Maurice Voisin on Aging-in-Place

The pandemic we have all experienced over the past year has reaffirmed to me the important role local associations for community living have in supporting people with disabilities in the community. I would like to share the journey we had with a gentleman we supported for over twenty years at our agency – South-East Grey Support Services.

This gentleman was one of the last five residents to leave Oxford Regional Centre (ORC) in Woodstock. ORC was closed in 1996 as part of the Ministry’s facility closure plan to repatriate people to the community. Although he and his family were not former residents of our geographical area, our agency agreed to support him as no other agency was interested in developing a plan for him. There were a few factors in him being one of the last residents to leave the facility: He was a physically large man, who sometimes pushed staff and other residents; he was a smoker who was trained in the facility to have only so many cigarettes per hour and the staff kept him accountable to that schedule; and he often exhibited repetitive actions that were usually attributed to a mental health condition. Interrupting him during these repetitive actions could result in a number of reactions ranging from a scowl, a loud verbal outburst, the flinging of a plate, invading staff’s space or physical aggression. Our individualized support model was a great fit for him as he lived in his own apartment in the same home as a staffed apartment in the other part of the house for another gentleman we supported. He had one-to-one staff during the day and then the staff in the next apartment could respond if there were any issues overnight. Once he left the facility, his medications were reviewed and reduced by a psychiatrist skilled in consulting with individuals with a dual diagnosis. Staff also learned to give him space when he needed it and implemented the least intrusive method of staff intervention which was very successful. There were no roommates needing protection, and we did learn that other residents at ORC had provoked some previous aggression by ‘pushing his buttons’ at times.

For the first fifteen-plus years that we assisted him, things were relatively stable and, other than some staff leaving his team and us needing to repair some damage to the apartment, it was a good match both ways. He then started to develop some health issues and saw the doctor more frequently for some breathing difficulties and other complications. He continued to be comfortable in his own home with a few more support hours until it became necessary for a period of hospitalization for more serious breathing difficulties.

While in hospital, his family doctor suggested to our agency that this gentleman would require more personal support due to the chronic nature of his illness and that his condition would be progressive and there was no cure. The doctor suggested we may need to look at some long-term care options due to the increased level of care. The doctor was able to make a referral for some overnight home care hours upon discharge from the hospital. We continued to support him during the day and home care provided staff overnight as he needed assistance to be physically turned every two hours to reduce bed sores. Home care was able to provide this support for a few weeks and then gave notice that they could not continue, as their support was time-limited and linked to his discharge from hospital.

We then went to our agency’s Board of Directors for approval for us to finance these additional overnight hours. We also made MCCSS aware of the potential need for fiscal dollars to offset these costs. We continued to provide awake staff from our agency for these overnight shifts in addition to the day-time staff for a number of months. He was admitted back to our local hospital when his condition worsened. His doctor advised that we contact the gentleman’s family if they wanted to visit. He passed away peacefully in hospital within the next few days with family, staff, and former staff visiting to say their goodbyes.

His family and many of our staff commented on how wonderful it was that we were able to provide the increased staff support for him to remain in his own home. We were convinced that an admission or transition to any long-term care facility would have been traumatic and detrimental. We were honoured to have him age in place in his own home and to maintain the relationships he built in his more than twenty years with our agency.

—Maurice Voisin, Executive Director, South-East Grey Support Services