The following two articles appeared in The Recorder & Times (Brockville) and are reprinted courtesy of the newspaper and by permission of the author.

Long-term care: Are you ready?

By Keith Pelton

Reforming long-term care in Ontario has been one of the provincial government’s priorities since the Liberal Party was brought to power in the fall of 2003. Last fall, it promised a "revolution" in long-term care, with the necessary legislation to be introduced "early" this year.

Ontarians, particularly people who live and work in long-term care homes, were asked for their comments. These were to be submitted by December 15 to be considered by Minister of Health and Long-Term Care George Smitherman. Over the next few months, meetings with associations and the general public are to be held to review the suggestions received by that deadline as part of the process to reform long-term care.

All well and good.

But, what is there about current legislation that needs to be reformed?

What does the current legislation provide? What’s out there now?

What am I required to do to be admitted to a long-term care facility, should I ever be in that position? What are the eligibility requirements? And–what is a long-term care facility?

There is a wealth of information available, much of which the general public is unaware. But, when you absorb some of this background information on which I base this paper, one question remains unanswered: "You’ve told me what’s available. Now tell me how it affects me. How do I go through the process should I need to be admitted to a nursing home, or a home for the aged, or a long-term care facility?"

To answer that question, we will look at some of the findings of the Advocacy Centre for the Elderly, at the role of the Access Centre for Community Care in Lanark, Leeds & Grenville Counties, at the costs and facilities at long-term care (LTC) accommodation in the tri-counties, and we’ll examine, in some detail, the government’s position on which public input is being sought to reform the system as it exists.

I am indebted to a group of health practitioners for their assistance either through personal contact, or by cannibalizing–with permission–their efforts on paper. It was most helpful, in fact quite necessary, that I draw upon the knowledge, experience and wisdom of Judith Wahl, Executive Director and barrister-solicitor Graham Webb, of the Advocacy Centre, of Carol Ravnaas MSW, RSW, Director of Quality and Program Development, PCS Coordinator Louise Dolinki and Case Manager Janice Mack of the Access Centre for Community Care, on Administrator Tom Harrington and Director of Care Janice Pearson, of St. Lawrence Lodge, upon the Ministry of Health and Long-Term Care, and upon various papers, brochures and articles that I have accumulated.

In October I attended a day-long seminar on Elder Abuse in Perth. Included in the handouts was an excellent paper, "Introduction to Long-Term Care," prepared by Graham Webb of Judith Wahl’s Advocacy Centre for the Elderly, in Toronto. In correspondence with Ms. Wahl, I commented that the paper provides much information of which the general public is unaware, an observation with which she agreed. She gave me permission to quote any or all of the Graham Webb paper when I told her this had prompted my thinking in putting together a series of columns, or a feature, on long-term care. I draw, also, on the Ontario government’s report, "Future Directions for Legislation Governing Long-Term Care Homes." This report builds on the work that was started by Minister Smitherman’s Parliamentary Assistant, Monique Smith, MPP.

In "Introduction to Long-Term Care" Webb explains that, in Ontario, there are three kinds of long-term care facilities that provide high levels of care to eligible persons: nursing homes that are regulated by the Nursing Homes Act, municipal homes for the aged that are regulated by the Homes for the Aged and Rest Homes Act, and charitable homes for the aged, regulated by the Charitable Institutions Act.

Under proposed legislation, the three Acts governing LTC homes, will be brought together in a single piece of legislation "to ensure uniform standards and accountability." Based on this proposal, the government is proposing to introduce a new consolidated "Long-Term Care Homes Act" this year. It is noted that "retirement homes" are not currently regulated by the provincial government and are not included in this legislative proposal.

According to the Webb paper, nursing homes, normally, are operated by private for-profit companies. Homes for the aged are nearly identical to nursing homes in their operations, but are normally owned and operated by a municipal corporation or a charitable institution. Long-term care facilities are funded and regulated by the Ontario Ministry of Health and Long-Term Care. "Each facility will have a service agreement with the Ministry, and is subject to the applicable statutes, the regulations made under those Acts, the Ministry’s policies, the terms of the service agreement, and the Ministry’s "Long-Term Care Facilities Program Manual."

