Interview with Queens Estate Retirement Residence - Metta Lifestyles management, Michelle Bergman

I'm passionate about my job. Easily put. I love our elders. I'm a huge advocate for our elders. And I love their stories. Everyone has a story and there's so much wisdom in their stories. ... I feel the pain, too, certainly, having been there myself at one time with my mother. I feel the pain when they’re feeling the pressure of making a decision. I like being able to support the families and the elders. I can relate to the families that are calling for their loved ones because I too have had to do that decision-making with my family, for my mother.

At Queens Estate, we have 120 suites, seven floors, and the specialty is assisted living and memory care. Certainly, healthy, independent people move into our building, and in independent living, one can come and go as they choose. For meals, they select a time that they'd like to eat. We’ll soon be introducing a second mealtime.

We do independent living very well, but I would encourage families to look at those small hints that the family is picking up on or the doctor has advised about. How long will one be independent? 

When you’re looking for a retirement home, look for a home that ages-in-place that is not just independent, but also offers assisted living and memory care. … It could take one bad flu or stroke, and all of a sudden that resident is no longer able to toilet on his own. [Here] if it's in independent assisted or memory care, we can address [that].

What makes Queen’s Estate really different is the size of the company. After coming from a larger [company], I immediately noticed how nimble we are. I was blown away that when I needed a decision—and that meant walking in or calling my general manager or leaning on my support team—it was instant, [without] the red tape that I was so accustomed to in the past. It's not a one-size-fits-all in this business … We're very much 'think-outside-of-the-box' and we'll investigate to see: Can we do it better? And how can we do that? 

That nimbleness translates directly to the resident. Take dementia, for example, which we specialize in. We have the skill set, the equipment, and we know how to address dementia. The dementia will [be] a little different in each patient. So we're very resident-centric and we do profiling. This is standard in the business, but we do a deep dive to get to know the likes and dislikes. We bring the team together and they all provide profiles on a resident. We go a little further than 'What's your favorite food?' and 'What's your favorite activity?' 

We stretch that to try to bring new creative thinking and activities to the residents and flexibility. Again, being a smaller company and growing, we can adjust, we can fine-tune so that it is more person-centric, it's more inclusive for that individual resident and family.

We stretch that to try to bring new creative thinking and activities to the residents and flexibility. Again, being a smaller company and growing, we can adjust, we can fine-tune so that it is more person-centric, it's more inclusive for that individual resident and family.

If you haven't checked out our menu, you really should! We are, without question, five stars. Chef Peter Ho is our regional culinary manager. Our menu is phenomenal. Peter has a diverse background and it certainly shows. One of my favourites that he's done is lobster [with] fresh-made buns and coleslaw. It reminded me of the first time I went to Halifax and was beautiful. … I might want to add as well that I'm really proud of the culinary team’s purchasing. A lot of our fresh produce comes from local farms, including some meat as well. We're an all-Canadian company, and we do business largely with Canadians.

[We invite residents to] bring their own recipes. We want to know about them. Queens Estate is capable and does carry out specialized diets. The inclusion runs from 'Mr. John loves his mother's homemade casserole and would love the chef to make it.' We can do that and promote who the recipe came from.

For complex care or diabetic care, we do menus specific to any dietary need. Puree, for example, when it's done, it looks very appetizing. It's well presented on the plate. Most importantly, it's made the way that the resident needs to eat. So, yes, thick and fluids, everything from mincing right through to puree foods and special recipes, we can do it all.

We can take people through to end-of-life and do it Metta style, with dignity. But I will say our commitment is not to have the initial intake as palliative. If someone is staying with us, we are committed to the end, if that's the wishes of the family and the patient's restrictions. 

We specialize in complex care and memory care, but one restriction certainly could be physical behaviors. We will work with the hospitals and with the family on medication adjustments, to see that change, and once we see [that] there's no longer a risk to our other residents, who we have to look out for as well as our employees, were then in a better position to bring that person in. There're very few limitations. … We do one-on-one feeding, but we can't do NG Tube feedings, for example. That's more for a hospice environment or hospital environment.

It's all hands on deck when it comes to communication. The lines are open and our recreation lead has a roster that she emails out on a weekly basis. If there're any special events, we notify families that they can attend.  

On a care-plan level, we have care conferences that include the activities director as well as our charge nurse and the family, so that the family can understand better where mom or dad was when they arrived, and where they are now, and what’s foreseen in the future. In all steps along the way, we involve residents and family members in the decision-making so they understand why decisions are being made. Communication is absolutely key, by email, by phone, and by those conference calls, we make it happen.

My coaching style is to hear the voice and to be able to assist in those steps. I always remind the families there's a reason why we started having this conversation and not to lose sight of that, because we all have good days and we all have bad days. It’s a fact that if I don't want something to happen, I can easily mask that, as elders sometimes do, to maintain what they know, their balance. Nine times out of ten, the family members that were distraught and were overthinking maybe or feeling guilty, within a few months, they come back and say, 'You were absolutely right. I should have done this, should have done it a year ago.' [Or if they went ahead and moved in, they say] 'She's loving it,' or 'She's getting exactly what we need, and that burden is off our shoulders now. We have the time to spend with mom and dad, that time, quality time. I'm coming in and I'm doing things that I wanted to do with her.'

So there's a lot of thinking and putting yourself in the customer's shoes. This has nothing to do with me … it has everything to do with where they're at. Some feel stuck. I have to have that knowledge and empathy, to know how to help them move forward.

Everyone has individual needs and desires. Not everybody is a 'chatty Cathy' or wants to come to all activities. It goes back to really understanding the person and what motivates them, their likes, and personality. Our recreation lead, Amy, is spectacular. … She and her team do amazing profiles. … She understands what that resident may thrive in doing, and planting a seed and making it happen where it's not [or] a challenge for a resident to come and play cards or learn how to bake, or maybe it's a movie. But it’s engaging periodically until they feel, I want to do that again.