• Jim Kitts: Getting along with good guidance
  
• Bernice McDowell: A view of the big city, memories of a small town
• Frank Ostrowski: Finding new life helping out
• Lucille Risanne
  
• Ashley Thomson: Managing care without support
• Ruth Vellis: Living in the here and now and enjoying every minute

Jim Kitts: Getting along with good guidance

Jim Kitts is an 83-year-old veteran of World War II who lives in the village of Temagami, where he settled at the end of the war.

Jim’s health troubles started in 1982, when, after years of persistent pain in his chest, he was finally diagnosed with coronary artery disease so severe he needed bypass surgery. Seven years later, on New Year’s Eve, 1989 he had another heart attack and was sent back to Sudbury, the closest major health centre, for another round of bypass surgery.

Jim credits his family doctor for his strong recovery from heart surgery. The cardiologists and specialists, far away in Sudbury, were not there to guide him through his rehabilitation. “Ever since my first heart attack, I’ve made it a practice to see my family doctor once a month,” he explained. “I’d tell him my symptoms, and he’d keep me on track and encouraged me to develop quite an exercise program.”

The doctor helped him live a healthier life in other ways. He quit smoking and he’s recently lost 25 pounds of the weight he gained after his wife, Aliette, became sick with cancer. Now Jim makes sure he gets his five servings of fruit and vegetables every day and regularly visits the ambulance station to have his blood pressure checked. If it seems a little high, Jim gets it checked again, and calls the doctor if it seems necessary.

In effect, Jim’s put together his own chronic-disease monitoring program. He gets help from a housekeeping service and other community organizations such as Meals on Wheels. He’s enjoying life and says he’s not ready to go yet.

“I’d like to live a little longer. I enjoy every day. I like a laugh every day. All the clubs and things I belong to, they know, if there isn’t a laugh in it, I don’t want to be there.”

Bernice McDowell: A view of the big city, memories of a small town

There’s a big window flooded by sunshine outside Bernice McDowell’s room at her long-term care home in Toronto. Two easy chairs are placed to capture the view of downtown Toronto.

It’s a spot she loves. “I sit out there in the sun. I never did that at home,” says Mrs. McDowell, 89, who moved here from Blind River a couple of years ago after a bad fall.

The transition hasn’t been easy for her. Blind River is seven hours from Toronto, a long trek for Mrs. McDowell’s daughter, who has a young girl of her own, so she urged her mother to move into this home, just across the street from her own house.

Mrs. McDowell had to spend a year in another long-term care home before a spot was available, but she had been warned of the wait, and says it was worth it to be just across the road from her daughter and granddaughter.

Still, she misses Blind River, where she led a busy volunteer life after retiring in 1988 from 20 years of working in the town’s Ontario Provincial Police office. “I was in charge of everything up there,” she says. Mrs. McDowell thinks she may be one of the one-in-four long-term care residents who show signs of worsening depression when checked at regular intervals. She hasn’t been able to keep in touch with her friends, she says, and it worries her, but writing Christmas cards just seemed too hard.

She also counts herself among the 20 per cent of long-term care residents who say where they’re living doesn’t feel like home. “There’s lots of things I love about it. The staff are kind and the people are friendly, but there’s nobody related to me,” she says.

Well-run activities that keep residents busy and engaged are important for countering depression, and Mrs. McDowell particularly likes the birthday parties and exercise classes. And of course, visits from her granddaughter, from just across the road.

Frank Ostrowski: Finding new life helping out

Frank Ostrowski’s health went downhill rapidly when he moved to his long-term care home in 2002. He was admitted after a four-month hospital stay and fairly quickly became bedridden. Even as his strength slowly returned, he didn’t want to come out of his room and he didn’t want to meet people. But that’s all changed.

“I am never lonely or sad, especially with Tina,” Mr. Ostrowski, 81, says.

Tina Angelakos is the personal care attendant who gradually won Mr. Ostrowski’s trust and looked for ways to involve him in day-to-day activities that helped him feel good about himself. He now volunteers in the dining room on his floor. It’s been a change that’s meant the world to him. “I like it here. I watch TV and I work. I work in the dining room. I set the tables.” Tina adds, “And he doesn’t like it if anyone does any part of the job for him.”

Mr. Ostrowski emigrated from Poland just after the war, at the age of 21. He worked up north before moving to Toronto in 1956. He never married (“No one ever asked me,” he explains) and has no family. But he has found something close to it in this home.