Residents of long-term care facilities are predominately older adults. "However, since eligibility for admission is based not on age but on care needs, there are also significant younger populations within long-term care facilities. Admission is arranged through a Community Care Access Centre, which determines eligibility based on OHIP eligibility and the presence of care needs that cannot be met in the community."

Residents of long-term care facilities are charged a co-payment to cover the cost of meals and accommodation, while health care and other costs are covered by the Ministry of Health and Long-Term Care. The resident co-payment for basic accommodation may be reduced based on an inability to pay. Details of this arrangement are covered later in this article.

The fundamental rule of a long-term care facility, the Webb report observes "is that the facility is the home of its residents. ‘Home’ is the essential element of the phrase ‘nursing home’ and ‘home for the aged.’" This point is stressed repeatedly in the Bill of Rights for people who live in LTC facilities.

Commenting further on the "home" factor, Graham Webb underlines the fact that residents are not "patients" of the facility generally, "although they may be a ‘patient’ of a particular regulated health practitioner who provides services within the facility, and if mentally capable to make their own decisions, they are free and independent to do so. If a long-term care resident is not mentally capable, then decision-making authority will rest with a substitute decision-maker. Therefore, whatever a resident could do in one’s own home, can be done by a resident of a long-term care facility."

This consideration was enlarged upon when I discussed details of LTC residency with Tom Harrington and Janice Pearson of St. Lawrence Lodge, and this is covered later in this report.

Eligibility for admission is determined by a Community Care Access Centre (CCAC) or, as the organization is known in Lanark, Leeds and Grenville Counties the Access Centre for Community Care. Once eligibility is established, you may choose up to three facilities to which you would like to go. If the facilities you choose agree to accept you, you must then wait until a bed is available in one of them, unless you are in a crisis situation.

In a discussion with Carol Ravnaas and Louise Dolinki and in a review of information made available by the Centre, I learned that no one can be forced into a facility. You must agree to accept a bed, or if you are not able to make this decision for yourself, your substitute-decision maker who has legal authority must agree. If the facility you have selected as your first choice is not immediately available, you may be offered one of the other two you chose, and then when your first choice becomes available you will be moved there. If you refuse to accept a bed at one of your chosen facilities when offered, your name is removed from the waiting list.

So, how does the CCAC fit into the picture? And how did it become empowered to such an extent? And what does it all cost?

In her presentation during the Perth seminar, Janice Mack described the Access Centre concept as "a vital component of local health care and a gateway to care at home, supportive care and children’s services, access to long-term care facilities, adult day programs and respite care and a resource for information about services available within the community."

Formerly called the Home Care Program and the Placement Coordination Services, the Access Centre concept was established in April 1997 as a "one-stop" approach to provide information on health, social and community services and to link residents with resources available to them. The local centre is one of 42 across Ontario. It is governed by a Board of Directors as a not-for-profit, charitable, statutory corporation, and is funded by the Ministry of Health and Long-Term Care. It is "committed to providing quality health care in the community by coordinating nursing, personal care/homemaking, physiotherapy, occupational therapy, speech language pathology, social work, nutritional counselling and placement to long-term care facilities, access to adult day services, and respite care."

Services are available to people of all ages in the home, school, workplace or LTC facility. At one time an applicant must have been referred by a doctor. This is no longer the case. The individual, or a person representing the potential resident, may apply.

The Access Centre for Community Care for Lanark, Leeds and Grenville is located in Smiths Falls at 52 Abbott street N. Unit #1, K7A 1W3, with a satellite office at 555 California avenue, Unit #1, Brockville, K6V 7K6. The telephone number for both locations is 1-800-267-6041.

At present the resident pays $1,480 per month (or $48.69 per day) for basic food and accommodation, $1,724 for semi-private and $2,028 for a private room. Contrary to a view held by some, this is not the total cost. Over and above the cost borne by the resident, the Ministry pays the facility the difference between the co-payment rate and a total of $120.84 per resident per day to cover nursing and personal care, raw food, program and support services and the other costs incurred in the operation and maintenance of the premises. A resident who cannot afford the basic rate is entitled to a rate reduction which leaves a "modest" amount for personal expenses. This "modest" monthly amount is currently $112 with the government’s intention to increase this to $116 under the proposed legislation to reform the system.

