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Published Praise

for There’s No Place Like Home

Review by Hélène Meurer
Alive Magazine (Richmond, British Columbia)
(reprinted with permission)
Canada’s Natural Health and Wellness Magazine
October 2010 issue No. 336, www.alive.com

It is a sure sign of the times: we who comprise the sandwich generation have a growing bank of written resources to draw upon for help dealing with our aging parents.

Preparation is key to success, yet so many of us (me included) would prefer to keep our heads in the sand rather than face the fact that our parents now need our support. Cloutier-Steele’s book provides an important reality check as we take on the role of navigator for loved ones entering long-term care.

There’s No Place Like Home was born out of the ongoing frustration experienced by the author as she found herself becoming a guardian and advocate for her father even after he had entered a care facility in Ottawa. Written in a personal, almost journal-like style, Cloutier-Steele shares the most intimate and challenging day-to-day aspects of her role. At times, to preserve her father’s dignity and well-being, she is forced to compensate for the shortcomings of the system by taking matters into her own hands. Along the way, she learns about health care facilities. Her experiences and insights are laid out for the benefit of readers.

This is not a daunting in-depth exposé about the system. Rather, it’s a quick read for busy friends and relatives that provides just the right amount of information to nudge readers into a state of active concern and responsibility. It is an eye-opening guidebook with plenty of practical advice for those who will soon be in Cloutier-Steele’s position of caring for parents.

The book provides a thorough list of tips for choosing a good nursing home. This includes such considerations as location, short-staffed days, physician care, response times, nutrition, new friendships, resident autonomy, eye care, and bedtimes. For example, do you know how a facility’s mealtime seating arrangement might affect your loved one? We also learn how to request and prepare for care review meetings, should problems arise.

There’s No Place Like Home is fuelled by emotion and delivered with grace. It is a gentle nudge toward taking responsibility for those who loved us first.

― Hélène Meurer enjoys being touched by the unfailing joie de vivre of her mother Odette who lives in nearby Sidney, BC.

~~~

Long way from home

Book is insightful guide and a touching memoir of helping an aging parent
(reprinted with permission)
BY BRUCE WARD, THE OTTAWA CITIZEN JUNE 3, 2010

Three years ago, Lise Cloutier-Steele placed her then 82-year-old father in an Ottawa nursing home. It was time.
Her father had been given a diagnosis of Alzheimer’s disease and was suffering from several other ailments, including a bladder infection. Ever the dutiful daughter, Cloutier-Steele did her homework on long-term care facilities.
“Compared with others, this home had a wonderful reputation for its outstanding medical and spiritual care,” she writes in There’s No Place Like Home ($15.95, www.ottawacaregiver.com). Her book, available at Books on Beechwood and Collected Works on Wellington Street, is a sobering, insightful guide to the day-to-day reality of being an advocate for a parent with dementia living in a long-term care facility.
It’s also a moving portrait of one woman’s battle to maintain her father’s dignity as his mental capacity diminishes.
Despite the home’s solid reputation, Cloutier-Steele learned she has to be vigilant to make sure the staff consistently meets her father’s basic needs, including toileting.
During a recent visit, she encountered her father coming out of the dining room.
“His catheter bag was dragging on the floor,” she said in an interview. “When it’s that full, it hasn’t been emptied all morning.”
Cloutier-Steele was upset but far from shocked.
“It took 18 months and an official complaint to the Ministry of Health to stop the smell of urine in his room. And 18 months later, they can’t empty his bag.”
As she writes in the book, “I never imagined myself cleaning my father’s false teeth and cutting his toenails … but I am the only one he’s got to oversee all his personal hygiene and grooming care, which falls under the category of basic care that no one else at the home seems to have the time to provide in a consistent manner.
“I don’t even want to think about what he would look or smell like if I didn’t cover all the bases for him.”
On another recent visit, Cloutier-Steele noticed that her father’s catheter bag had been incorrectly fastened at his ankle.
“The straps were on so tight they were cutting into his skin. You can’t pull the tubing from the penis down to the ankle because it causes pain. Dad doesn’t notice because he has dementia.”
The facility is not named in the book. Cloutier-Steele’s primary aim in writing the book was to share personal experiences, and to provide practical information for those in the process of finding a nursing home for a parent or loved one — or preparing for the day when they move to a nursing home.
Cloutier-Steele notes that, according to Statistics Canada, Ontario has “the second worst long-term care staffing levels in the country.” In her experience, staff shortages result in a gap between care levels and assessed needs.
Most of the full-time health care aides at her father’s facility are “great at their job,” she writes. “But the 15-to-one resident-to-aide ratio (or greater depending on the floor) prevents them from meeting the needs of each resident during a shift,” and from living up to the home’s commitment to provide exceptional care.
Understaffing has a deleterious effect on residents, she says.
“No way you can get to 15 people and do a good job in a 7.5-hour shift. It’s impossible. This is the consequence of understaffing and it has a major effect on them. People are left to lie in their beds and stare at the wall; that’s it.”
The spotty monitoring of residents places an extra burden on caregivers like Cloutier-Steele.
“It makes for added pressure. It makes you feel you should be there all the time. You can’t leave them there and do nothing; you have to check on them all the time.”
Interacting with staff and management at the home requires a will of iron and the skills of a diplomat. “You have to be prepared to negotiate,” says Cloutier-Steele. “You have to enter into negotiations for every little thing. You have to keep going back, all the time. It’s very hard.”
Ironically, Cloutier-Steele is grateful at times for her father’s dementia.
“Luckily for me, he has no short-term memory. When something happens he doesn’t remember it five minutes later. It’s a huge blessing to me.
“Part of the reason why homes across the city can carry on the way they do is the people are ill and they don’t notice stuff. If the room’s floor is filthy and the windows are never washed, they don’t see it.”
There’s a Boomers’ mantra that says you should enjoy retirement to the max. Spend all your cash on travel and good times while you can. Why leave anything for the taxman, right?
Cloutier-Steele’s book cautions against that sort of thinking. It serves as a warning of what lies ahead, should you find yourself in a publicly funded nursing home without supplementary health insurance or the money to pay for additional private care.
“If my parents had prepared and made provisions for this, I would have been able to hire someone to look in on him all the time, which is the best solution. Make sure you can hire private care in addition because private care will make up for everything the home can’t do. And the home can’t do much.”
The book also provides several excellent checklists for those looking for a nursing home for a parent or loved one. Seemingly, she covers every aspect of life in a nursing home, from staff friendliness to seating arrangements in the dining room, and how to recognize symptoms of caregiver burnout you may experience.
The book includes a series of questions that should be asked about the home’s policies regarding residents who are incontinent. In some homes, heavily soiled pads are left on the floor to be picked up later.
“If this is the case at the home you select, you will often be greeted by the smell of urine or fecal matter as soon as you get off the elevator on the floor you are visiting.”
Cloutier-Steele wrote the book partly as a “reality check,” she says.
“In doing this book, I wanted to spare others a lot of what I went through. I want people to avoid the shock and prepare themselves.”

―  © Copyright (c) The Ottawa Citizen

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