You are not abandoning your parents if you decide to place them in a nursing home. In fact, you are being responsible children because you will be entrusting them in a facility that is capable of looking after their needs, especially their medical needs.
This is the mindset that is being promoted by the Order of the Ministers of the Infirm (MI or the Camillians), a religious congregation founded in 1582 by St. Camillus de Lellis whose mission is into health care. This religious order manages Camillus Medhaven Nursing Home which is located in Marikina Heights in Marikina City.
“Camillus Medhaven Nursing Home was formerly the St. Camillus Home of Charity that was founded in 1992. It was established to respond to the needs of the abandoned quadriplegic and paraplegic patients discharged from the Philippine Orthopedic Center. On February 2, 2006, the Home of Charity changed its direction from being a shelter and health care provider for abandoned persons with disabilities into a home for the elderly,” said Father Rodel R. Enriquez MI, Chief Operating Officer of the Camillian health institutions that is made up of three hospitals, two polyclinics, one nursing home and one formation center.
In 2018, Medhaven reached its full capacity of 104 residents and this led the Camillians to open the St. Camillus Medhaven Annex which is located just across the main facility. The annex houses Medhaven’s Dementia Village and increased its bed capacity to 185.
“We consider ourselves to be the biggest private nursing home in the Philippines. Our clients say we are the best in the country as per the facility and the programs,” Fr. Rodel said. “There are around 20 nursing homes in Marikina alone but their services and their programs are not at par with us. That is the reason why when clients do visit our facility, they are the ones telling us that this is the best so far.”
Residents, not patients
Fr. Rodel related that they refer to the seniors at Medhaven as residents because the nursing home is already their home. Of the total number of residents, 80 percent of them suffer from different forms of dementia. Medhaven also caters to seniors who are already bedridden or require hospice and palliative care.
“Our residents stay with us on the average for five to six years. The longest resident has been with us for 15 years. The original ones have been with us for around 18 years. But that probably is one of our bad reputation and our bad reputation is that our residents live long because of the good environment, our program of care,” Fr. Rodel said jokingly.
Medhaven has specialized units for dementia care and their staff are sent out of the country, specifically in the Camillilan run nursing homes and hospitals in Taiwan, for dementia care training. In house training for dementia is also available.
The nursing home offers three levels of care to its residents—low, intermediate and high care. Low care are those residents who are still able to carry out activities of daily living or ADL like taking a bath, eating meals without much assistance. They are retired and who just want to be in a facility where emergency health care and social activities are readily available.
“Intermediate are for those who need some form of assistance to perform ADL. These may be persons with dementia. You may be mobile but because you have dementia, you need some form of assistance and there are also those who are wheelchair bound,” he said.
The last category is high care or also referred to as skilled nursing because these residents require high nursing and bedside care. These are residents who may need convalescent care, or those who are recovering post surgery or post stroke. There are also residents who have end stage Alzheimer’s, end stage of ageing and those who need hospice and palliative care.
Medhaven also goes the extra mile for residents who need to be hospitalized but their relatives are abroad. While this is not the usual practice for nursing homes, Fr. Rodel said they do assist residents who require hospitalization. The Camillians also manage and operate three hospitals and Medhaven residents can be admitted there with expenses charged to their Medhaven account.
“We have also had cases where we were the ones who attended to the remains of residents who died up to the time they are cremated or until the funeral parlor takes over,” Fr. Rodel said.
Prior to the lockdown, seniors who wanted to become a Medhaven resident had to undergo an application process. This usually starts with relatives visiting the facility for an orientation and tour. Once the relatives have decided to avail of Medhaven’s services, Medhaven visits the incoming resident whether they are in the hospital or at home.
“From there, they will have to submit a medical abstract, undergo a chest X-ray and some laboratories and then we submit all this to our physician for the proper care plan,” Fr. Rodel said.
Before the implementation of the enhanced community quarantine in March, Fr. Rodel related that the facility was already placed on lockdown since the residents were a high risk group. The infection prevention protocols that were implemented were based on the guidelines provided by the Center for Disease Control specifically for nursing homes.
What was most challenging for Fr. Rodel and his team was how to change the mentality of the residents in order to adopt to the new normal and how to strike a balance between isolation and the need for social activities.
“Before Covid-19, we wanted our residents to socialize, join activities and have meals together so that they have someone to talk to,” he said. “With the new normal, we provided them with individual tables, they had to eat in their rooms, face masks and it was more challenging for our residents with dementia.”
The staff had to stay in. Those who had direct contact with patients like nurses, nursing aides, caregivers, care assistants, physical therapists had to stay in for 17 days. Instead of an eight-hour duty, they worked for 12 hours to comply with the number of hours to be rendered monthly. The staff had to stay in a dormitory and were categorized based on their place of assignment.
However, no matter how the facility prepared for Covid-19 the virus eventually found its way into the facility. Out of 128 residents and 22 staff, the facility had 15 confirmed cases with only eight of them requiring hospitalization.
As for clients who wish to enter the facility, Fr. Rodel said the application process is now done virtually. They meet with the client online, give them a virtual tour of the facility and the admission officer explains the admission procedure and other necessary information.
For their future plans, Fr. Rodel said they were planning to come up with a facility in Cogeo that would cater to lower income bracket. The goal is to construct a 60-bed capacity, three story building with a polyclinic on the first floor. He added that they were also looking to expanding their services to Cebu and Davao. They are also looking into providing home health care services because not all families would want their relatives placed in a nursing home.
He added that there is already a gradual change in mentality from the time they started in 2004. Nowadays, they receive more inquiries from the local market.
“That’s because they realize that certain conditions of the elderly are in need of specialized care and they could not actually provide at home even if they have much resources,” he said.
He added that facilities like Medhaven have moved away from the old health care ambiance to a more community of village ambiance. “How can you say that we abandoned our parents if we place them in this facility? That is the shift in the philosophy of aged care in the Philippines,” Fr. Rodel said.
Image credits: Bernard Testa