Monthly ward accommodation–the basic rate–is based on disposable monthly income up to a maximum of $1,480.99. If the applicant cannot afford the basic rate, a reduction will be required, and an application will be completed upon admission to a LTC facility. A minimum basic co-payment of $963.16 per month will be required, that is the revenue for someone with only pension income (Old Age Security, Guaranteed Income Supplement and GAINS). The subsidy does not apply to semi-private and private accommodation.

There are 14 LTC facilities in the counties with a total capacity of 1,355 beds. There are five facilities in Leeds, four in Grenville and six in Lanark. In Leeds are located the Carveth Nursing Home, in Gananoque (94 beds), Maple View Lodge, in Athens (60 beds), Sherwood Park Manor, Brockville (107 beds), St. Lawrence Lodge, Brockville (240 beds). In Grenville are located Bayfield Manor Nursing Home, Kemptville (66 beds), Hilltop Manor Nursing Home, Merrickville (60 beds), Rosebridge Manor Nursing Home, Jasper (78 beds), Wellington House Nursing Home, Prescott (60 beds). Lanark’s six facilities are Almonte Country Haven, (82 beds), Broadview Nursing Centre, Smiths Falls (75 beds), Fairview Manor, Almonte (100 beds), Lanark Lodge, Perth (163 beds), Perth Community Care Centre, (110 beds), and Stoneridge Manor, Carleton Place (60 beds).

Application may be made for accommodation outside the counties.

All long-term facilities are inspected by the Ministry. Each facility is accountable to the Ministry for the provision of services. There are regulations governing standards of care and you can apply for either a long or short stay. Care and services provided include room and board, 24-hour professional supervision, routine care by skilled health care aides such as help with eating, grooming, bathing, dressing, toileting and walking, as needed. Services offered also include physio or occupational therapy, regular medical care and emergency medical care by the on-call physician.

If the family caregiver is planning a vacation or needs a well deserved rest, a short stay at the facility can be a very good solution. The care provided is the same as for long stay residents, with the opportunity to take part in activities and share in all aspects of the daily routine. Because of the limited number of designated short stay beds in this area (not all homes offer this service) and it takes time to complete going through the process, application should be made early. There is a maximum of 90 days available per person each year. A person has access to short stay beds for a maximum 30-day duration, three times per year to make up the 90 days. To use this program, you must intend to return home at the end of your stay.

That the population is aging is evident from statistics kept by the Access Centre. For example, 28% of the clients interviewed were in the 75-84 years bracket and 23% were 85 years and over. In a seven-month period there were 18 clients 95 years and over.

In discussions with Carol Ravnaas, Louise Dolinki, Tom Harrington and Janice Pearson, we reviewed the most detailed "determination of eligibility for admission" worksheet. This form is completed by the placement coordinator, and the applicant must meet the requirement to varying degrees. For example, all applicants must be 18 years of age or over, must be insured under the Ontario Health Insurance Act, and the individual’s care requirements can be met in a long-term care facility. As well, the applicant must meet one of a list of several eligibility criteria such as the need for on site nursing care around the clock, assistance each day with activities of daily living, is at risk of being financially, emotionally or physically harmed when living at home. The three-page form contains many other requirements that may or may not apply to the applicant.

Apart from its size–it is the largest of the 14 LTC facilities in the counties-- and the fact that it is presently undergoing a major construction project, St. Lawrence Lodge is representative of the operation of all the centres. The average age of residents here is 92.4 years.

Janice Pearson outlined the long list of basic services that are included in the charge for basic accommodation. These include nursing and personal care on a 24-hour basis, the administration of medication and assistance with the activities of daily living. Residents may continue to have their personal physician provide care to them in the facility. Also included are medical supplies and nursing equipment necessary for the care of residents, the prevention or care of skin disorders, continence care, infection control, and sterile procedures, medical devices such as catheters and colostomy and ileostomy devices.

Basic services also include equipment for the general use of all residents, such as wheelchairs, geriatric chairs, canes and walkers, toilet aids and other self-help aids for the activities of daily living. Also included are meal service and meals, including three meals daily, snacks between meals and at bedtime, special and therapeutic diets, dietary supplements and devices that enable residents to feed themselves.

