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The average age of nursing home residents is 83,29 and most are
female. The predominance of women in part reflects their greater
longevity combined with more disabilities, and in part the pattern
of women taking responsibility for the care of their male partners at
home. Nevertheless, compared to the past, more are male. Men tend
to be heavier and more prone to violence. More of the residents are
under the age 65, and there is increasing diversity among both staff
and residents.
The majority of residents must be assisted to get out of bed,
use the toilet, dress, bathe, and eat, all tasks that require attending to
frailty, medical equipment, personal preferences, and resistance. The
majority use incontinence products. Many spend most of their time
in bed, and thus need to be constantly repositioned to prevent ulcers
and to be bathed in bed. Many require specialized medical care, and
not just assistance with activities of daily living, as this nurse explains:
Anyone who tells you long-term care is easy is lying. Or they
haven’t worked in long-term care. … I have a guy who’s having
a heart attack over there, a stroke over there, this one’s got a pic
line, this one’s got this … like all sorts of complex [care] … so I’m
running my own blood work, X-rays and everything else … so
I’m actually operating in a sense at a higher level than you would
as a hospital nurse.30
All this work requires a high level of technical skill, as well as the
social, psychological, and emotional skills that require familiarity
with both residents and other staff. It also takes staff into direct and
close contact with residents. That almost all the residents have some
form of cognitive impairment complicates any intervention, especially
if the care provider is not known to or recognized by the resident.
Close, regular, personal contact is an essential part of this skilled
work. Administering medications, for example, means knowing who
can swallow the medication, how to convince them to take it, and who
usually spits it out or is at risk of choking. This may involve touching
the resident’s face and mouth to assist or ensure the resident swal-
lows. Similarly, treating pressure ulcers requires technical skills that
not only includes close personal contact but also working in close
29. Ibid.
30. Pat Armstrong et al, “RNs in Long-Term Care: A Portrait” (2019) at 12, online:
Ontario Nurses Association <https://www.ona.org/carenow/>.
VULNERABLE
The Law, Policy and Ethics of COVID-19
- Title
- VULNERABLE
- Subtitle
- The Law, Policy and Ethics of COVID-19
- Authors
- Vanessa MacDonnell
- Jane Philpott
- Sophie Thériault
- Sridhar Venkatapuram
- Publisher
- Ottawa Press
- Date
- 2020
- Language
- English
- License
- CC BY-NC-ND 4.0
- ISBN
- 9780776636429
- Size
- 15.2 x 22.8 cm
- Pages
- 648
- Categories
- Coronavirus
- International