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Long-term care is not ‘broken’: manager finds hope at her facility during the pandemic
Jul 12, 2021, By: Lara Kutowy
management team at Carleton Lodge taking a group picture outdoors with a tree
Courtesy of Lara Kutowy
The management team at Carleton Lodge, from left to right: Mary Zion, administrator; Anna-Leigh Oldford, program manager of hospitality; Karen Gallagher, program manager of recreation; Lara Kutowy, program manager of resident care; Lucia Johnson, program manager of resident care; and Jean-Michel René, program manager of personal care.

The past year has been woefully lacking in good news stories coming out of long-term care (LTC) facilities as the COVID-19 pandemic wreaked havoc on a system already stretched to its limits. The number of lives lost in LTC facilities throughout Canada has been devastating. Those of us who have been working in LTC during this period experienced a constant state of worry and stress. The news brought us continuous information about the state of LTC in Canada. Over and over, we heard about another LTC residence being devastated by COVID. But the forgotten side of the pandemic was missing from all of these reports — the side that brought people together, that turned co-workers into friends, and the friends into family. Repeatedly, we heard only that the LTC system was broken.

There is one thing that I want to make very clear: regardless of your thoughts about the system, the people who work in LTC are not broken! They are caring professionals who came in every day to care for the most vulnerable in our society, despite the risk to themselves. To that end, this article is dedicated to the thousands of staff working in LTC who performed small acts of kindness in order to bring some humanity to the lives of our seniors, who have lost so much during this extraordinary time.

The weight of the world

Throughout this pandemic, I heard stories from the staff at our facility in Ottawa about how they constantly worried about the safety of residents. Every trip to the grocery store was accompanied by a sense of “What if?” “What if this is the time I am exposed to COVID?” “What if I bring this to my residents?” The weight of what we were up against was overwhelming. I remember sitting down with young nursing students to inform them that everything they did in the community mattered. Every party they decided to attend could be detrimental to our residents. Anything less than carrying the weight of someone else’s life on your shoulders could not be tolerated. The leadership team of Carleton Lodge, the LTC residence where I work, attempted to communicate with staff the staggering weight of the responsibility we had been entrusted with. We ensured that staff recognized their part in ensuring the residents’ safety. We all needed to bear part of this burden because of the risks associated with letting our guard down.

I am certain that if you looked elsewhere you would find similar stories of hope and life within LTC during the pandemic.

We spoke with our staff repeatedly about the importance of infection prevention and control. We suggested the need for universal masking, at a time when there was much debate about its effectiveness. In fact, my retired mother made over 300 masks to be distributed to our staff for free to help keep them safe. The message was simple: take one and wear it in the community to protect us all! When universal masking became a requirement in the facility, we dubbed ourselves the “mask police.” We stood at the door and, before anyone came in, instructed them on the proper way to wear them. We worried not only about the virus but also about whether our supplies would hold out. At the beginning of the pandemic, we didn’t know if or when additional personal protective equipment (PPE) supplies would be replenished. Thankfully, we always had enough.

Courtesy of Lara Kutowy
“This article is dedicated to the thousands of staff working in LTC who performed small acts of kindness in order to bring some humanity to the lives of our seniors, who have lost so much during this extraordinary time,” says Lara Kutowy.

Supporting each other

One thing that made a huge difference for us at Carleton Lodge was our ability to come together. As health-care leaders, we had to remember that, in all of this doom and gloom, our most important task was to support our staff and have fun doing it. Early in the pandemic, my manager implemented a ritual that encouraged staff to sing to each other. Trust me when I tell you that there is nothing more powerful than a group of socially distanced, masked, front-line health-care workers singing Lean on Me to each other. This has now become standard at Carleton Lodge’s staff meetings. It started as a solemn observance but has developed into a singing and dancing party. Staff provide suggestions of songs to sing to support one another. And the residents love to join in.

When you feel the weight of the world, you need the support of others. During this period, our normal support systems were sorely lacking as no one could see their friends and family. In addition, the only people who could truly understand what we were going through on a day-to-day basis in LTC were our co-workers. The people who began the pandemic as my co-workers soon became my closest confidants, friends and family. No one except your fellow nurse, who does this every day with you, can quite understand how counting thousands of masks, gowns and gloves and getting a different number each time can be the funniest thing in the world. Having crazy hair days and celebrating every holiday brought back some normalcy and helped the facility become a home not just for residents, but for staff too. At all times, but especially during this pandemic, happy staff who are encouraged to celebrate and laugh are the ones who bring the little “extra” to their jobs to really make a difference in residents’ lives.

Little things that make a big difference

A little gesture can make a big difference in people’s lives. Last summer, for example, one of our residents was celebrating her wedding anniversary, and as we had recently instituted garden visits for families, her husband, who lives in the community, had booked a visit. Unfortunately, Ottawa was in the grip of a heat wave at that time. Knowing that our residents are most vulnerable to the heat, we cancelled many of the outdoor visits with families. This resident was understandably upset that she would not be able to visit with her husband on their anniversary. The recreation staff member who was to accompany her that day arranged to arrive at work hours early so that the resident and her husband could celebrate together before the heat became dangerous. In doing this, she made a small personal sacrifice to help the resident feel normal — all while keeping everyone’s safety in mind.

In another instance, a personal support worker (PSW) was assigned as one-on-one staff to ensure that a new resident remained in her room during her 14-day isolation. While that resident was asleep, the PSW asked her co-workers to bring other residents to her. As the PSW was also a hairdresser, she used that time to cut and curl the hair and apply the makeup of several residents, all while taking appropriate safety precautions. She thus gave the residents back the sense of self that the virus had viciously stolen from them, all while she continued to do the task she was assigned.

All over Canada and probably the world, I am certain that if you looked you would find similar stories of hope and life within LTC during the pandemic. The one thing that has been missing in all of the narratives we’ve heard is that LTC staff do what we do because we want to make our residents’ final years as good as possible. My hope is that other LTC leaders and nurses will remember to support their staff and encourage innovation. You will be amazed by the improvements you will see in your residents. At Carleton Lodge, we began this journey as residents and staff, separate people with a shared goal. But what the pandemic has created is a home. One home, one heart!

Lara Kutowy, NP, is a program manager of resident care at Carleton Lodge, which is operated by the City of Ottawa. She has been working at Carleton Lodge for 17 years, first as a unit charge nurse and later as a manager. Lara has recently been licensed as an NP, which she hopes will allow her to provide greater support in her LTC setting.