Social, recreational and physical activities and programmes, including the related supplies, equipment and staff are also made available. Laundry, bedding and linen, bedroom furnishings, cleaning and upkeep of accommodations are provided.

Long-Term Care facilities are permitted to charge residents for optional services that do not form part of the services that are included as basic. Residents must have the choice of either using an optional service that is offered, or making alternative arrangements for themselves. All residents receive a full and clear written explanation of services for which they cannot be charged. Optional services may include but are not limited to hairdressing and barbering, dry cleaning, telephone service in a resident’s room, purchase of liquor, financial services that include banking, tax return preparation and trust account management and audit, transportation services, ironing and mending of clothes and the purchase of cable television services.

Visiting hours are daily from 11 a.m. to 7 p.m. In fact, visitation is encouraged, and volunteers are most welcome. Prospective residents and their family members or personal representative, are invited to visit the facilities to become acquainted with what is available. These visits can be arranged by appointment.

In Ontario, long-term care services are provided by not-for-profit organizations as well as for-profit operators. Both are funded by the provincial government, and the Access Centre facilitates placement to both. But there are fundamental differences. St. Lawrence Lodge is a member of The Ontario Association of Non-profit Homes and Services for Seniors, and Tom Harrington drew to my attention some of the differences outlined by the Association.

Not-for-profit operations use every dollar to enhance and expand their services and operations. With LTC facilities specifically, both not-for-profits and for-profits are funded by the government and they essentially receive the same amount of money. Not-for-profit operators that generate a surplus re-invest these monies to enhance or increase the level of service provided to residents. For-profits, on the other hand, generate surpluses but they are allowed to keep them and withdraw these funds as profit for investors. The Association stresses that "profit seeking diverts funds and focus from clinical care..." Not-for-profits have strong community support and believe that services in the community should be governed by the people who live in and care about that community.

Every resident of a long-term care facility "has the right to be treated with courtesy and respect and in a way that fully recognizes the resident’s dignity and individuality, and to be free from mental and physical abuse."

So reads the first of 19 clearly enunciated clauses in the "Bill of Rights for People Who Live in Ontario Long-Term Care Facilities."

You do not stop being the person you were before you moved into the long-term care facility. You may want to continue your hobbies, to follow your religion, and to do other activities. The care facility should make it possible for you to do these things, within reason. The long-term care facility is your home. You are not a patient. You are a resident.

Let’s return to the future.

"The only standard in long-term care is a high one. Our seniors deserve nothing less."

So comments Minister George Smitherman in his letter of November 3 in which he announces the government’s plans to introduce legislation to reform long-term care in Ontario.

Smitherman writes: "Over the last year we have made important strides to improve the care and quality of life in LTC homes. We invested an additional $191 million dollars annually to hire 2000 new long-term care staff, including 600 new nurses. This funding will also allow our long-term care homes to meet a consistently higher standard of care. We are reinstating the requirement in regulation–removed by the previous government–that a registered nurse be on site 24 hours a day, and we are creating a regulation to ensure residents receive at least two baths a week. We established a toll-free action line (1-866-434-0144) for residents and their loved ones to register complaints, concerns and questions about services. We have adopted a policy of unannounced visits and inspections...provided funding to support homes to create residents’ councils and family councils..."

It is the government’s plan to bring together the three Acts that now govern operation of LTCs into a single piece of legislation "to ensure uniform standards and accountability." This proposed new Act will focus on five major areas, including residents’ quality of life and care standards; residents’ rights and safeguards to combat abuse and neglect; compliance, inspection and enforcement programmes in long-term care homes; systems for licensing home operators and approving beds; and planning and renewal of long-term care homes.

Over the next few months, meetings are to be held with associations and members of the public to review the comments and recommendations that were submitted by the December deadline. The Ministry has observed that over the past 11 years, the level of health and personal care needs of residents in Ontario’s LTC homes have increased y nearly 20 per cent. Higher and more complex care needs must be matched with tighter accountability and strengthened quality assurance.

