| Feb 25, 2015

The one constant at Fairmount Home, through all its renovations and changes, from a 96-bed municipal home for the aged, to a Class D and then a Class A nursing home with 128 beds, has been the smiling face of Mary Lake.

As director of care, Lake has watched over the residents at Fairmount through all those years, and she will retire at the end of this week.

“I literally grew up in long-term care,” she said in an interview on Monday. Not only has she worked in long-term care for over 40 years, she started working summers in a nursing home when she was a young teenager.

“My grandmother owned the Picton Manor, and as soon as school let out each summer I would head over there to work. I changed beds, did cleaning, whatever was needed.”

A lifelong Frontenac County resident, Mary Lake was raised at Elginburg (in what was then Pittsburgh Township), where she attended public school. She went to Sydenham High School, and then studied Nursing at the Kingston General Hospital (KGH) School of Nursing. After graduating in 1972, she took a job at KGH.

In 1974, she started working as a long-term care nurse, and aside from a short stint at Kingston's Prison for Women in 1984 (as a nurse not an inmate) she has remained working in long-term care ever since.

She took on the job of director of care at the municipally owned Fairmount Home for the Aged in 1987.

She has seen a lot of changes at Fairmount over the years. When she first started there, the home was licensed, and funded by the Ministry of Community and Social Services, not the Ministry of Health, which now oversees all long-term care facilities under a single set of rules under the Long Term Care Act of 2007.

“We were a country home, and we served the residents of Frontenac County mostly, at that time. The care we delivered was always excellent, but the facility was not what it was today,” she said.

All of the rooms at Fairmount had two beds, and the rooms did not have private bathrooms or showers. It was more of a dormitory-style facility with a single dining room for all 96 residents.

Improvements to the level of care came with new standards of care in the 1990s. As director of care, Lake was in charge of operations at the home, including nursing and personal support workers as well as all of the support staff in the home. The administration of Fairmount was taken care of by Frontenac County. She helped the home maintain its reputation as a caring facility, for families and residents to feel safe and well supported.

When municipal amalgamation took place in the late 1990s, Frontenac County decided to keep Fairmount Home, even though its location was becoming subsumed by the City of Kingston when it annexed Pittsburgh and Kingston Townships.

The Chief Administrators of the new County, first Bob Foulds and later Elizabeth Savill, became administrators of Fairmount, giving Mary Lake someone to report directly to.

When all long-term care facilities started to come under the same set of standards and regulations, Fairmount was designated as a Class D facility because of the physical limitations of the home. It was faced with a choice to upgrade or close, and this led to a long, sometimes difficult, set of negotiations with the City of Kingston and the province, funding partners of Fairmount, over plans to renovate.

The $17 million upgrade eventually got underway in 2003, and this led to a challenging period for Lake as director of care, ensuring that residents were well cared for and as well prepared as possible for the changes that took place.

“Through attrition we dropped to 78 beds, and when the new section was completed, the residents all moved there as the old section was completely retrofitted. In 2004 everything was complete and we became the 128-bed facility that we are today,” said Lake.

Once the new state of the art facility was complete, a new challenge faced Mary Lake.

“We had to get used to the change, and change is difficult, even positive change. We lost our culture of care for a while when the new Fairmount opened. Our staff took some time to transition, but we worked hard at it and we got it back. It took about a year,” she said.

Aside from the physical changes in the early 2000s, the home also acquired a full time administrator. Under the regulations, Class A municipal homes must have a full time administrator and full time director of care.

“If I ever wanted to be an administrator,” Lake said, "I would have been one, but I always wanted to be involved in the service end of things. I never wanted to have any other job than the one I kept.”

Ironically, however, that is the role she is retiring from. She has been filling in for Julie Shillington, the full time administrator, who has been on a leave of absence for health reasons and will not return until later this year.

As Lake looks back at her career, she says that while tightened up regulations were a good change in long term care, the ministry has gone too far, leaving homes with more concerns about rules and less time for care.

“They have really gone too far with regulations, because there isn't enough staff available to cover all the requirements and still provide the kind of care that we all want to provide. That is why we came into long term care in the first place, not just to comply with regulations but because we want to provide care,” she said.

Another issue faced by the home is the push for ageing at home, which Lake said is a good thing. However it has meant that people do not come into care until they are at a point where their needs are greater. As well, there is pressure on Fairmount, and other homes, to provide care for patients with mental health issues that are more severe than the home can handle.

“There is a gap in the health care system for these people and they get shuffled around,” she said.

One of Mary Lake's major professional and volunteer interests is providing service to those suffering from dementia. Many of the residents at Fairmount have dementia of varying forms and levels of severity. The home has a wing devoted to those with advanced dementia.

She has been a board member for years with the Alzheimer's Society and has volunteered with Southern Frontenac Community Services to run Alzheimer's support services.

“It is very trying on families, on other residents at Fairmount, and of course on those with dementia themselves and the staff who care for them,” she said, “but we have learned. The drugs are better and the techniques for helping people have advanced over the years,” she said.

While she said she has no plans for retirement other than a summer at the cottage, it will be impossible for her to stay completely away from her calling. She expects that by next fall she will be looking for a part-time volunteer role doing something.

No doubt it will involve looking after people in some capacity or another.

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