A conundrum in care

Bastion Place: Daughter worries about mother’s safety.

Facility: Marilyn Marshall

Facility: Marilyn Marshall

Marilyn Marshall, 81, has always been a nurturing caregiver who acted as “an unpaid home care worker” to others, says her daughter Nan.

Six years ago, Marilyn was diagnosed with Alzheimer’s disease and went into care three years ago. This month marks her second anniversary in Bastion’s special care, secure unit that is home to 12 residents.

Nan was satisfied with the care her mother received until this spring.

“The problems started in April when a new resident arrived and I started getting phone calls that Mom was being hit,” she says, noting she received calls from nurses and care aides at least four times, advising her that her mother had been pushed, slapped or hit – all by the same person. “They (staff) are good for the most part; they love her and care for her and don’t want to see her hurt.”

Worried about her mother’s safety, Nan admits her mom is regarded as a gentle wanderer, who agitated the newcomer by approaching him in the common room.

“She will go up to a person, pat them gently and say something like ‘It’s going to be all right,’” says Nan.

Concerned by the phone calls from staff, on May 2, Nan met the manager and was given phone numbers for Interior Health’s patient quality care co-ordinator and a licensing officer.

“I phoned them both on May 2 and have yet to hear back from either one of them,” she says. “I made sure I had time to talk but got a recording. A recording? Really?”

Nan says she has had no response in the three months since then.

Interior Health disputes this, saying Marilyn’s safety is not in jeopardy and health officials have indeed been in communication with the Marshall family.

Frustrated by what she views as a lack of communication at all levels, Nan says she returned to Bastion on May 3 and discovered the manager had assigned a staff person to her mother but hadn’t filled her in on what steps were being taken to protect her mom. While things seemed to settle down with the extra caregiver, in mid-June the male patient began to pay Marilyn unwanted attention, says Nan.

After demanding the manager call her with a plan to resolve the matter, Nan says she was advised the next day that the plan was to be “hyper vigilant.”

“She asked me if I’d consider moving my mother,” says Nan, noting her father lives in Nakusp, a community that lacks the level of care her mom needs and the trip for her 81-year-old father is already onerous.

“When you move seniors, they die.”

Nan was also horrified to be asked if she would agree to having her mother confined to a special chair that would restrain her movements.

“My mother is being punished for someone else’s action; the one thing she has left is the ability to move her body,” says Nan, noting she has been advised moving the new resident to a psychiatric facility is not necessary.

Nan’s father, Ken, is also distressed by what he calls the male patient’s “possessive attempts” to lead his wife of 62 years around.

“Last Friday (July 22) I took Marilyn outside to the patio and when we came back in, he’d taken his shirt off and his pants were down so you could see his bum,” says Ken, noting the resident took a swing at a caregiver who was trying to persuade him to go to his room. “It’s bad enough seeing her with Alzheimer’s but to be more less terrorized by another patient is not permissible.”

In only her third week as Interior Health’s west residential services administrator, Marg Brown says she plans to visit Bastion Place this week.

“I can tell you the manager and the administrator have been having discussions and the manager has met with the interim administrator,” Brown says, pointing out the complexities of providing care to those with cognitive issues.

She says IH has introduced a tool to assess factors that contribute to certain behaviours in older adults with dementia.

As well, an inter-disciplinary team develops a personal and family centred care plan for each person, says Brown, noting a behavioural specialist assists with the plan.

“We don’t have concerns for Marilyn; she’s fragile, but most of them in there are and he has not done anything violent,” says Brown.

In terms of the level of care in Bastion’s secure ward, a minimum of 3.15 hours of care per resident, per day is provided. This includes 2.8 hours of direct care from professional nurses and care aides, as well as 0.35 hours additional supports like recreational therapy staff, says an IH media spokesperson.

“Changes (in staffing) in June resulted in an increase of care in this area, in particular, professional nursing oversight on the unit that would assist with more comprehensive assessment and care planning for individual residents,” says IH media rep Michaela Swan in an Aug. 2 email.