"Residents, families, and residents’ groups want to see key programme standards placed in legislation. The proposed legislation will contain clear and strengthened care and safety standards for the service provided by LTC home operators and their staff...As it is for all Ontarians, quality of life is a central issue for people who seek admission to and live in LTC homes...People who are well informed feel more in control of their lives. The Ministry is proposing to strengthen its requirements to ensure that operators provide residents, their families, the public, and those seeking admission to LTC homes with clear, accessible information about the operations and policies of Ontario’s LTC homes."

(March, 2005)

************

Sherwood Park Manor is just like home

Long-term care facilities take pride in providing their residents with a welcoming environment

By Keith Pelton

Put yourself in this picture.

You’ve just driven by a nursing home, or you’ve spent a couple of hours with a friend or a family member who is a resident of such a long term care facility.

You find yourself wondering about your own future. Perhaps the day will come when you take up residence in such a home. And you ask yourself several questions:

What happens when, as a prospective resident, I go through the door of one of those homes? What do I face? What sort of procedure must I undergo to be admitted? What is expected of me? What may I expect? What will it cost? What must the staff do?

Let’s assume that, for various reasons, you have expressed a desire that should the day come when it will be necessary that you take up residence in a nursing home, you would want to be admitted to Sherwood Park Manor.

The Manor is one of 14 long term care facilities in the tri-counties of Leeds, Grenville and Lanark, with a total capacity of 1,355 beds. There are five facilities in Leeds, four in Grenville, and six in Lanark, each distinct in its own way, each striving to provide the care and careful attention to which the residents are entitled in what has become their home.

By reading the several pages of information available, we learn that Sherwood Park Manor is a full-service, accredited, non-profit nursing home licensed by the Ontario Ministry of Health and Long-Term Care. Located in the Township of Elizabethtown-Kitley at the eastern edge of Brockville, the Manor is close enough to the city to take advantage of the urban amenities while having the distinction of a quiet country setting. Cedar rail fencing surrounds the property, encompassing colourful gardens, lush lawns, paved walkways, spacious patios and attractive gazebos.

Thus reads the introduction to a most comprehensive website review of the facility and what it offers to the occupants of its 107 beds and 106-member staff.

Located in Leeds County are Carveth Nursing Home, Gananoque (94 beds); Maple View Lodge, Athens (60 beds), Sherwood Park Manor (107 beds), St. Lawrence Lodge (240 beds); in Grenville, Bayfield Manor Nursing Home, Kemptville (66 beds), Hilltop Manor Nursing Home, Merrickville (60 beds), Rosebridge Manor Nursing Home, Jasper (78 beds), Wellington House Nursing Home, Prescott (60 beds); in Lanark, Almonte Country Haven (82 beds), Broadview Nursing Centre, Smiths Falls (75 beds), Fairview Manor, Almonte (100 beds), Lanark Lodge, Perth (163 beds), Perth Community Care Centre (110 beds), Stoneridge Manor, Carleton Place (60 beds).

In Ontario there are three kinds of long-term care facilities that provide high levels of care to eligible persons: nursing homes that are regulated by the Nursing Homes Act, municipal homes for the aged that are regulated by the Homes for the Aged and Rest Homes Act, and charitable homes for the aged, regulated by the Charitable Institutions Act. Under proposed legislation the three Acts are to be brought together in a single piece of legislation "to ensure uniform standards and accountability." Based on this proposal, the provincial government is proposing a new consolidated "Long-Term Care Homes Act." Retirement homes are not currently regulated by the provincial government and are not included in this legislation proposal.

Residents of Ontario nursing homes are protected by a Bill of Rights that became law in 1987. Then in 1993, it became law for the residents of Ontario municipal and charitable homes for the aged. This legislation ensures that long term care facilities are "homes" for the people who live in them.

Every long term care facility must post the Bill of Rights. It tells staff that they must respect the individual’s rights. It tells residents to remember that they are in their home. The Bill of Rights "reminds everyone–residents, staff, friends, family, and neighbours–that residents of long term care facilities are valued members of the community."

According to the Bill of Rights, every resident "has the right to be treated with courtesy and respect and in a way that fully recognizes the resident’s dignity and individuality, and to be free from mental and physical abuse."

