Pictured here doing one of her many favourite activities. Taken in the last few months of her life, just before her 97th birthday, we sent it to her daughter, who lived in Vancouver. She always enjoyed receiving her mom’s “moments of joy” during the course of her day.
Isabel was a client for five years. A very capable and active woman, Isabel grew up in Alberta and found her way to nursing in BC. She told colourful stories about being a public health nurse; a career that took her throughout the Kootenays, Interior and Northern BC. Famous for having naps when life threw curveballs, Isabel was living in supportive housing for seniors and was extremely independent and capable. However, concerns about her memory were being raised. Her daughter contacted us as she was noticing her mom was missing more and more medical appointments, her medication management was less than ideal and Isabel, on more than one occasion, was having difficulty with cheque writing and dealing with her bank.
We first met her in 2012 but at the time, she was quite resistant to any notion of requiring help. Fast forward one year: we received a call from Isabel’s daughter that she was in hospital requiring a blood transfusion due to a slow leaking ulcer. Could we be the “surrogate family caregiver” after she left to return back home to Vancouver? Isabel’s son also lived in Vancouver. Both her children worked full-time and her son had children still at home.
The family felt, in order for their mom to remain independent and receive proper support, Keystone Eldercare had to be an essential member to have on “Team Isabel”.
First off, Isabel liked us and how we treated her. She just didn’t think she needed us for anything.
Funny side note: even in the last year we worked with her, when asked what Keystone (or Wendy) did for her, Isabel would reply in a slightly hushed voice to avoid hurting our feelings, “I’m not really sure she does very much but I really like her, and she makes sure I get to all my appointments”.
This isn’t an uncommon stance for seniors. Isabel didn’t really “need” us for anything but she greatly benefited from having us on her team. We took the time to understand her values, preferences and needs. We never lost sight of this up until the day she died. When she was hospitalized for the last time, as soon as we entered her room, she broke out in a big smile, took my hand and said, “I am so glad you are here to help me”.
In the end, having us as one of her allies in care and keeping her values and preferences as first priority made a huge difference in her “wanting us” in her inner circle.
We take a holistic approach to our work by understanding the big picture at work with our clients and their families.
What did we do for Isabel?
At the core of our services, we were her “surrogate family caregiver” and provided case management, ongoing check-ins and health care advocacy.
We initially started by checking in with Isabel weekly and wherever possible, getting her out into nature. One of her passions was hiking. It gave her purpose and was also one of her goals – to be able to get out into spaces she couldn’t get to on her own anymore. She also recognized the value of having someone with her when she out in the woods. We were able to connect with her on a personal level while having the opportunity to see how she was doing functionally, cognitively and in her space at home. We also took her to all of her medical appointments and acted as note-taker. With her permission, we passed on this information to her daughter and son.
Over time, our visits grew more frequent and we were her “go to” in emergencies. When her frailty increased, we ensured she got a walker and maintained her function as much as possible. We made sure she had what she needed for her daily living. We coordinated her health care appointments. We worked with the housing provider and her family doctor to make sure her decline in health was balanced with supports in her environment. If Isabel was admitted to hospital or to emergency, we were her on-the-ground first response. We made sure there was a discharge plan in place. We made sure any follow up was done and relayed to her family doctor.
At the end of her life, we filled the gaps when her family couldn’t be by her side due to travel time and work and family commitments. We worked with hospital staff during her admission and stay and we made sure the transition to hospice went smoothly. We gave her family peace of mind knowing their mom was getting the support and services she needed by a company that truly cared. Most importantly, we were a familiar caring and loving presence in her last few weeks. We gave Isabel continuity of support and compassionate care.
Watch for the Signs
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– Mike G., Nanaimo, BC
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