CHSLD | How many years for three glasses of water?

How many civil servants does it take to offer three glasses of water to an elderly person in a CHSLD?

I asked the question in the form of a riddle last April in a column recounting the struggle of a caregiver. The story of a lady who, after noticing that her mother, housed in a CHSLD, was always thirsty when she visited her, was the instigator of a project which made it possible to remedy the problem^⁠1.

The “Make Drink” initiative, set up in July 2022 by the committee of residents of the CHSLD de Saint-Flavien with the collaboration of the accommodation center staff, is disconcertingly simple. The objective: to ensure that elderly people in CHSLDs who have difficulty drinking independently or asking for a drink are adequately hydrated at all times. To do this, we have implemented a procedure in three easy steps:

1. Check with staff if the resident’s condition allows them to be offered water;

2. Check the texture of the liquid required for the resident;

3. Offer a drink.

Completed in barely a month, the project proved to be very effective in improving the well-being of elderly people without overburdening nursing staff. Very quickly, we noticed the benefits of more adequate hydration. This made it possible to prevent and reduce problems with urinary infections, pressure ulcers and constipation among residents of the CHSLD in Lotbinière where the pilot project was implemented.

Why stop there and not benefit the seniors of the 28 other CHSLDs of the Chaudière-Appalaches integrated health and social services center (CISSS-CA)? asked Denise Duguay, who carried out this project with the president of the residents’ committee, Diane Anglehart. After all, drinking to your heart’s content isn’t exactly a luxury. It’s a basic need.

Even though her own mother’s dehydration problem was now resolved, M^me Duguay took numerous steps and meetings to ensure that the initiative of his residents’ committee took hold. She challenged the CEO of the CISSS-CA. She contacted the management of Support for the Autonomy of Elderly People (SAPA).

But for some mysterious reason, the pilot project implemented in the blink of an eye at the Saint-Flavien CHSLD has transformed into a titanic undertaking in a system mired in bureaucracy and acute reunionitis.

Asked about this in April, the CISSS-CA responded to me by email that it intended to “deploy the “Make Drinking” project in all of its 29 CHSLDs in a safe and gradual manner. To justify that it took so long, it was explained that the operation is more complex than it seems, given that it can be dangerous, for example, to give water to patients suffering from dysphagia .

For me^me Duguay, who herself worked as a speech therapist with dysphagic elderly people, the important precautions that are necessary for certain residents do not justify an endless procedure. If a senior suffers from dysphagia, it is included in their intervention plan. The CHSLD staff already knows that he needs a suitable diet and thickened liquids. And the “Make Drinking” initiative obviously takes this into account.

Eight months after publicizing the affair, M^me Duguay is sorry that the project is moving at a snail’s pace.

She continued to defend him even after the death of her mother, who passed away peacefully last June at the age of 92. In February 2024, only one other CHSLD should implement the “Make Drink” project. “At this rate, it will take 27 years before this essential need is met in all CHSLDs! », she is indignant.

It is all the more frustrating since the initiative was unanimously hailed as a success. Last October, the residents’ committee of the CHSLD of Saint-Flavien even won the prize of excellence from the Provincial Regroupment of Users’ Committees in the “defense of rights” category. It was the Minister for Health and responsible for Seniors, Sonia Bélanger, who presented the prize to the instigators of the project. They were scheduled to speak with her after the ceremony. M^me Duguay told himself that this would finally be his chance to transform the tortoise into a hare. Unfortunately, the minister was not available…

After the award ceremony, M^me Duguay sent an email to M^me Bélanger. She told him what she would have liked to say to him in person. She reminded him that after 20 months of approaching the leaders of the CISSS-CA, the “Make Drink” project, which had nevertheless proven itself and won an award of excellence, was still not in place. She strongly suggested that he contact the responsible manager and head of the living environment unit at the Saint-Flavien CHSLD who was able to step out of his comfort zone to improve the living conditions of vulnerable seniors. Unfortunately, the email, sent on October 17, went unanswered…

In the minister’s office, it is indicated that “follow-ups are underway”. “Our priority is to ensure the well-being and safety of residents in CHSLDs and [de s’assurer] that sufficient water is offered. This is a very interesting initiative, our priority is that stakeholders can put the right measures in place. »

How much longer will it take?

If I believe the response from the CISSS-CA, it will not take 27 years as the current pace suggests, but another year at most, we promise.

We can see the glass half empty and tell ourselves that it’s still too long.

We can see it as half full by saying that without caregivers at the front like M^me Duguay, it would be even longer.

Half empty or half full, I raise my glass to M’s health^me Duguay, who, by defending the rights of his late mother with his committee of residents, defended the rights of all vulnerable elderly people.