I am pleased to share the latest edition of our newsletter. We welcome any and all comments. Please send us your feedback as well as ideas, stories and information we can share.
Each month we will share news and information about home care, long-term care, community supports and services and shed light on the wonderful people and services that contribute to continuing care in our province.
Susan Stevens
Senior Director, Continuing Care, NSHA
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It was a Happy Halloween for everyone at Victoria Haven Nursing home in Glace Bay as they welcomed children from a nearby school.
Shared with permission from CTV News.
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Our people in profile: Hospital-based care coordinator works with her team ‘behind-the-scenes’ to help clients return home sooner
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When p
eople are hospitalized, we know that most want to return home as soon as possible.
“My goal is to make that happen,” said Coleen Lewis, hospital-based care coordinator at the Halifax Infirmary site of the QEII Health Science Centre.
With over twenty years of care coordination experience at different sites across the province, Lewis shares the behind-the-scenes workings of hospital based-care coordination.
Even though Lewis works in the hospital, her job is coordinating the care and supporting clients that have the potential to return home with continuing care services.
Continuing care services
allow people to receive care where they live, effectively improving quality of life and establishing a greater sense of fulfillment through meaningful relationships between care providers and their clients.
“On my unit at the Halifax Infirmary our team is made up of a care coordinator, social worker, occupational therapist, physiotherapist, dietician, pharmacist and the physicians and nurses. I depend greatly on my team,” Lewis explained.
“For example, the physiotherapist and the occupational therapist may say that the client needs special equipment to go home safely or therapy at home. From equipment, nursing services, home support services—I make sure all these things are in place.”
Lewis also stresses the important role family members have helping getting clients back home.
“As a care coordinator we do a lot of behind-the-scenes work—talking with the family, the client and the team on the unit to determine what the needs, the services and the level of support they need to return home and if we can meet those needs.”
“Family is a big part of the client’s life. I help guide families and clients, and together we come up with a plan,” said Lewis.
As a care coordinator you are always reviewing the plan, looking at what new supports are available, monitoring and coordinating the plan and evaluating the client’s progress.
Good care coordination takes time as well as a team effort. “We all support each other. No matter where in the province we work. We share knowledge of the programs and services that we provide, the criteria around them and information about the agencies and how to connect with them.”Support from your team is key she said.
“The continuing care program is huge and having all those working parts in the background is what makes it work. I couldn’t function alone in the hospital setting. We have an excellent teams. There’s no stopping us.”
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Behaviour Resource Consultant Mary Anne Johnston passionate about people-centered care
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For behaviour resource consultant Mary Anne Johnston of Pictou County, a simple mantra of “find out what they like and give it to them” helps her provide clients with compassionate care.
Johnston began her career as a nurse and diligently worked to become the director of support planning at Riverview Home Corporation in Stellarton. Years later, she came across a job opening for a behaviour resource consultant, “It was interesting how I ended up in this position,” said Johnston. “I saw a job posting with the title ‘putting the pieces together’ and I was intrigued because I’ve always loved jigsaw puzzles.”
“My background is in mental health and applied behaviour analysis,” she explained. “When I learned more about behaviour resource consultants, I knew that it would be a good fit for me.”
In her current role, Johnston spends her days providing support to NSHA’s continuing care coordination team, home care agencies and long-term care facilities who serve older adults with cognitive impairment, mental health issues, addictions and other neurological conditions.
Whether conducting case-based consultations with acute care to ease transition from hospital to long-term care, or facilitating education sessions for home care providers, she draws on the strengths of care partners, coaching them to better understand the needs of the person in order to provide better care.
“I meet a lot of people and everyone brings something new to the table. I really enjoy the collaboration with my colleagues,” she said.
After 11 years in her position, Johnston says no two days have been the same.
“All behaviour has meaning and in my role I support care teams and families in becoming behavioural detectives to figure out what that behaviour means and what the client is trying to show and tell them.”
“We have clients who have advanced stage dementia and can be fearful and confused about what is happening to them. Their reality isn’t necessarily our reality and we have to put the puzzle pieces together to help them.”
She added, “I’ve always had a very strong philosophy of people-centered care and doing what the client needs and wants. Not judging the behaviours that you are seeing and looking for the meaning behind them is important.”
“You need to get to know the person you’re caring for,” Johnston said. “They were all someone else before this illness happened to them and it’s important to have compassion.”
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Thank you to the VON for sharing this inspiring story with us.
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The contributions of home and community care professionals are a vital part of our health system. VON plays a significant role in helping people remain safe and well at home and in their communities, providing 94 per cent of home care nursing services in Nova Scotia as well as delivering home support services.
For Elke Huber, the support of VON touched her in more ways than one. Elke was the primary caregiver to her mother who sadly passed away earlier this summer. Prior to her mother’s passing, Elke was her primary caregiver and had home support services to aid in her mother’s palliative care at home.