Lucille Risanne

Lucille Risanne is an Aboriginal elder who has lived and worked in Thunder Bay for the past 55 years. She raised seven children and has 17 grandchildren. But now she’s struggling with diabetes, hypothyroidism, angina, arthritis, heart disease, obesity, neuropathic pain, migraines and high blood pressure. As well, she has a pacemaker.

Lucille says living with chronic illness is like “living in a jail.” The diabetes and obesity have the most impact on her, emotionally, physically, and socially. Sadly, both problems are common among Aboriginal people, who have worse health than the majority of Canadian, with three to five times more diabetes and twice the rate of heart conditions and breathing problems.

Poverty has played a role in Lucille’s health problems. There were times when she had to decide whether to pay the rent, help her kids or buy medication. Often, medication lost out. “It was hard to afford all of the medicine, later the needles and the [blood-sugar testing] strips.” She even stopped taking her medicine at one point, until her doctor warned her that could kill her, so she started taking her pills again. “There are people here that still need me, and so dying is not an option,” she said.

Lucille is supported by her family doctor and a specialist. She says both are good listeners and explain things well, but she’s encountered racism from other physicians. She thinks there should be more resources for native people who come from the north to get treatment in cities, to take care of their community and social needs as well as their health problems.

Ashley Thomson: Managing care without support

Ashley Thomson was diagnosed with diabetes at age 12 — but one of the biggest challenges she faced with the disease was managing with no family doctor to back her up after she moved to Pembroke a couple of years ago.

It helps that Ashley, 25, has very stable diabetes. The medications, targets and dietary restrictions that were set for her when she was diagnosed have essentially not changed. And, as she says, when you’ve been diabetic for a long time, you know what to do.

“I spent a lot of time with the dieticians and nurse practitioners, and they tell you targets. Also, I volunteer with the Canadian Diabetes Association, so I’m pretty well informed.”

Ashley quickly learned how to test her blood and give herself insulin when she was first diagnosed, then she went back to her regular life, swimming, going on school field trips and just being a teenager.

She was well enough when she finished college to move to the North West Territories. But when she came back to Ontario for a job with a radio station in Pembroke, she couldn’t get a family doctor.

There’s a serious shortage of family doctors around Pembroke. Pleading and calling towns all around did no good. No one would take her on.

“I was saying, ‘Listen, I have juvenile diabetes, I’m not someone who just thinks they’re sick all the time, I’m young and I don’t want to get complications, don’t ignore me,’ but they did.”

Finally, she broke down after waiting seven and a half hours in the emergency department in Pembroke to get her prescriptions renewed. This time, the doctor on call talked another physician, who had diabetes, into taking Ashley as a patient.

It was pretty bad, having to hit rock bottom before she could get help, but she’s doing fine now — still managing her own care, but knowing she has back up.

Ruth Vellis: Living in the here and now and enjoying every minute

Leave your past behind, don’t expect perfection and you’ll find long-term care a fine way to live, according to Ruth Vellis, a 93-year-old resident of a home in downtown Toronto.

“It depends on your mental attitude,” Mrs. Vellis explains. “There are people here who are always talking about what they used to have and what life used to be like. I am not one to say it was so wonderful in the old days.”

Mrs. Vellis lived nearby and watched her long-term care home being built. A practical person, worried about being a burden to her daughter, she put her name on the waiting list — then broke her hip, and had to leave her apartment. While she was waiting for admission, she broke her hip a second time and eventually arrived at the long-term care home in a wheelchair.

Now mobile again with the aid of a walker, she gets out to ballets and concerts, even walks several blocks for a bagel and cream cheese when the home’s food needs a bit of a boost. She went to meetings about the food a couple of times, but “I’m not a committee woman.”

She is not afraid to complain, but doesn’t need to. “The women who work here are very devoted.” The exception is at night, when two staff must get 25 residents ready for bed, which Mrs. Vellis says is too much for them. She blames underfunding.

She speaks highly of the activities in the home, but she’s happy to sit in her bright room, reading books and the daily paper, listening to classical music, surrounded by pictures and furniture from home.

“I’m very pleased. There’s a woman here who’s always talking about the business she used to run and the big house she used to have, and I say, forget it. That’s gone.”

Mrs. Vellis thinks there should be orientation sessions for people before they move in, to help them understand what their new life will be like.