Quebec Sending in The Clowns 

By Rheal Seguin, The Globe and Mail

May 21, 2009

Canada

After failing for years to meet urgent demands for more staff to wash and feed the elderly in nursing homes, Quebec is hiring clowns to entertain them.

The provincial government is signing a four-year, $293,000 agreement on Monday with Dr Clown, a provincial non-profit organization that sends clowns to visit residents in nursing homes.

For the province, this is no joking matter. Hiring Patch Adams is seen as a real solution. The so-called “therapeutic clowns” are part of a program aimed at breaking the isolation and loneliness of nursing-home residents.

“Since the public consultations on the living conditions of the elderly [in 2007], our government has injected $2.3-billion to improve their living conditions,” Marguerite Blais, the Minister for the Elderly, said in the National Assembly yesterday.

However, most of the money has gone to maintaining salaries and a minimum level of staff and services. Hundreds of private nursing homes as well as homes for the elderly are without properly trained staff, according to patients' rights groups who contend that the elderly can go days without being washed. They are often left alone to eat and they receive inadequate care for some of their most basic needs.

Lisette Lapointe, Parti Québécois critic for the elderly, noted yesterday that the vast majority of private residences that care for more than 100,000 patients operate without proper certification. “What are you going to do to make sure our elderly get proper care from trained personnel?” Ms. Lapointe asked Ms. Blais in the legislature.

Part of the problem, the minister argued, was that too many people are negligent and forget to visit their aging parents or family members who live in nursing homes. “We all have a responsibility in overseeing the living conditions of the elderly,” Ms. Blais said in explaining the usefulness of hiring clowns.

The solution does not lie in having clowns as part of therapy to break the loneliness, said Paul Brunet who heads the Council for the Protection of Patients. There's nothing wrong in wanting to entertain people, he said, but that certainly isn't the priority expressed by the more than 400 local user committees in the province's nursing homes.

“If anybody thinks this is a priority, then they must be living on Mars,” Mr. Brunet said in an interview yesterday. “There are some elderly residents that stink. They aren't bathed because there isn't enough staff to do the work. They lose their dignity and, when that happens, they lose the desire to live. Their basic needs aren't being met. And that's what they need more than clowns.”
The clowns are just a cheaper way of tackling the problem, Mr. Brunet said, adding that the real solution would cost a great deal more.

Reform of services for the elderly has been a long, drawn-out process. In 2002, the provincial auditor underscored the serious problems involving the lack of proper care in nursing homes as well as homes for the elderly.

Coroners' inquests into the deaths of elderly patients caused by abuse and improper care prompted the government to hold public consultations in 2007.
The government required owners of private nursing homes and residences to improve basic services in order to obtain a licence to operate their businesses.

But since then, the certification process has proceeded at a snail's pace and little has been done to ensure that properly trained staff are hired to care for the elderly.

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