“Working in long-term care these days is breaking my heart” by Monica Catto

“We’re going to have you sit two metres apart; just to be on the safe side,” I say to the residents as my colleagues and I rearrange their wheelchairs in the activity room.

We know the storm is coming and begin to batten down the hatches, making what preparations we can in our long-term care home before it strikes.

But the wind picks up speed, and we need to change course.

“We’re going to bring your meals to you in your room. It’s just a precaution.”

These words bring little comfort when spoken from behind goggles, a surgical mask and a gown. Their own fearful eyes and trembling lips are not hidden by personal protective equipment.

I continue to be positive and focus on spreading joy, not fear. Under my own PPE, I’m sweating as I play my guitar and sing songs of faith outside the residents’ rooms. They hum along and gently sway in their wheelchairs, a distraction from the wind howling just outside the doors.

News of the virus’s impact on our facility spreads with as much speed and virulence as the illness itself. Some residents aren’t well enough to fully comprehend the enormity of the situation, but others are well aware that they are witnessing – no – becoming part of history.

We connect family members to their loved ones through FaceTime and Skype. It starts out as a novel project; it’s fun and gives me a real sense of joy to watch our residents experience the magic of technology, some of them for the first time.

The novelty wears off quickly. I link a daughter to her mother. “Mama, stai bene?” a worried voice asks. “Sei malato?” She’s asking her mother if she is okay or if she’s sick.

The praise we receive for being proxy for loved ones not permitted to visit, becomes accusatory. “Do you clean the iPad between visits? Did my mom just cough – is she okay?”

I answer positively, as much as I can. Yes, we use strong anti-microbial wipes between uses. As for the cough, I just don’t know. I’m tired, physically and emotionally.

I pass by one woman’s room, peek my head in her doorway. She says she’s okay, but lonely. I enter her room, not sure if she’s infected, but take my chances.

“This is so hard,” her tears form quickly at the corners of her eyes.

“I can sit with you a while,” I tell her, perched at the edge of her bed. The room is shrouded in deliberate darkness. She suffers constant migraines and cannot tolerate the light; a malady that further darkens the isolation.

"My husband died when he was 41 years old. I know it’s been a long time, but I miss him so much. Especially now when I’m stuck in my room and my sons cannot visit.”

I know a thing or two about grief, and I’ve learned what helps to ease the pressure on the bereaved. “Tell me about him.”

In 15 minutes, I learn about her beloved Mario whom she met in the same village in her homeland of Italia. She tells me about her eldest, only 12 when his father died; his thrust into manhood and role of family provider. Her face relaxes in the brief time she purges herself of memories, good and sad. Even in the shadow of her room I can see a sliver of light pierce the darkness, bring something close to relief.

I’m called away for a debrief meeting with the administrator and my colleagues. We discover that the virus has begun to infect our residents.

Despite our administrator’s attempt to sound positive, it does little to allay the fears of a caregiver who’s been looking after one of the affected residents for the past six hours. Her head bows in defeat; her goggles fog up from tears she’s trying to hold back. She is a single mother of two young children. How is she going to look after her kids and keep them safe? We’ve already been instructed that we are to self-isolate when we leave work.

I’m working long hours and I’m tired. Still, l manage to put on a brave face and crack jokes with the staff and residents. But then the nurse practitioner takes me aside.

“Monica …” he begins slowly, "Mrs. M is not doing well, and her family would like to see her before she … well, you know.”

I get the iPad and head for her room. In more than 30 years of elder care I have seen the passage from this life to the next many times. There has never been a time when family members could not be by their loved ones’ side as they die.

I punch in the contact information and immediately see a grief-stricken daughter on the screen. I don’t focus the iPad on her dying mother right away.

“I’m so sorry.” My words are muffled inside my surgical mask.

“Can I see my mama?”

It’s a contortionist’s feat to get Mrs. M in the iPad’s view. I sit on the floor beside the bed which is on its lowest setting. My own head rests on the mattress, almost touching Mrs. M’s head, and my arms are raised and off to the side so as to keep her weakening body in view.

My arms ache as I struggle to hold the iPad in place. I weep quietly along with the daughter as I bear witness to what should be a private moment of farewell.

Eventually, I discover that if I lay beside a resident on their bed, with one foot on the floor to brace myself, I’m better positioned to hold the iPad in place.

“Papa,” a grown son’s voice cracks between sobs, “Talk to me, Papa.” But Papa can’t talk and passes within the hour.

This is the point where I break. I leave Papa’s room to go charge the iPad. I collapse into a chair and the tears fall. Breaking the physical-distancing rule, our nurse practitioner awkwardly tries to console me, rubbing my back. Another nurse makes me a coffee and I find quiet shelter in the storm to regroup.

Another day brings a rare light in the midst of the storm. It’s one resident’s birthday. We decorate her room and have a virtual party with her sons. Singing Happy Birthday and serving her a piece of cake is a welcome reprieve.

Another day, another resident and another family member.

“Her breathing seems strange. Is she okay?”

With my head beside her mother’s, I can smell the sickeningly sweet smell of death emanate with each breath she struggles to take. But it’s not my place to say.

We’re slowly seeing things turn around. No new cases in the last few days and we’re all breathing cautious sighs of relief.

I don’t want things to return to normal. What was deemed normal in long-term care clearly wasn’t working. What I do long for is a new normal – one where people are cognizant and appreciative of the efforts that professionals in LTC make every day.

Monica Catto is an aspiring photographer, writer and social justice activist working in the human trafficking field with the White Rose Movement of Toronto. She lives in Mississauga, Ontario. You can visit her blog here. 

“Working in long-term care these days is breaking my heart” was originally published in the Globe and Mail in their “First Person” feature. For information on submitting a personal essay to the Globe and Mail (and to 21 other places), see here.

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