“Prepare for the worst, Sharron isn’t looking too good” was repeated 50 times to us over the week and a half that we were at the hospital. That sentence that kept going through my head for the next two years.

Before grandma got really sick, I never really questioned Alberta’s health care system. I thought it was decent but after watching her go through all the pain and frustration, my impression is that the health care system – specifically long-term care (LTC) – is broken and it makes everything worse for families struggling with loved ones in the hospital.

Nurses are being spread thin with long hours while understaffed, allowing unqualified aids to take on complex tasks. This is not what should be happening in a section of the hospital that needs extra care.

My grandma was my rock all through high school. I went to Livingstone, a K-12 school that roughly had 200 kids in Lundbreck, Alta., a little hamlet just 20 minutes outside of Crowsnest Pass.

I would walk over to her house at lunch and after class just before my basketball and volleyball practices. We would talk about everything from boys, to bullies, to mental health, to school and to my future.

She’d always tell me, “Don’t listen to those dumbasses, you’re so smart and that’s gonna help you do great things, bub. I just know it.”

She had the best facial expressions and the most contagious laugh.

Family History

bigfamBODY(From left to right) Andy Bradbury, Darcy Bradbury, Sam Paton, Brian Paton, Grandma holding Mason Bradbury, Doug Paton, Joanne Paton, myself, Felicia White, Mike White, Acacia Young. We all went out for Grandmas 73rd birthday in November 2015, after surprising her with all her grandkids. Photo by Kate Paton.

Grandma Sharron was my dad’s mom. She and her husband Wayne had four kids: Doug, Teddy, Brian and Sheri. We had lost Uncle Teddy to mental illness years before I was born, and we lost Sheri at birth. Sharron has six granddaughters: Kirsten, Felicia, Acacia, Darcy, Sam and myself.

She harped on us all the time to get married for the sole reason that we needed more men than my papa, dad and uncle Brian in the family. We finally had boys in the family when my sister Kirsten had twins, Lincoln and Araya. Then Darcy had Mason and Felicia had Dominic — the rest of us got off the hook for finding husbands.

Despite supporting me to move from home and start a new chapter of my life, she really was my best friend and it broke my heart to move away from her to go to university. I kind of lost touch with her when I moved to Calgary, but I would always try and catch up when I returned home.

She was super proud of all the work I did in university. When I bought my first camera, the first portrait I ever took was of her.

Gram2004BODYRight

My grandma was a fighter. At the age of 68, she was diagnosed and battled Chronic Obstructive Pulmonary Disease (COPD) for six years after that. A side effect of COPD was congestive heart failure, which also took a toll on her.Grandma relaxing on a bench, having a smoke while waiting for lunch to be ready on a vacation to Calgary in 2004. Photo courtesy of Felicia White.

I always remembered her working at the bakery, knitting and helping run the curling club when she was more limber. Grandma Sharron had another role that was a little bit different than most grandmas would.

She also was “mom” to my older sister Felicia. Confused? Let me explain. Felicia’s mom had died when she was just nine months old from a tragic car accident. At the time, my dad wasn’t able to care for her alone, so he did one of the most responsible things he could think of and allowed his parents to raise his daughter.

Felicia only knew our grandma as mom. Even though her kids had grown up and moved out, she was able to be a mother again, raising Felicia and working on the side.

For the longest I can remember, my grandma was sick. Papa Wayne passed away in 2006 from a heart attack and soon after, her health really started to decline.

She had been a drinker and a smoker for most of her life and had grown up in a time where smoking wasn’t really known as a health hazard. An article from Adweek shows that back in the 50s, smoking was promoted and seen as healthy, making it a social norm to smoke and drink.

I always remember her having a scotch and water in her home in Crowsnest Pass while watching “Holmes on Homes” or curling on the TV. After she got really sick, she stopped cold turkey.

After she was diagnosed with COPD, her health slowly declined. In 2011, she needed an  oxygen tank to breathe as her lungs had gotten weaker and weaker over the years. Despite that, her attitude and spunk never diminished.