This is the first of 22 clauses in which the Bill covers a wide range of residents’ rights, and the responsibility of staff to ensure that these rights are protected. These cover proper shelter and clothing, privacy, displaying personal possessions, pictures and furnishings, being informed of medical condition and treatment, being able to accept or refuse medications, the right to participate fully in making decisions concerning any aspect of care, maintaining confidentiality of medical records, the right to communicate in confidence, to receive visitors, and to consult in private with any person without interference.

A resident whose death is likely to be imminent has the right to have members of the family present 24 hours per day, has the right of a citizen to raise concerns or recommend changes in policies and services, has the right to meet privately with his or her spouse or same-sex partner in a room that assures privacy and, where both spouses or same-sex partners are residents in the same long term care facility, they have the right to share a room according to their wishes.

The resident has the right to manage his or her own financial affairs when able to do so, and has the right to be given access to protected areas outside the long term care facility in order to enjoy outdoor activity, unless the physical setting makes this impossible.

Where and how does Sherwood Park Manor fit into all this?

I am indebted to the Manor’s administrator, Mrs. Joan Bennett, R.N. who took time from her busy schedule to spend time with me, and who provided a wealth of information. A former executive director of the tri-counties branch of the VON, and administrator of St. Lawrence Place retirement home in Kingston, Mrs. Bennett holds a RN diploma, a diploma in Public Health from Dalhousie University, a Bachelor’s degree from Queen’s University, and a Master’s degree in Public Administration with a specialty in Health Care policy.

Sherwood Park Manor is 30 years old this year.

"It was founded because the hospitals needed to free their beds for acute care, yet for those who still required continuing care, a safe, comfortable alternative to home was necessary," Mrs. Bennett explained. "Nowadays people are living longer, sometimes in a state of chronic ill health. Moreover, families are busier and tend to live farther away from the place of their childhoods. Sherwood Park Manor has come to play a central role in providing the security, warmth and comfort of home for its residents and peace of mind for their family members."

Having visited nursing homes only occasionally down through the years and that for the purpose of spending time with a particular friend or relative, I remain amazed at the amount of paper work that must be completed when a person is being admitted. And I quote from some of that printed material, information that is made available to prospective residents and their families or designated substitute decision maker.

According to the Manor’s mission statement, "Care provided meets the highest standard based on current knowledge and practices and is in compliance with current legislation. The atmosphere is conducive to the dignity and well being of the residents, and their special needs and wishes are considered in all aspects of planning. Partnerships are encouraged with health care and community agencies, educational institutions, and hospitals throughout the area to provide clinical experience for students."

And: "We are committed to the well being of the staff."

The information package available to prospective residents includes the physical description of the buildings, a list of key staff members and associates, the mission statement, a list of bedroom furnishings, a suggested clothing list, gift ideas, the floor plan and accommodation rates. Contact numbers for further information are 342-5531, fax 342-3767 and the information-packed website www.sherwoodparkmanor.com.

According to the Manor’s administrative manual, it is policy "to ensure that the admission process provides the new resident and family with the necessary information, welcome and reassurance to promote peace of mind."

It is stressed that the admission process should be preceded by a tour and, if possible, a viewing of the Manor’s web page and brochure. If Sherwood Park Manor is selected as one of the resident’s three facility choices permitted by provincial legislation, the family will register that preference with the placement coordinator at the Access Centre for Community Care and wait for an available bed. The family will also choose a level of payment and provide the necessary documents, powers of attorney forms, income tax summary for subsidization, health care card, birth date, and medical information.

When the Access Centre’s coordinator offers the family the bed at the Manor, the family has three days in which to accept it. They may return to view the room or may do an initial tour.

"It is always best if admission is preceded by a full tour." Mrs. Bennett advises.

"On the day of admission," the administrator adds, "the resident and family will be escorted to the room and visited by the nursing staff for an initial assessment." (This is an ongoing process on a regular basis during the resident’s tenure.) "The family is invited to stay as guests for lunch with the resident. Other department managers and the attending physician will visit the resident as soon as possible after admission."

Time will be arranged for the family to complete all the business documents.

At Sherwood Park Manor there are three types of accommodation: basic, semi-private and private. There is no preferred accommodation surcharge for short-stay residents. The monthly rate for basic if $1,480.99; for semi-private $1,724.32 and for private $2,028.49. These rates remain in effect until July 31, 2006.

