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13 · Friday, June 18, 2010 OAKVILLE BEAVER · www.oakvillebeaver.com SCOTT GARDNER / SPECIAL TO THE BEAVER HOME SWEET HOME: While Ontario's most urgent problem is the thousands of people stuck on unbudging wait lists for a nursing-home bed, barriers to care can also arise once a senior secures a placement. Fragile seniors need more than just a bed By Rob O'Flanagan THIRD IN FOUR-PART METROLAND SPECIAL REPORT hen a visitor pounds on the metal door of his no-frills, $550 a month apartment, George LeLievre slowly, painfully answers. That he is able to unlock the heavy door and swing it open with enough energy to flash an inviting smile and offer a "Please, come in," is a remarkable feat, given the number of complex medical conditions that reside, or have resided, in this frail 67-year-old man's body, and considering the number of times the tough Hamilton senior has walked a tightrope around the mouth of his grave. A broken back, five hernias, tuberculosis, colitis, lymphoma, at least two heart attacks and coma -- LeLievre's scar tissue draws a map of a tough life lived hard, of a body ravaged by manual labour, tobacco and drink. One of 17 children born to Pearl LeLievre and her husband George Sr., of Kirkland Lake, LeLievre is a living, labouriously breathing anomaly: He walked out of a long-term care home and returned to life in the community. Ministry of Health and Long-Term Care statistics from 2009 show just 11.6 per cent of residents across the province were discharged to a private home. The average stay for more than 75,000 frail elderly in 625 provincially-supported nursing homes is three years. During LeLievre's year and a half in Victoria Gardens Long-Term Care, the sound-of-mind senior said he was witness to a situation that W Part three of the four-part series Situation Critical explores seniors' concerns about the care they receive in long- term care homes and a representative example of those who experience exemplary care. was as much detention centre as home, where residents were left in wheelchairs in front of televisions morning to night, and where, he said, the recently deceased were left in their beds for hours in plain view of visitors. LeLievre said he was provided a bare minimum of medical care and personal attention, despite his serious needs. "Seven-thirty in the morning they give me my medication," said LeLievre, sitting at the kitchen table of his sparsely furnished flat, pictures of his large family on the walls, a cigarette burning in his bony fingers. "Then at noon, I get my medication. And four o'clock, I would get medication. And that's all they done for me." Ranka Stipancic, administrator of Victoria Gardens, on Victoria Avenue North, defended the level of care at the home. While she wouldn't speak to LeLievre's case specifically, citing privacy regulations, she said the home has been caring for residents with high-intensity medical needs for years, and that the province has a special program that helps defray the costs of that care. Current Ministry of Health records (from May) show Victoria Gardens performed better than the provincial average on inspections over the last four years. Stipancic said round-the-clock registerednursing care and staffing levels are adequate to meet the care requirements of residents. LeLievre's view of his time at the government-licenced home in the Landsdale neighbourhood reflects concerns expressed by patients, families and elder advocates during research for Situation Critical, Metroland's special report on long-term care. While Ontario's most urgent problem is that tens of thousands of its most medically needy, fragile seniors are stuck, sometimes for years, on unbudging wait lists for a nursinghome bed, barriers to care can also arise once a senior secures a place in long-term care. Years of understaffing and pressure from the influx of increasingly older residents with more complex medical and personal needs leave staff gasping to cope with the demands. The average age of residents at admission is 80, and about 73 per cent have Alzheimer's or other dementia. It can be overwhelming for front line personal support workers just to meet the daily living needs of the majority of residents, leaving those more able to fend for themselves. About 98 per cent of Ontario long-term care residents need help with toileting, 95 per cent with eating, 94 per cent with dressing and 88 per cent moving from bed to a wheelchair and back. Concern about lack of attention leads many families to rearrange their schedules to provide extra help, often at the cost of a job or family time. A skeletal figure with sunken cheeks and large, animated eyes, LeLievre said he often had to change his own colostomy bag in the nursing home despite chronic back problems. He continues to battle cancer and heart disease. "When I needed help to change my colostomy bag, I'd say, `Can I get some help to do that?' They'd say, `With you in a minute.' Then it was, `Oh, it's my smoke break.' Or it was, `Oh, dinner hour, can't do it now.' I'd wind up changing it myself." Stipancic, the home administrator, said See Many page 14