I remember this one time my grandma and I went to Wal-Mart and she was ripping around on one of those motorized scooters, which she needed for lugging around the heavy oxygen tanks. She didn’t have the best control of it and knocked over all of the garbage bins in the one aisle.

Everyone looked at us and she just pointed at me and said, “She did it!” As someone who is terrified of getting in trouble, the look on my face was priceless – we both roared laughing for the rest of the day.

gramhugsBODYGrandma and I playing around with my polaroid camera after a visit to her senior lodge at York Creek in 2015. We ended up having a photo each, she carried hers in her purse and mine is in my wallet. Photo by Kate Paton.

She had been in and out of the hospital for smaller things, but it wasn’t until 2015 when it got really bad. I got a phone call that my grandma was rushed the hospital when I was sitting in one of my journalism classes in my second year.

The paramedics were told not to use extreme life saving measures on my grandma unless she, my sister or father stated. When she had gotten very sick, she panicked and asked for help that would ultimately hurt her more than save her.

She got very sick with pneumonia in January, 2016. It was so bad this time that she requested a tube put down her throat to help her breathe. She was rushed to the Chinook Regional Hospital in Lethbridge, where she reached the tipping point of her health.

Life in the hospital

The air was clean and smelt like hand sanitizer. Flowers were placed on the window sills and the food tray was full of uneaten mashed potatoes and cup of juice. There was a melancholic vibe throughout the intensive care unit (ICU). Those silent hours sitting bedside to one of my heroes is something that I will never forget.

They pumped her full of all different types of drugs. She could barely respond to us speaking and refused to eat or drink anything. She wasn’t the grandma I grew up with, she was just a lady that somewhat looked like Gram and it looked like she was in so much pain. My whole family was there. My one sister had even flown in from Ottawa to say goodbye.

While she was in the ICU at Chinook Regional Hospital, there was lots of miscommunication.

The nurses and doctors were telling my family different things. One doctor that worked on her predicted she would recover while another doctor believed she was there to have palliative, end of life care.

“There’s not one person that you can get a straight answer from. You get sent to another division, then another, then another and all with different answers. They were just interested in what care she had so that she can die faster,” my dad recalled.

She somehow made it through all the problems and made a recovery no one saw coming.

She stayed there for almost two months until she was given the okay to be able to move back to the Crowsnest Pass hospital in Blairmore.

Moving back to home was a larger problem than we thought. My grandma needed to be in LTC. LTC is a part of the hospital that patients with unpredictable medical needs go, requiring  24-hour care with a registered nurse. It’s for patients that can’t go into senior homes or be on their own.

The problem was that there wasn’t any LTC beds available in the Crowsnest. According to a 2016 Parkland Institute report “Losing Ground,” there are over 14,768 beds in LTC in Alberta. Depending on the town, the availability of beds differs. These beds are only available for patients in need of long term care.

She was advised to stay in the Lethbridge, Cardston or Fort Macleod hospitals, where some LTC  beds were available until one in the Crowsnest opened up. My father struck a deal with the hospital that allowed her to stay in the general area in the Lethbridge hospital for the maximum three months, in hopes that a bed would open up.

It didn’t, and my family wanted her closer to home.

Out of ideas, we decided that she would come stay at my sister Felicia and her husband’s home. My sister was very pregnant at the time and had to take compassionate leave to be able to stay with my Grandma at home while they waited for a bed.

Stressful as it was to coordinate health care aids, beds and life, it was beautiful time in the middle of chaos.

Have you ever met someone that was super excited over Kraft Dinner and hotdogs for supper, or just simply pancakes? My grandma was so happy to be home with her grandkids, including her new great grandson Dominic, and just enjoyed the most of it.

pancakesBODYSharron enjoying her first home-cooked breakfast of pancakes in August 2016 at Felicia’s home. Photo courtesy of Felicia White.

And like all good things, that had to come to an end when a bed opened up in the Crowsnest Pass hospital in November of 2016.

