurse. The public is outraged how this could happen, how our system fails to ensure we provide seniors and elderly a safe place to live.

I am outraged too. But this is not a fault of the home.  And we should not generalize to think all nursing homes provide poor care to residents. In fact, many facilities try very hard everyday. Their efforts seem to go unnoticed, yet the inspector reports detailing how they have failed to comply with Section XYZ will be made publicly available on the internet, shaming these homes every day.

It’s time to pay attention to all the good things individuals provide at the nursing homes. It’s time to recognize all the individuals who do excellent work around residents with dementia. It’s time to appreciate all the interventions that have been implemented to prevent a fall, to avoid a crisis and to ensure each resident has a peaceful day at the nursing home.

It’s time for another point of view.  


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My name is Cynthia Leung and I am a practicing pharmacist in Kingston Ontario, Canada. This blog is for me to share my ideas, opinions and perspectives on how medications are used in our health care system. Note that these posts are my own opinions and do not represent the opinions of my current or former employers and / or organizations that I may belong to. Any possible case scenarios described in my posts would be modified to maintain patient confidentiality. This blog is not a platform for professional advise for patients or health care providers and the content is not meant to support any clinical decisions or replace professional opinions. Also the images are either taken or created by the author, or adapted with permission. I hope you will enjoy reading my posts!

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