Reviews of new senior care model mixed

Yorkregion.com
Sept. 8, 2015
By Lisa Queen

A year-and-a-half after residents of seven seniors’ residences in York Region were surprised to learn the assisted living model of care in their homes was changing, reaction is mixed about whether the new plan is a success.

Some seniors say they miss the consistent, personalized attention on which they used to rely, while others say their new personal service workers have already become like family.

In the winter of 2014, residents of Heritage East in Newmarket, Keswick Gardens in Georgina, Hadley Grange in Aurora, Cedar Crest Manor in Markham, Armitage Gardens in Newmarket, Genesis Place in Richmond Hill and Kitchen-Breedon Manor in Schomberg discovered they would lose their on-site Alternative Community Living (ACL) offices as of April 1, 2014.

The change was due to a provincial policy that resulted in the Central Local Health Integration Network re-examining how the needs of high-risk seniors living at home are served.

Under the new model, Community and Home Assistance to Seniors (CHATS) and Care First would provide care.

Initially, there was to be a hub-and-spoke model (a centralized office operating around the clock that would dispatch PSWs who could be up to 15 minutes away) and a mix of scheduled and unscheduled visits.

Seniors were worried about the possible length of time for a response if they required immediate attention.

After some residents took their concerns to Queen’s Park, it was agreed the new model would continue to provide on-site, round-the-clock care at all the residences.

That was a huge relief for residents, said Joe Pearson, a blind, double-leg amputee with diabetes and cancer who requires kidney dialysis.

“That was the biggest concern we had. They have stuck to that (providing 24/7 care)” said the Keswick Gardens resident, part of the group of seniors who went to the legislature.

However, Pearson has concerns with the new model.

“I remember (Premier) Kathleen Wynne stood up at Queen’s Park and said ‘They (residents) are going to get better service than they had before’ and frankly, I don’t see it.”

Pearson believes CHATS has not hired enough full-time staff and has relied too much on an outside agency to fill in the gaps.

That has left residents, who suffer from a variety of health issues up to palliative care needs, not knowing who their caregivers will be on an ongoing basis.

“It’s very frustrating because I have no idea who is going to come through (my) door,” he said.

The lack of continuity of care means new staff aren’t able to recognize changes in residents’ wellbeing and some vulnerable seniors aren’t able to tell them, he said.

“Before, the (ACL) ladies were right on everything,” he said, adding he misses the former model of care, which used to have new staff shadow veteran employees and get to know the needs of residents.

At Hadley Grange, 89-year-old Edna Edwards called the care provided by CHATS “absolutely great”.

“They’re like family to me, they take really good care of me,” she said, adding a PSW even accompanies her to get her mail and makes her morning coffee.

“They’re so good to me, they all are. I couldn’t ask for better.”

Bev Murray, 79, who also lives at Hadley Grange, said it was a difficult transition to lose the ACL workers with whom residents had become so close but said she is forging strong relationships with the CHATS workers.

“I find them very good,” she said.

“I find their quality of care is what it should be.”

While Murray, who has health concerns, such as heart and back problems and torn bicep muscles, has had good luck with her continuity of care, she has heard other residents say they have concerns with changing staff.

At Heritage East, 78-year-old Rena Ilott, who has inclusion-body myositis,
a rare degenerative disease that causes weakness and wasting in her muscles, said there seems to be a “revolving door” of staff under the new model of care.

“Seniors hate change. We just want to be peaceful and quiet and get on with our lives,” she said.

“We want our dignity ... You get used to somebody and it becomes a family. But there is no continuity ... It will never be what it was.”

Overall, the response of residents to the new model has been overwhelmingly positive, CHATS chief executive officer Christina Bisanz said.

“I’m basing it on feedback we get from our clients. I think the program and the service has been working extremely well,” she said.

“We’ve had high levels of satisfaction reported and I think, importantly, our clients see the service as something that allows them to remain in their own homes with a service that they feel treats them with respect and dignity.”

CHATS has been able to enhance service by linking clients with other programs provided by the organization, Bisanz said.

During the initial transition when CHATS first took over care for more than 150 clients, it hired agency staff.

Now, most of the employees are full-time CHATS workers, although agency staff is sometimes hired to cover vacations, illnesses or other absences, Bisanz said.

“The important thing is, there is an experienced, qualified worker 24/7 for the clients,” she said.

“I appreciate that for some individuals that this is something they see and is a continuing concern for them, but based on the feedback that we get from clients in all the buildings and other buildings, this is not a big concern to them.”

Even though the staff may work for CHATS, there appears to be a high turnover rate, Ilott said.

CHATS’ retention rate is very high and workers have developed close relationships with clients, Bisanz said.

About 20 of approximately 90 ACL workers with York Region lost their jobs when the new model of care was brought in, Doug Sheppard, unit chair of Canadian Union of Public Employees (CUPE) Local 905, said.

A handful of employees were hired by CHATS but at significantly reduced salaries and benefits, he said.

The employees were heartbroken to no longer be caring for seniors who they had taken care of for years, Sheppard said.

“They were crying leaving the seniors. It was gut-wrenching for them. They became part of your family,” he said.