Although she was much happier at home, she was still very sick and needed to be in the hospital.

The image of my frail grandma was something I couldn’t get out of my mind and after saying goodbye at my sister’s home, I didn’t have the emotional strength to see her again. I only heard about her problems through my dad. The Thanksgiving of 2016 was the last time I saw her.

Life in LTC

Once we were in LTC, it wasn’t a walk in the park. On the Alberta Health Services (AHS) site, it states: “The purpose of the accommodation standards is to ensure that all long-term care accommodations maintain a high quality of accommodation services that promote the safety, security and quality of life for Albertans living in those accommodations.”

It didn’t seem that the policy on the site and procedure in hospital were on the same page.

The nurses were very slow to respond to her requests. Her level of care also seemed to be different than previous times when she was healthier.

“It seems that when you get diagnosed with a terminal illness, they back off with the amount of care. If you came in with a broken leg, they would be all over it,” my dad recalls.

LTC was also very different than the regular hospital section. There were a lot of different rules that the staff had to follow. For example, if she fell, they would have to call the nurses in the hospital side to come pick her up as the staff didn’t have the qualifications to help her.

According to  the AHS’s website, LTC is 24-hour care with registered nurses. The LTC in the Crowsnest Pass Hospital had health care aids working on the patients and only one registered nurse per shift.

Our guess was that there weren’t enough registered nurses to go around the hospital – a complaint voiced multiple times in the surrounding rural hospitals, as we heard through a family friend that worked in the front desk of one.

In a recent survey done by the Health Quality Council of Alberta, it stated that “only 18 per cent of family members said there were always enough nurses or aides.” The survey took experiences from 2014-2017 in this report. 

The time to help get her up was much longer than it needed to be. She would lay in bed until they came, or she’d get fed up and try to do it herself. She barely had the strength to sit up, let alone get out of bed.

The staff in that section were spread too thin. The nurses were very understaffed and the health care aids that also worked in the LTC just weren’t qualified at the same level as the registered nurses. Some of them cared quite a bit, but they just didn’t have the skills to help patients like my grandma.

I reached out multiple times to AHS for comment on my grandma’s situation and received no reply.

A report, “Losing Ground: Alberta’s Residential Elder Care Crisis” by David Campanella, stated that almost half the beds that are available for the elderly that need them won’t have a registered nurse on site and will have little staff requirements.

My dad remembered a time when the nurses dropped her out of the tub from the sling.

“There are some really wonderful nurses but there are some really [messed] up ones in there too,” Dad said on the phone.

Nurses would be notified with the call button located on my grandma’s bed and on her wrist that my grandma needed help like going to the washroom, or needed a drink but they ended up taking over an hour to get there.

When my dad noticed this, he and my sister sent in multiple complaints about the level of care my grandma received. Some nurses got the hint that they should be doing their job when caring for my grandma or when my family was in the hospital, but it took a long time to do that.

firstportraitBODYThe first portrait I ever took with my camera, grandma was just sitting in her front porch talking about life in the summer of 2014, just before I started my first year of university. Photo by Kate Paton.

My dad remembers that all the patients in LTC were there for different reasons, and all of them are scared of what’s going to happen next. He thought having those people who don’t treat you with kindness shouldn’t be how you see the last of your days.

An article in the British Medical Journal looked into the planning and communication that goes into elder care and the end stages of elder care in the health care system. The study was conducted in Sydney, Australia but there are aspects to take from it.

The constant bombardment of misinformation and mistreatment really turned my family away from the health care system. There is only so much you can do when you’re stuck in the middle of it . I feel like every family goes through a painful moment. This was ours.

This was how life was until July 2017 when she died.

Just after moving into my new place in Calgary, I received the phone call that I had been dreading to receive for the past two years. I lost my hero.

Even though I said goodbye to her months before, this was a new and more painful goodbye and one that I wish I could redo every single day.

cpaton@cjournal.ca

Editor: Paul McAleer | pmcaleer@cjournal.ca

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