A daily dose of togetherness is a perfect prescription for young and old

Over medicating in care facilities, and self-medicating, or in some cases, over- self-medicating at home is not new and it’s not confined to the elderly, who are often thought to be forgetful and not ‘checking it twice’. Medication over-use and misuse is sadly, and often tragically a growing problem amongst all age groups.

Thankfully, when it comes to seniors and those of significantly advanced age, clinical staff in many care facilities are addressing the issues head-on and hands-on, examining what patients are taking and why. Very often, the ‘why’ is taken care of right away when drugs are no longer ordered as the condition for which they were required no longer exists. That should beg another question - why, in some cases, was a drug no longer required still being prescribed and dispensed? Along with that is learning how drugs interact with each other and how some drugs offer the same benefit as other drugs and taking away one cuts into ‘duplication of services’. 

The rationale of prescribing drugs that serve only to sedate should be examined more closely via conversations with the patient, as he is able, and anyone attached to him who has regular contact who knows how the patient lives/copes on a day to day basis. Once in assisted care, a lot of the routine tasks normally undertaken by the elderly person are charged to someone else - a nurse or other caregiver. That being so, some of the previously ‘required’ drugs, like those for pain management, may not be indicated. Again, conversations about the ‘why’ of pharmacological intervention  is critical.

In the clinical care setting, there has to be an admission of culpability by hands-on clinicians that some patients are sometimes or even frequently sedated for the convenience of staff. If asked, I’m sure some frontline health care workers will admit to wanting to sedate ‘so-and-so’ ‘because s/he’s too needy, too demanding’, ‘always ringing the nurse’, and so on. 

Nashwaak Villa and many other such facilities, with the Planetree model in place, have gone a long way to enhancing quality of life of their residents. Inviting the community to ‘come on in’ has been a huge success. Seniors in care have lost access to a big part of themselves and their identity - the community in which they live. They’re now relegated to a life behind brick walls. Certainly, facilities are  high tech, but they’re still ‘facilities’, and they are sterile no matter how much of ‘home’ is brought in to ‘pretty up’ a room. It’s the ‘people connection’ that will ultimately make a huge difference in the life of an older person in care, even if dementia plays a role in their daily interactions. Wouldn’t it be great if a hug could be pulled out of a bottle and dispensed at will? It’s long been demonstrated that a touch, a hug, a kind word, and a smile go a long way to lifting the mood. Make no mistake, a senior, even those lost in dementia, need all of that and more. Their need for connection doesn’t disappear the moment they pass through the doors of a care facility. In fact, it’s even more critical that they be made not to feel abandoned and forgotten. 

Planners of primary and elementary education are developing programs that include ‘friendly visiting’ at local nursing homes. Young school children are often removed from what goes on with the older persons in their community by virtue of age, certainly, but also because lots of children are still functioning in the ME mode, which is to be expected.  But, at some stage, they have to be guided into more WE activities and what better way to do that than to get them acquainted with serving the community, serving those who have lived and worked in the community for decades. The young meeting the old must be part of the circle of life, to coin a popular phrase. No one should live in isolation at the end of their days. That’s not humane. 

Youngsters, if given the opportunity, would enjoy spending time with older people, hearing their stories, listening to and singing their songs, sharing a meal. The daughters of my former mail carrier are testament to that, thoroughly enjoying their time with the folks at Nashwaak Villa - breaking bread together.

Imagine what the lost art of actually making bread together could accomplish? Dough kneading has been proven to help persons recovering from stroke with the repetitive motion of hands and arms communicating with the brain to restore function. As well, on many levels, persons with dementia will ‘remember when’, if they are given opportunities to ‘get back in the kitchen’. The mutual benefits to a 7 year old and a 70 year old rolling up their sleeves to work together for a few hours a week are many and will create cherished memories. No pills required.

