I am, of course, a supporter of improving and increasing home care for elderly people who are losing their independence. Being able to stay at home is the legitimate wish of almost everyone. We must therefore do everything we can, as a society, to make it achievable.
The fact remains that, in certain cases, this desire no longer corresponds to reality. A person with a very serious loss of autonomy, suffering from irreversible cognitive problems and needing care and support 24 hours a day, then has only one option: go and live in a residential and care center. long-term (CHSLD).
You should know: even if Quebec offered the best home care system in the world, CHSLDs would still be necessary. There is also, it is true, the option of medical assistance in dying, but that is another story.
My father, 91 years old, has lived in one of these centers for six years. While visiting him, I realized that all the people who live there couldn’t be anywhere else. These people are, for the most part, very old, very confused, often incapable of expressing their needs and, therefore, extremely fragile. Their loved ones, even with the best intentions, no longer have the capacity to care for them at home.
In Quebec, approximately 4% of the population aged over 75 lives in CHSLDs, a proportion which increases to 11% for those aged 85 and over. Out of respect for those who are there and because one day, whether we like it or not, it may be our turn, it is essential to reflect on what is at stake in this experience, both for the residents and for their caregivers.
In On the threshold of silence (Novalis, 2024, 296 pages), Pierrot Lambert, retired translator and spiritual worker in CHSLD, recounts with great sensitivity the end of his wife’s life in a CHSLD in Outaouais. Where some see only sadness and indignity, he finds, not without fighting daily against pessimism, moments of grace. Lambert does not sugarcoat the pill; it tells of a forced dive into wounded humanity.
“To be admitted to a residential center,” writes sociologist Éric Gagnon, specialist in CHSLDs, in the preface, “is to experience a form of exile. […] It means having to cut yourself off from your past and all those little occupations that fill your days. […] It is experiencing helplessness, discovering oneself incapable of doing something for oneself or finding the right words, feeling lost and disoriented. »
Simone Saumur, Lambert’s wife, had been a teacher for 30 years, a pastoral worker and head of a support service for victims of domestic violence within the Canadian military community in Germany. When she entered the CHSLD in October 2020, she was an 87-year-old woman to whom this rich past meant almost nothing. “I understood,” writes Lambert, “that “quality of life” must be invented with our backs turned to the past. »
Lambert is full of praise for the center’s staff. He highlights his kindness, his skills and his astonishing good humor. He welcomes the fact that “all employees constantly speak to residents, even those who seem most confined in their bubble.”
My experience at CHSLD Désy, in Saint-Gabriel-de-Brandon, confirms these observations. In many situations where I found myself powerless in the face of my father’s condition, the energetic attendants, who deserve all our admiration, generously came to my aid and his.
The difficulties, despite everything, remain. “The CHSLD staff, despite admirable good will, are not capable of dealing with this confusing feeling of alienation, aggravated by cognitive losses,” Lambert rightly writes. Although it provides for needs, it struggles to meet desires, due to the nature of the disorders affecting residents.
The latter, in fact, become incapable of expressing themselves. The deprivation of their independence makes them unhappy without anything being able to be done about it, “except support, help, care”.
On several occasions, Lambert will have this cry from the heart that all those close to these people have: “If she could speak!” If I could understand his long silences, his pleading look. » But there comes a time when that no longer happens, unfortunately, because “their poetry is deeper”.
All that remains, then, is to “live all the same”, in “the authenticity of our mutual presence”, in “solidarity with people who are going through difficult things”, with in our hearts the only hope that remains, here linked “to the care, to the acts of kindness of the staff, to the presence of loved ones”.
Simome Saumur died in January 2023. My father is still alive and well cared for. It’s hard, but you have to love CHSLDs.