Humanizing Healthcare

By Faye Ferguson


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JANUARY 2007 EDITION OF SENIOR LIVING MAGAZINE VICTORIA BC

In 1967 Vera McIver faced a difficult decision. She was asked by Sister Mary Elizabeth OSB (who was also Vera's sister) to take on the role of Nursing Director at St. Mary's Priory extended care facility located in Langford. Recalling the offer, Vera says: "It wasn't nepotism; Sister could find no one else." Vera was less than enthusiastic. "I was too steeped in the prevailing false impression that working with the elderly wasn't challenging."

She decided to take the job for six months. Little did she know what a life-changing decision she had made. At the end of the six months, Vera knew she had found her calling. "I was hooked! I had no intention of leaving those wonderful old folks."

Vera commenced her new job by rolling up her sleeves and working side-by-side with the care aides. What she saw was discouraging. The frail elders at the Priory, all women, had a roof over their heads, regular meals and adequate hygiene. That was it. The environment was sterile, monotonous and regulated by impersonal routines. Restraints, both physical and medicinal, were frequently used to keep patients "manageable." Not surprisingly, these ill elders quickly lost interest in life with resulting declines in physical and mental abilities. This deterioration created increased dependency that, in turn, eroded the women's spirit, pride and dignity.

"I knew changes had to be made," says Vera.

The care the residents at St. Mary's Priory were receiving reflected common practices of the time. Similar depersonalized approaches were common in extended care facilities all over Canada - and throughout the world. Care practices in long-term institutions were modelled on those that had been established for acutely ill hospitalized people. They were not geared for older people who required continuing assistance and who were likely to live out their lives in a facility.

Before coming to her work at the Priory, Vera had had extensive nursing experience. "I always had a strong calling to be a nurse," she says. Graduating from the Regina Grey Nun's Hospital in 1941, Vera spent much of her career as a private nurse. In those days, before the advent of critical care units, the private nurse was utilized when patients required intensive monitoring and care.

Although her years of acute care nursing did not specifically prepare Vera for the challenges she faced at the Priory, her nursing practice had always focused, first and foremost, on the needs of the patient and this perspective served her well in her new role.

As Nursing Director of an extended care facility, Vera found herself in an arena of health care with little prestige and meagre resources. Nevertheless, she was determined to find ways to improve the care being provided. Her commitment was boundless.

"I was consumed by a passion to bring humanity to all those who became my responsibility. I don't know what took hold of me. It became my vocation."

She read by the hour, seeking information that would eventually be used in a program of care, which became known as The Priory Method. "We began by meeting our residents' basic human needs," says Vera. The elderly women were gradually introduced back to walking and basic exercises. Social activities were planned both in house and in the community. The residents wore daytime attire, not hospital gowns, during the day. Their rooms were painted in bold colours and each woman was encouraged to use personal mementoes to individualize her environment.

The Priory's Activity Co-ordinator, using an 8mm movie camera, documented the various activities within the institution. The residents enjoyed watching these in-house movies and, over time, Vera and her staff realized they had evidence on film of some remarkable transformations. Vera pieced these "before and after" segments together into a 30-minute film. "Then I had to make sense of what these pictures represented." In creating the commentary for the film, she developed her model of care. Vera travelled the world with the film. "I had never spoken or presented papers before, but now I couldn't shut up," she says with a smile.

Vera's approach to the care of institutionalized elders shook up the accepted practices of the time and not everyone involved in health care was pleased. She often had to struggle with uncommitted health professionals and government bureaucrats in order to get her philosophy implemented. As the years passed, however, the concepts inherent in The Priory Method have become increasingly accepted as part of recognized health care practice.

With considerable sadness, Vera left St. Mary's Priory in 1979. Her husband's health was failing and he needed her attention. She cared for him until his death in 1985.

Since the loss of her husband, Vera has immersed herself in history. In 1987, she was approached by the Bishop of the Catholic Church in Victoria to take on the role of Diocesan Archivist. She immediately began the daunting job of organizing, sorting and cataloguing a vast array of diocesan material dating back to 1842. "I'm still doing it. I just love it," she says.

She has also researched and written a book that traces her family - hard working, resourceful Germanized Poles - who immigrated to Canada from Russia in the early part of the last century.

Since her retirement, Vera has had time to enjoy travelling with her daughter, Ruth, whom she refers to as "the apple of my eye." One especially enjoyable trip was to Ottawa in 1986, where Vera was presented with the Order of Canada for her work in humanizing care for ill elders. In 2002, she also received the Queen's Golden Jubilee Medal. While the accolades are appreciated, Vera affirms that it was the work itself, and the appreciation of the people in her care, that meant the most to her. Thinking back to her time at the Priory, she says: "Oh, I had so much fun."

For more information about McIver's work at St. Mary's Priory, a recent book entitled Forgotten Revolution: The Priory Method: A Restorative Care Model for Older Persons by Jessie Mantle and Jeanette Funke-Furber (in dialogue with Vera McIver) is available at www.trafford.com/robots/03-0112.html

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