The Story of “Gladys and Albert” - how VON Respite Services Support the Strategic Aims of the CE LHIN
October is "Community Support Month" and the Central East LHIN is proud to salute the numerous agencies, outstanding staff and dedicated volunteers who provide crucial services like adult/Alzheimer day programs, attendant services for persons with physical disabilities, Meals on Wheels, personal care and home support, transportation to medical appointments and supportive housing programs. Stories such as the one posted below demonstrate how the services provided by Community Support Services agencies are integral to the continuity of care for people in a well-functioning health care system, keeping seniors out of hospital or the Emergency Room.
During the month of October and beyond, agencies are invited to submit their own stories highlighting how they are working with their partners to achieve the LHIN's Strategic Aims. Stories can be sent to the Central East LHIN via email - firstname.lastname@example.org - to be posted on the "Tell a Story'" page.
Gladys was a tiny woman, 88 years of age, who lived with her elderly husband of 62 years. They led a relatively private life as part of a rural community where they were active members of their local church. A few years ago, Gladys was diagnosed with dementia and they had to give up their home in the country to move to an apartment. They always assumed very traditional roles in their marriage but with Gladys’ declining abilities, Albert had to take over many of the household duties, such as laundry and meal preparation. Combined with the loss of their home and church involvement, this was a very stressful adjustment. Gladys was neglecting to bathe or change her clothes and although he tried to assist, Albert was not comfortable providing this type of care. The couple had one son who lived three hours away with his wife and young son. While the son and daughter-in-law were supportive, they did not visit regularly and had an almost formal relationship with Gladys and Albert, referring to them as “Mr. and Mrs”. They would not consider assisting with Gladys’ personal care and in fact felt that Albert should not be doing so either.
Gladys was eventually referred to VON Respite Services by the CCAC case manager who had trouble getting Albert to agree to accept any help in their home. He felt it was an invasion of privacy and was not comfortable having an “outsider” assist Gladys with her personal care. The case manager presented the CARE In-Home Respite service as ‘respite only” with no personal care and Gladys and Albert reluctantly agreed to an intake visit from VON.
When the VON Supervisor arrived, Albert declared that he did not wish to initiate the service but through conversation stated that he used to spend a great deal of time volunteering with his church. The VON Supervisor used this as a way to offer help and Albert finally agreed that a regular respite visit would allow him to resume this important activity. Sharon, a VON Respite Worker, started to make a “social” visit to Gladys on a weekly basis, with the goal of eventually assisting with meal preparation and laundry. Over time, Sharon developed a supportive relationship with both Albert and Gladys and they came to appreciate and trust her assistance. Eventually, Sharon was able to assist Gladys with some personal care and on occasion even wash her hair.
VON Respite Services had such a positive impact for this family that Albert began to see the benefit of having more support. The VON Supervisor was able to communicate this information to the CCAC case manager and personal support services were initiated successfully. Ongoing communication between Albert and the VON Respite Supervisor revealed that he was becoming increasingly stressed as Gladys’ care at home became more challenging. The VON Respite Supervisor suggested the addition of the Adult Day Program as another opportunity for caregiver respite. Encouraged and supported by the VON Respite Worker, Albert finally agreed to bring Gladys for a visit if accompanied for the first time by her VON Respite Worker. This provided the supportive transition that both Gladys and Albert needed and over time Gladys adapted to the new setting. The frequency of attendance at the Day Program was increased to better support both Gladys and Albert. As she became more familiar with the Day Program environment, Gladys began to let staff help her more and more. Albert eventually agreed to have Gladys remain at the Centre for the Weekend Stay overnight respite program. This allowed the Day Program staff to provide even more support by laundering her clothes and ensuring that she was dressed appropriately.
The once weekly in-home respite visits continued until one Friday when the Respite Worker buzzed their apartment and got no response. A neighbour recognized her and accompanied her to knock on the apartment door. They both heard Albert say ‘let Sharon in dear”, however, on entering Sharon found Albert on the floor with the telephone in his hand, responsive but unable to move. Gladys was sitting in her chair in the next room unaware that anything was wrong. Sharon immediately called 911 and an ambulance took Albert to the hospital while she remained with Gladys at the apartment. Albert was able to communicate that his wife was at home with a VON Respite Worker and Sharon soon received a call from the GEM nurse informing her that the hospital had been unable to reach the son. The VON Respite Supervisor was alerted and eventually made contact with the family. Because they lived at a distance, she suggested that Gladys be brought to the VON Adult Day Program for the rest of the day.
The Respite Supervisor also called the CCAC case manager and updated her on the situation. While the case manager started the process to find an emergency placement for Gladys in LTC, she doubted that it could be arranged for several days. VON was able to offer the family the support of the Weekend Stay Program for Gladys while they supported their dad in hospital and made plans for the future care of their mother. Meanwhile, Gladys remained at the centre for the weekend, in a familiar setting with staff and a routine with which she was comfortable. Sadly, Albert passed away the next day as a result of his stroke with his son and daughter-in-law by his side.
Stories such as that of Gladys and Albert occur within the services provided by Community Support Agencies on a regular basis. Caregivers are supported through respite services, education and emotional support. Clients are provided with the right services, by the right person at the right time so they can remain at home as they desire. The health and wellness of both client and caregiver are maintained through the Community Support Services they receive, and through coordination within the health care continuum.
In the story of Gladys and Albert, there are many examples of “system savings” – whether it is the avoidance of early caregiver burnout by the sensitive introduction of personal care supports for Gladys; the avoidance of a premature placement in a Long Term Care Home through the respite provided for her at home and in the Adult Day Program; or the ability of the Weekend Stay overnight respite program to provide the enhanced care required to avoid an emergency room visit or hospital admission for Gladys during Albert’s health crisis.
As a letter of thanks from their family so aptly puts
“...It is no exaggeration to say that without the help of VON and the services of other home visitors their lives would have been very difficult. The home visits they received not only brightened their days but made it possible for them to stay in the comfort of their own home amongst friends and neighbours...”
Submitted by Doreen Anderson Roy, Manager of External Relations and Administration , Community Support Services, VON Canada - Peterborough, Victoria, Haliburton and Durham Sites