At any time during the year, or upon admission, a resident in basic accommodation who cannot afford the full rate, can request a reduction in the accommodation co-payment if his or her income situation warrants such a consideration. For subsidized residents in basic accommodation the rate is adjusted to income and can be as little as $31.67 daily, or $963.16 monthly.

Contrary to the view held by some, this rate structure is not the total cost. Over and above the cost borne by the resident, the Ministry of Health pays the facility the difference between the co-payment and a total of $120.84 per resident per day to cover nursing and personal care, raw food, program and support services and the other costs incurred in the operation and maintenance of the premises. Extra costs are incurred for such services as hairdressing and hair cuts, clothing maintenance, TV connection and meals for guests.

A resident who cannot afford the basic rate is entitled to a rate reduction which leaves a "modest" amount for personal expenses of $116. per month.

The business office at Sherwood Park Manor is open daily from 9 a.m. to 4 p.m. while visiting hours are 10 a.m. to 9 p.m. Except for midday December 24 and holidays, family members and friends are encouraged to share lunch and dinner with residents, but must give notice a day in advance.

Events for the month are posted on the bulletin boards next to the nurses’ stations. A monthly newsletter and calendar are sent out with the billing for the month. A monthly calendar is also placed in each resident’s room, and residents are assisted to and from activities when necessary.

All residents not only receive the necessary nursing care, but are also regularly assessed for their ability and desire to participate in leisure and recreational pursuits. Physiotherapy, music, pet therapy, and walking programs are all available and advantageous for physical and mental stimulation. Entertainment is provided on a regular basis, and local clergy hold weekly church services in the chapel. Group outings are organized to visit shopping malls, theatres, and special events, and arrangements can be made for a resident to go out with a friend or family member.

In keeping with the home’s expressed objective, the Manor Auxiliary is extremely active and makes an outstanding contribution to the quality of life. The Auxiliary shop is a favourite spot for both residents and visitors. The afternoon coffee shop is much enjoyed, and so are the regular bingo games and other special events that the Auxiliary sponsors. Through various fund-raising activities in the community, the Auxiliary helps finance capital projects such as new furnishings and equipment and subsidizes the costs of para-transit service for the residents’ activity outings.

In Ontario long term care services are provided by not-for-profit organizations–like Sherwood Park Manor–as well as for-profit operators. Both are funded by the provincial government, and the Access Centre facilitates placement to both. Not-for-profit operations use every dollar to enhance and expand their services and operations. Not-for-profit operators that generate a surplus reinvest these monies to enhance or increase the level of service provided to residents. These homes depend on strong community financial support, and believe that services should be governed by the people who live in and care about that community.

Mrs. Bennett expanded on this feature.

"Sherwood Park Manor is unusual in that it is a not-for-profit home functioning entirely independently. It is owned solely by the community and operated by a Board of volunteers representing that community. Because of that, its staff and residents are blessed in many ways.

"Because we are not-for-profit, we receive many donations and in memoriam gifts. A couple of years ago, for example, a private citizen gave us $100,000. and we were able to purchase electric beds and new mattresses for everyone. We have an Auxiliary whose members contribute greatly in time and money for the benefit of the residents. Just as important, we have over 130 volunteers who spend over 3,000 hours a year with the residents. They provide a vast array of extra service for which we could never otherwise pay. And finally, we can benefit from having a private endowment, the Fulford-Hardy Endowment Fund, the interest from which is directed to the care of our older ladies on subsidized rents. The work here is very satisfying, and the staff are extremely dedicated and loyal. There is a sense that one is playing a vital role for the benefit of one’s own neighbours."

The building consists of five bedroom wings extending from central nursing stations and common areas. The design is bright, open and airy, and the decor and furnishings, both in the bedrooms and the common areas, provide a welcoming home-like atmosphere. As Mrs. Bennett and I walked along hallways in the five wings, it was evident that at Sherwood Park Manor careful attention is given to each and every aspect of the residents’ daily life so they can truly say:

"This is home."

(February, 2006)

TOP OF PAGE

RETURN TO HOME PAGE