Carla MacInnis Rockwell is a freelance writer and disability rights advocate living outside Fredericton, NB with her aging Australian silky terrier and a rambunctious Maltese. She can be reached via email at carmacrockwell@xplornet.ca

Having a safe place to go when home becomes a battleground

Kenny House, part of Fredericton, New Brunswick’s Liberty Lane’s  second stage housing project which features 10 units had been in the works for 10 years and it’s finally here. With one apartment tailored to the needs of a women with disability, Kenny House recognises that those with challenges to daily living are not immune to abuse. 

In planning accommodations for the differently able, it’s critical to gear environments taking into consideration the ‘most’ disabled. Accessibility issues for a C2 quadriplegic are more involved than for a paraplegic or for a woman with cerebral palsy who walks with crutches or uses a walker. Transition houses and 2nd stage housing and non-profit housing need to be fully aware of the unique changes that must be made to dwellings that will become home to women in crisis who live with various types of disability.

Research suggests that women with disability are more likely to suffer domestic violence and sexual assault than women without disability and women with disabilities report abuse that lasts longer and is more intense than women without disability. By virtue of obvious visible limitations to freedom of mobility and movement, women with disability may also live with various components of health and wellness that are not visible. So there’s the case of ‘all is not as it seems’. They stay in abusive relationships for many of the same reasons that women without disability stay in abusive situations, but there’s another layer to their decisions to stay in place.

Some will stay because their home is where they feel safe because the spaces ‘fits’ their physical limitations and meets the emotional needs sometimes imposed by those limitations. The tendency to ‘put up’ with slaps, kicks, punches, verbal abuse and emotional abuse get squashed down. Sadly, what often happens to break that cycle is a major emotional explosion that sometimes requires hospitalization. Then, the woman in crisis will allow herself to ‘break’ in what must be a safe place. A hospital is supposed to be safe.

With  hospitalization, whether for an overnight or two nights, is an opportunity for a woman to feel safe to attempt to settle herself. Clinical staff can go a long was to contributing to wellness by ensuring that the woman, upon presenting in the ER, which is often the first stop, is immediately taken to a quiet room and not obliged, in a public space, to disclose the reason for her visit. Sometimes, the person who abused her may very well be the one who brought her to get medical attention. Hospital staff need to quickly become proactive to protect privacy and safety. Women with disability need that extra layer of protection put in place. Minimizing their risk of further harm is paramount. Connection with a woman’s shelter while a medical exam is underway would be an appropriate step. 

If there is no going back home, after a period in a women’s shelter, and secure housing becomes necessary, places like Kenny House with its accessible unit offers a safe place to heal and make a plan to move forward. If staff need to be educated about specific needs of women with certain types of disability, they will learn. They will ask questions. The staff is there to help in whatever way they can. Let them in. Women stay at Liberty Lane units for a year, during which time they develop skills to move on with their lives - education and employment empowerment are crucial.

Like other women, women living with disability are often abused by someone they know. In addition, women with disabilities face the risk of abuse by health care providers or caregivers  — being abused by someone relied upon for care escalates that trapped feeling, so it’s important that the victimized is able to communicate with a person who can be trusted, whether a doctor, family member, friend, or neighbor.

When the violence is perpetrated by personal assistants, family members and/or friends, it is often considered to be a problem that can be addressed by the social service system rather than considered to be a crime that should be addressed by the police and/or the criminal justice system. Women with disability who are victims of abuse deserve the same considerations at law as their non-disabled peers, and to minimise their situations because they live with disability is yet another crime against them.

Access to safe havens like Transition House and accommodations provided through Liberty Lane are a necessary part of the community. It is important for us to do our part as we belong to the same community. Think about it. Someone you know may be utilising their services while you’re reading this commentary. Our contributions continue their efforts.

Carla MacInnis Rockwell is a freelance writer and disability rights advocate living outside Fredericton, NB with her aging Australian silky terrier and a rambunctious Maltese. She can be reached via email at carmacrockwell@xplornet.ca