Support workers need support By Jillian Follert METROLAND SPECIAL PROJECT A daughter's tale I was so thankful that I was able to get to the nursing home (Sherwood Park Manor Nursing Home), before my mom, Verna Poole, died. The head nurse told me that they had already started palliative care when I spoke to her at 6 p.m., and that her vital signs were weak, but at least she was breathing normally. That was not the case when I got there at 11:30 p.m. -- her breathing was laboured and she gave no indication that she knew I had arrived. The head nurse was amazing -- when I told her that I had never been with anyone when they had died, she told me what I could expect. She then showed me how to hold my mom's hand, something that she had learned from her Verna Poole training in palliative care. "The trick is to put your hand under your mom's hand, not on top of it", the nurse explained, "so that she feels that she has some control." I asked her if she would mind if I crawled into my mom's bed, and she said, no, certainly not, but cautioned me that I would have to leave the room when they changed her position in the bed. Thank goodness for guardrails! They helped to keep me in the bed while I lay with my mom, singing to her, holding her hand, and telling her how much I loved her. At 6:50 am, the head nurse woke me up. "Brenda, I think your mom has passed away." In the stillness of the early morning light, she had slipped away. The head nurse immediately said that she would give me some private moments alone with my mom. When the staff came back into the room a few minutes later, I cried that I was feeling guilty that I had been sleeping when my mom had passed away. They cried with me and assured me that my mom would have known that I was there with her, and that I had been a comfort to her. I am so thankful that my mom was able to die in a peaceful, loving environment. Having not been transferred to a hospital, my mom was able to receive care from staff who knew her, and I saw how they treated her with respect as she was dying. My sister and I were fortunate in knowing the administrator of Sherwood Park Manor Nursing Home, having gone to school with him. He went out of his way to give my sister updates on my mom during the 14 months my mom lived there. When I saw him later in the day after my mom's passing, I had tons of praise for the nursing home staff. Our family's experience of long-term care was very positive. I have had people raise questions with me about my mom living in a long-term care facility. Some nursing homes are really great and others aren't. As with child care centres, one of the indicators of success is low staff turnover. Imagine how happy I was to learn that the hairdressing woman had worked at my mom's nursing home for 14 years, one of the head nurses had been there for 18 years and the personal services worker who turned my mom in her bed during her last night alive has worked there for over 10 years. Let me conclude by telling you a scene my sister saw a few months ago while leaving the nursing home...as one of the staff was putting a resident to bed, the staff member leaned over and kissed the woman on the cheek. Good night! BRENDA POLAND, OAKVILLE 15 · Thursday, June 17, 2010 OAKVILLE BEAVER · www.oakvillebeaver.com As a champion for PSWs, Miranda Ferrier, 30, is outgoing, outspoken and easily outraged. She worked in long-term care for three years before switching to advocacy, and is still haunted by a particularly disturbing incident from her short stint in the field. "I started an afternoon shift and took a woman to her room to change her. She was wearing a pad and it took me about ten minutes to peel it off her skin. She had been sitting in feces since the morning," Ferrier recalls, her voice cold. "It took me and another PSW 35 minutes to clean her and she was screaming. The other PSW and I were bawling. No one should have to go through something like that." Ferrier said she realized early on in her career that there simply was no support system for personal support workers. PSW Canada launched in 2006, as a grassroots "by PSWs for PSWs" initiative, Ferrier said. Today it has 4,500 members, and its founders are responsible for the newly-minted Ontario PSW Association, with its mandate to Miranda Ferrier self-regulate the PSW profession and create a provincewide PSW registry. Personal Support Network of Ontario also launched four years ago, in affiliation with the Ontario Community Support Association, but isn't pursuing regulation. "We want to work with the government," said PSNO director Lori Holloway Payne. "It's difficult to regulate a profession when the government has said they're not interested ... so we have to work within the environment that exists." PSNO has drafted a list of steps to make the profession more accountable, including a third-party process to evaluate and approve PSW training programs, a certification process that includes provincial exams. The group counts its membership at about 1,200. Neither PSNO nor PSW Canada comes close to representing the estimated 100,000 PSWs working in Ontario. The push and pull over PSW regulation in Ontario has been going on for years. In 2006, the Health Professionals Regulatory Advisory Council stunned advocates when it recommended that PSWs not be regulated, citing a lack of infrastructure, support and willingness. But, with PSW Canada and PSNO growing and the public taking more notice of the PSW situation, HPRAC had planned to take another look at the regulation question this spring, with consultations slated to start in April. Health Minister Deb Matthews scrapped those plans in March, saying ministry officials are instead working to develop a common understanding of what a PSW is and what training is required for the job. Lack of regulations concern support workers Continued from page 14 underneath it. Her catheter had a slow leak," Christine said. "But, the last rounds before I got there were at 1 p.m. There's no way she would have been that wet if someone had just checked her two hours ago. It means that no one came." In order to meet each resident's complex needs, homes need to be run on strict, even rigid, schedules. Residents are sometimes awakened before dawn or put to bed at 6 p.m. to accommodate the crunch to provide care, often in an operation similar to an assembly line. Natrice Rese, who retired last summer after decades as a PSW, recalls dinner hours where she'd feed up to 15 people at a time, "literally shoving food in their mouths and trying to make sure they didn't choke." Lack of time isn't the only pressure PSWs face. Scant resources -- a problem blamed on inadequate government funding -- is a constant frustration, especially when incontinence products are involved. Many PSWs reported watching residents sit soaking for hours, to the point where urine dripped from the bottom of a wheelchair, or a bed was soaked to the mattress. PSWs in Ontario banded together over the last few years to try for the same type of standards that apply to other health professionals, and in the wake of increasing public concern about the overloading of the longterm care system. "I want to try to change things, but I can't afford to lose my job over it," said Cathy, who went back and completed another course after banging her elderly patient's head against a wall. PSWs say the lack of standards means people who aren't suited for the work are enticed by its reputation as an easy course that yields employment. "It's one of the courses they tell New Rules Ontario's recently updated Long-term Care Homes Act said PSWs hired in longterm care homes must complete a program which is at least 600 hours in length. The majority of PSW programs already exceed that requirement. Community college courses are typically eight months, while the average career college PSW course runs five or six months. PSWs are pushing for more specific standards for courses. people on welfare to take. They tell them it's easy, anyone can do it. And some of the courses are that easy, because they're not actually teaching you anything," said Heather, a Toronto PSW who said many of her co-workers are former Ontario Works recipients who completed six-month PSW courses offered by boards of education. Heather said anything short of a year-long community college course such as the one she took, is inferior. "The (career college and board of education) courses are too short. They don't teach them basic things like anatomy, it's more like here's how to give someone a bath. They don't teach a lot about mental health and dementia, and we really need to know those things." But, concern that PSWs are not regulated or certified, coupled with media reports of infractions -- a North Bay PSW, for example, was sentenced to house arrest this year for stealing an elderly resident's credit card -- have led to calls for the profession to go through an accountability overhaul. For the organizations working on behalf of PSWs, that means an Ontariowide PSW registry, uniform curriculum and clear-cut standards of practice.