I never do well when confronted with bureaucracy. I do recognize that some guidelines are necessary for any business, but it seems we have become obsessed and ruled by them.
With ‘policies and procedures’ people seem to lose their common sense along the way, creating a situation where a business or agency is forced to operate on what it says in the policies and procedures binder, as opposed to what is best for the client, patient or consumer.
It seems that flexibility in dealing with a situation is completely lost when these rules become rigid. They are so rigid they become brittle and as we know things that are brittle tend to break easily and no longer function efficiently, perhaps discounting the needs of a human being.
I bumped into that just recently when attempting to accommodate the needs of my 96-year-old mother who had fallen and broken her clavicle. I was told that she would qualify to have Interior Health Authority care aides come in and assist her.
So, a very nice someone came out from the Community Care group, assessed mom’s living situation (she lives in supportive housing) and said she would qualify for care aides.
Mom and I had a chat about what would be most helpful. Apparently care aides only help with bathing once per week (unless the client is incontinent).
A once a week shower or bath is not enough to feel fresh and clean, even if you are not incontinent. This impacts an individuals’ mental wellbeing too. If you feel unclean, it may impact your desire to socialize – something that is very important as we age.
With mom, they did agree to help with the shower twice a week, but the shower was offered at 1:30 p.m. So that would mean she would dress in the a.m., (‘cause its frowned upon to go to lunch in your jammies) then undress at 1:30 for the shower and then dress again, then undress again at night when she went to bed.
That would be four times she would have to dress and undress in one day. Broken clavicles are painful and can impede the ability to dress and undress.
They are not allowed to bring food up from the kitchen area, because somewhere in their infamous binders of policies and procedures it states they cannot ‘transport food.’
They are not allowed to walk patients down hallways for exercise, but will walk with them to the dining room for lunch. It was suggested by a young nurse that perhaps the care aide could ‘remind’ mom to walk down the hall, by herself. It’s not a matter of remembering, it’s a matter of being safe.
Boggles the mind doesn’t it?
I find the resistance to walking down the hall with a senior puzzling, as in the IHA’s own information about seniors, it states: “The prevention and reduction of falls among seniors is of particular importance, and B.C. is considered a world leader in this field.”
Walking alongside a fragile senior who uses a walker would reassure the senior and a way for the care aide to assess how well they are doing. They could also help the client take a moment to sit on their walker if necessary.
This is important to know Boomers, because bureaucracy tends to grow exponentially. You’ll need an advocate to make sure you are being looked after properly if this happens to you.
I believe we must acknowledge the important work that care aides do, pay them accordingly and perhaps increase their training. They are vital to the quality of the lives of those they help. We need to allow care aides to be flexible enough to help others in a respectful and empowering manner.
Just so you know, everyone I spoke with was polite, but they are, unfortunately, puppets of the system.
We need to change the bureaucratic policies and procedures and make them more humane. Health care bureaucracy has lost sight that it is dealing with human beings.
Carole Fawcett is a freelance writer, retired counsellor and humourist www.wordaffair.com