The attentive care and support her mother received made her comfortable and fulfilled her wish to stay at home. Beyond that, Elke was impressed by the warmth, compassion and high standard of care. In fact, it is what inspired her to join the VON family as a Registered Nurse in September 2019.
Moved by the level of care her mother received throughout her final few weeks, Elke wrote a letter to her MLA Leo Glavine, sharing her experience with VON and the importance of supporting continuing care services in Nova Scotia. Elke gave permission to share her letter below:
“My mother is a palliative care patient of the VON, dying of cancer. My mother’s only wish was to die at home and with me by her side. She decided to get a dog instead of chemotherapy. The dog is beside us, as I write this letter, and my mother is on her death bed.
I have been by my mother’s side every minute, and so has the VON. VON nurses would come in every morning to wash her, look after pain medication and ensure she was comfortable. During all of those weeks, I have not seen any employee of the VON be anything other than caring, professional, approachable, attentive, warm, open and accountable. These are all amazing people doing amazing work, beyond duty.
People who choose to work for the VON are special people with certain values that go beyond self interest. We need to support those people and give them what they need. My mother would tell them every day how much she loves them. She would thank everyone for all of their efforts and how much they enriched her life by caring for her the way they did.”
Elke’s letter and her journey of becoming an RN in home care demonstrate the impact compassion and collaboration can have on the life of individuals and their families.
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My father was a very responsible and hardworking man. As a child, I loved him mostly out of ‘duty’. He would often say to my mom that he was ‘the head of the house’ and she was the ‘heart’. I don’t have many memories of moments of real joy with my father when I was young. Luckily for us kids, my mom made up for what he was unable to give us emotionally.
When the last of my siblings left home, so did my mom. It was hard to live with a man who was defined by his work and not emotionally available at home. I don’t think my father even saw it coming, he didn’t think my mom could make it without him. But she moved on and he did not.
He became quite a lonely man in his post retirement years. He didn’t know how to take care of himself because my mom had always done that for him. He developed type 2 diabetes and that was the beginning of a long road of incremental health issues that eventually led him to long-term care.
He came from his home community to live in a nursing home near me and my family. When he arrived, he was not a happy camper. He was cranky and frustrated. He was very much in denial of the poor health that led him to need care. I can imagine that he was very difficult for the staff to deal with. But I was amazed at how quickly he integrated. There was a lot of “magic” performed by the front-line care workers. I witnessed some of this when I would visit. Much of the magic likely happened when I was not there. It was the combined effort of the staff, doing their ‘daily thing’, likely unaware of how much impact their caring approach could slowly soften even the ‘crustiest’ of residents.
My dad ended up being a ‘long timer’…nine years in long-term care. I say this to you as a caregiver who spent lots of time in both the homes where he lived during that long period of time: the love and genuine compassion given to my dad by most of the care workers filled his lonely heart and broke open its hard shell. It was a combination of tons of ‘small kindnesses’ that added up to big positive personality changes in my father. For me, he went from being an
obligation
to care for to a man I was
genuinely happy
to care for. He went from someone who
expected
me to visit him to someone who
expressed thanks
for the time I spent with him. I know that this only happened because so many of his direct care workers, just by virtue of being their true selves, modeled social skills for him that he had never practiced in his life. Looking back, if there was a ‘higher purpose’ to my dad’s many years of physical suffering, it was that he truly evolved emotionally. He could not have done this without the gentle influence of the many kind souls around him in long-term care. When he passed away, he was a noticeably kinder, gentler human being.
Please know that your work is very important and it has a huge impact on the well-being of the residents. Most people outside the doors of your workplace would never have the courage or stamina to do your job.
But hold your head high, yours is a job with the highest of purposes. You care for people at the most vulnerable stage of their life. Never underestimate your ability to love and its magic. Moments as simple as a warm smile, a little joke, or asking a question about the resident’s former life, are the secret ingredient to connection. And your simple, everyday acts of connection are the antidote to the suffering.
With sincere appreciation,
A grateful daughter
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As we head into the holiday season, we know you go above and beyond for the people we serve to ensure their festive season is full of joy.
We invite you to visit the Share the Care website, to share your stories that reflect the heart of the people delivering care, the experiences of those receiving care, and the point of view of family members involved in the care of their loved ones.
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The best gift you can give is the gift of time
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The holiday season is meant to be a joyous time spent with family and friends, but for some people it can lead to added stress, anxiety and a feeling of isolation. The “Gift of Time” Awareness Campaign aims to raise awareness of the loneliness and social isolation many seniors face, during a time when many families and friends are celebrating.
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Sign up to receive the latest NSHA news, updates and information.
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Please submit story ideas, photos and feedback to:
Jaimee Dobson, Communications Advisor,
Continuing Care
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