In the Media

The 42 year old registered nurse, who works nights at a geriatric facility, lives in the Burnaby home with her husband (who works days in the hotel business) and their two teenage children. There is always someone at home, always something going on. That’s what appealed to Ted Stellakis when he was scouting for the right home for his mom. That, and dire necessity. Ted and his wife Irene took Antonia into their own Richmond home last year following a series of hospitalizations. The doctor had advised them it was no longer safe for Antonia to be living alone. But within weeks they could see this was not a viable solution. Ted and his wife work full time and their daughter no longer lives at home. Even though they hired a private nurse for a good part of each day, Antonia spent too many hours alone in bed or in front of the TV. She was increasingly cranky, calling Ted at work to ask what time he’d be home. And Ted and Irene were increasingly exhausted, starved for free time during the day and undisrupted sleep at night.

The problem was, there was no where else for Antonia to go. At least, nowhere that was appropriate or affordable. In this, Ted Stellakis dilemma was not much different from the one faced by thousands (soon to be millions) of Canadian boomers and their aging parents.

But in Ted’s case, the problem was exacerbated by his mother’s immigrant status. Six years ago, Ted, who works at a Vancouver real estate brokerage firm, sponsored Antonia’s immigration from Greece. Her husband had passed away and her daughter – Ted’s only sibling- had died of cancer. “I was her lifeline. It was hard for her to move halfway around the world at that age but she had no one to care for her.”

Unless sponsored immigrants become severely disabled, they must wait 10 years before they become eligible for a publicly subsidized long-term care bed. Eligible, that is, to join the 7,000 or so other BC seniors waiting for such a bed – including many willing to pay more than $4000 a month in sliding scale fees. It can take two or three years to get to the top of a waiting list.

For Ted, the bigger question is whether he would want to place Antonia in such a facility, even if he could afford it and/or his mom lives long enough to get to the top of a list. Staffing is often inadequate and the lack of upkeep in many facilities verges on the criminal. According to a recent Health Association of BC survey only 3,000 of the province’s 25,000 long-term care beds meet recommended guidelines
“I don’t think it would be good for her to be in a nursing home” says Ted, whose ailing mother-in-law resides in one. “My mother likes her independence. She has her own suite (in the Burnaby home) and lots of attention from people of different ages. Being with only old people, especially being around those who have serious mental problems can be depressing. It can bring everyone down to the same level.”

Antonia is sharp, and she knows at least as well as her son what she wants and deserves for the last years of her life. The beauty of the FolkStone model is that it brings together people like Antonia, who expect more with people like her foster daughter, who wants to give more. On her night shifts in the nursing home where she has worked for 16 years, she and two nursing aides take care of 75 patients. You are always having to set your priorities, she tells me. Do you go immediately to the patient who’s calling you, or deal with meds, or make time for a consultation? There is never enough time. At home, in contrast, her “foster mom” is the number one priority.

One day soon, she would like to have a second senior sharing the ground floor suite – so she’ll be able to quit her outside job and devote full time to her FolkStone clients. She receives $1950 from Ted for Antonia and could add as much as $3500 a month more with a second client requiring higher levels of nursing care.

The prospect is so appealing to professional caregivers like her that FolkStone is in the enviable position of having a reverse waiting list. Since it started up last fall, program manager Nikki Nagy and director Stewart Smith have conducted hundreds of interviews and now have close to 40 home studies in their files. Many applicants are highly qualified health workers who would happily quit day jobs to stay home with their “foster parents.”

So far, however, only two clients, including Antonia, have been placed. FolkStone has been moving slowly for a number of reasons, Smith says. A tiny advertising budget means few people know about the agency. And those who do can’t, and shouldn’t be rushed.

“With seniors, it’s important for them to take their time,” he told me, “They’ve gone through a lot of life before reaching the point where they’re ready to make such a major move. There is a great deal at stake and we’ve got to respect that.”

For several months, Smith and Nagy have been working with a 96 year old woman who has been living alone for the past 41 years in a two-storey walk-up apartment in South Granville. Her only son died in the Second World War, and her husband passed away in 1962. She remains enormously capable for her age, but it is no longer safe for her to live alone. She absolutely refuses to go into long-term care, says Smith. “She’s determined to replace one comfortable home with another, on her own terms. Our job is to give her some choices.”

So Nagy and Smith talk to her almost daily by phone and take her on frequent home visits letting her “test the waters” and build trust with FolkStone and their outreach staff. A home-care aid visits the woman daily and to promote consistency, will continue to do so after the placement.

The foster model is apt, says Smith. He started FolkStone as an offshoot of the non-profit PLEA Community Services Society of BC – an advocacy and placement agency for troubled youth that he has headed since 1985. At any given time, PLEA oversees up to 180 young people living with families across the Lower Mainland.

The way we think about the needs of seniors is 25 years behind our thinking about youth, Smith tells me. “We don’t put kids in orphanages anymore, but how different is a long-term care hospital? The point is not to shut those down because there are good ones and there’s a need for them – but there’s a much greater need for choices.”

The lack of choice penalizes seniors across the economic spectrum. In fact, the socio-economic reality of urban life often works against seniors such as the South Granville client. FolkStone has no home-based caregivers on file in Vancouver’s west side which is where this client prefers to live. The result: those who are relatively affluent are just as likely as anyone else to fall through the care cracks. “Typically you find them rattling around all by themselves in large houses with maybe a couple of hours of home-care support a day, which is a drop in the bucket” says Smith. “It’s lonely for them and it’s not safe. By the time we hear about them they’re not eating well, they’re not getting out, their hygiene is not good and if there’s an illness, it’s progressed to the point where they’re really compromised.”

But how do you force people to leave their longtime homes, I wonder and where are they suppose to go? Flexibility is the key says Smith. He would be happy to help someone who’s living in a big empty house to find one or two other seniors interested in moving in. Together, he suggests, they could hire live-in care.
Flexibility come with trial and error attached he says. To make a good match, clients are encouraged to take trial periods in their new homes and to speak out in weekly case conferences if they are feeling uncomfortable. Even in the most successful placements, there are potholes to negotiate. In Antonia’s case, the biggest challenge was language. Antonia stubbornly speaks only Greek, and the Burnaby family is Filipino. Solution: Ted supplied a Greek phrase sheet, which the foster family quickly mastered and brought his mom a TV on which she can watch Greek programs. He drops in twice a week to have dinner with her.

It took a few months for Antonia to feel comfortable in her new home, but now she’s relaxed and cheerful. When she was recently hospitalized, she couldn’t wait to “go home,” Ted says, attributing her quick recovery to her new lease on life.

Viewing the success of this one foster placement, it would be easy to misrepresent the FolkStone model as a catch-all solution to eldercare. No one claims it is. The challenges are enormous, including financial barriers that will remain insurmountable for many seniors – unless/until the new Campbell government buys in and supports it with bed subsidies, as they ought to do.
An even greater challenge, to my mind, lies in the very nature of eldercare. The foster parents of the elderly have limited prospects for a lasting relationship with their clients. Attachments will be deeply forged and tragically broken, over and over.

I ask Antonia’s foster daughter whether this worries her. She says no. If it did, she wouldn’t be able to work in this field. The way she sees it, she is lucky to know Antonia right now.
For information on FolkStone Adult Family Care Homes: (604)736-3601 or e-mail: help@folkstonecare.com

Mrs. Stellackis was our first FolkStone client. She past away in November of 2003 and she is fondly remembered by the FolkStone team and her caregivers. She had a great sense of humour!

(Prices quoted in articles do not reflect the current costs).