“Where is she?”

Residents like Edna need an in-home BSO team in every long-term care home.

Edna hears herself say it, but the voice sounds like someone else’s.

Like these hands, she thinks. Some days they can do buttons but not today. It’s almost 8:00. It’ll be time for breakfast soon. I should be dressed. I need to be dressed.

She’s 85 years old and lost her husband Jerry to lung cancer eight years ago. Edna has only lived here a few months and she’s still getting used to the schedule. Jerry always got up a little later, after she made the coffee, but she’s an early riser. She takes pride in her appearance and wants to be dressed for breakfast but she can’t do it herself.

On Monday, Dina, her PSW that morning, arrived at the room just before breakfast.
“Are you okay if we get you dressed after you’ve eaten?” She had asked like it was a question but it wasn’t. Edna agreed hesitantly and went down in a wheelchair wearing her blue housecoat. Beatrice, Tina – even Henry – everyone at her table was dressed except her.

I’m not sick and I’m not a child, she thinks, staring at the door to her room. I just can’t do some simple things. Sometimes my fingers move like I’m wearing winter gloves. She’s rubbing her hands together as if to keep warm, but she’s not cold.

‘Where is she?’ Edna feels a sense of loss build like a wave inside her. She’s afraid, panicked, then shifts quickly to anger. “Where is she? Where is she? Where is she!”

As Jen, her PSW, walks in, she sees Edna’s behaviour is escalating. Dina said she had to call the BSO team on Monday, Jen thinks. But there’s no team on site today. Edna’s dementia is worsening and without the appropriate staffing trained in behavior supports to map out an individual plan of care for Edna, she may be put on medications that could alter her quality of living.

Residents throughout long-term care homes in Ontario experience disruptions in the approach to care that can start small but quickly trigger responsive behaviours. The need for BSO teams in every home is clear. And more PSWs mean more residents like Edna can have their breakfast without personal stressors and without impacting their dignity.