Mrs. Nirmala Mery is an exceptionally dedicated social worker at Schlegel Villages, a long-term care centre in Mississauga, Ontario. In her field of long-term care, she strives to create a welcoming community with a positive attitude, and aims to enrich the experiences of residents through persistent support. Throughout her career, Mrs. Mery has formed numerous life long relationships that demonstrate her inspiring role in the healthcare industry. In an email interview, she shares some indispensable knowledge she acquired over years of hard work:
“I have been working in Long Term Care for 16 years at the Village of Erin Meadows. My work has revolved around supporting residents with dementia. A lot of my work is focused on understanding residents who have specific expressions [for ex: words, gestures, actions]. I spend a lot of time getting to know each resident’s uniqueness and needs. I develop an understanding by meeting with people who know them best, observing them myself, as well as seeking advice from health care professionals. Then as a team we try different support strategies to promote the safety and well being of each resident. Some supports are simple while others are more complex. My professional interest is teaching. I am on a mission to develop a greater understanding of what the experience might be for someone living with dementia. Much of the stigma or lack of understanding is because no one has changed the story around by asking the question – what if this was me? How would I want you to support me? I keep my education interesting by using interactive activities, role playing and discussion.
A couple years ago a resident moved into our Village. This resident had lost everything we strive all our life to acquire: family, home, job freedom and ability to make choices. Due to a severe medical condition this resident was unable to speak so it was hard to determine this resident’s needs or feelings. As part of the Personal Expression Resource Team, it was my role to identify how the Village could support this resident. I read through this resident’s information [that] we receive at the time of their move into the Village. There wasn’t enough to help me paint a picture. I was able to trace someone who was able to give me some history. This resident’s story was so extraordinary that I collaborated with an external partner from an outside organization to help provide education to the team on how we were going to support this individual.
The day of the educational training, my partner and I wrote out a bunch of losses any of us would experience if we were in this resident’s shoes on post-it notes. One was the physical losses and the other were the emotional losses. My external partner and I took turns sticking these losses on separate panels of a door. Our session ran like this: We asked our team members to close their eyes and think about how they would feel if they couldn’t ever go back to work (that would be a physical loss), lost their family (emotional loss), were unable to read a newspaper (emotional loss), and unable to walk across the street to get a cup of coffee (physical and emotional loss). Then we asked the team to open their eyes. Both panels of the door were covered with post it notes. The note would have ‘unable to work’, ‘no coffee’, ‘no family’ etc. written on them. Each loss was placed under the heading of a physical or emotional loss. Then we asked the team if they knew who this resident might be and they were unable to identify the resident. Once we gave the team the resident’s name they were shocked as they assumed this resident was just depressed.
I realized it was important to allow this resident to grieve and that our first step as a Village was to provide tools on how we were going to allow this. This resident needed to feel valued as a person, so I felt a yearning to develop a strategy. I began to spend a lot of time talking to this resident about God as I learned this resident was deeply religious. As weeks slipped into months, this resident began to feel a sense of purpose and a desire to get out of bed. I work every other weekend. On the weekends I worked, I bought food for both of us and we would have lunch on the patio. It was such a special time watching this resident enjoying a slice of pizza or a burger, relishing fresh air on their face and beginning to have things to look forward to.
Each resident I engage with on a psychosocial level makes me think about my own journey in this life. I cannot go through these experiences and remain unchanged. However, this resident’s life sparked a more urgent need to help, to protect, to erase a tragic past and to give this resident back the life they once knew. I felt frustrated with my limitations. This interaction taught me the importance of remaining sincere and faithful in my commitment to helping this resident find meaning and purpose to live. I realized that this was not a limitation but an opportunity. Eventually this resident moved to another Long-Term Care Home to be close to friends but I hope I started the ball rolling in helping this resident want to live.
A change I would make to Long Term Care would definitely be more staffing. When we pay our taxes, it goes into one bucket and is then distributed. When the healthcare system budget is being planned, they don’t realize that if they fund more staff in Long Term Care then there will be less falls, less personal expressions, and more time for staff to actually spend with residents. So, if residents are falling less, having less expressions, need less wound care, and don’t end up in the hospital, then they free up hospital beds. Falls, wound care etc. costs the healthcare system significantly more money than paying for extra staff!
I think when it comes to human health issues we break people up into mental health, medically stable or unstable, and people with dementia or other conditions/diseases. Instead we need to look at the ‘whole person’ and recognize them as individuals with physical, mental, emotional, spiritual and social needs. I know it’s a direction health care is moving towards but the pace is still slow.
[At Schlegel Villages,] we educate, believe and live our philosophy of putting our people before the disease/medical condition. This is why it’s easy to work in this organization. We recognize the five factors I mentioned earlier that individualize a person. For example, if we meet someone’s emotional and spiritual needs the mental condition could automatically stabilize. Or if we meet the mental condition then the person could become emotionally stable which could lead to better social skills.”
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