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June 16, 2021
Josephine Lombardi, Ph.D. (c) 2021 All rights reserved.
In 1985, Pope St. John Paul II said, we need faith leaders who are “experts in humanity, who know the depths of the human heart, who can share the joys and hopes, agonies, and distress of people today,…” To become an expert in humanity, certain basic life skills–the inner work, or internal curriculum of life must be mastered. To reach full emotional and spiritual maturity, our spiritual cataracts need to be removed so that we can see ourselves and others with empathy, love, and clarity. “For now we see in a mirror, dimly, but then we will see face to face. Now I know only in part; then I will know fully, even as I have been fully known” (1 Cor. 13:12).
This process involves discipline, deep humility, self-knowledge, courage, self-regulation, and understanding of the factors that influence human behaviour, including family of origin issues. Following a multi-disciplinary approach, this journey of self-discovery is supported by the wisdom of our faith tradition. This knowledge, coupled with the internal curriculum, leads to growth and deep understanding of the human condition.
Self-mastery prepares us to investigate influences that hinder or help the quest for authentic freedom: that is, the ability to reason without fear and the ability to love without fear. Fear, the greatest obstacle, prevents us from becoming an expert in humanity. Only “perfect love” can remove fear (1 Jn. 4:18). An expert in humanity is a lover of humanity, open to growing in self-awareness and humility.
Interested in learning more about the internal curriculum? Consider reading my book, Experts in Humanity: A Journey of Self-Discovery and Healing, awarded first place in the category of Family Life by the Catholic Press Association of the United States and Canada (2017) and watch this video, Empowering Parents to Be Experts in Humanity, from the 2021 annual conference of the Ontario Association of Parents in Catholic Education (OAPCE).
Announcing a new date for viewing my film: Feast of the Visitation, Monday, May 31, 2021 7pm EST for 24 hours
Many thanks for the overwhelming show of support and encouragement regarding the premiere of The First Lady and Her Successors. I’ve received many wonderful emails and messages, telling me how much the film touched you and inspired you. I’m delighted to share the film will be available for viewing on the Feast of the Visitation, May 31, 2021 at 7pm for 24 hours.
Some of you have given me permission to share your feedback. I’ve included some of your heartwarming comments below.
“Dr. Lombardi what an incredible film. I didn’t think I could get closer to Mary but you brought me even closer to her. A deeper understanding and love for the woman that make it possible for us to be forgiven by her son.” – Sandra
“Words cannot describe the joy in my soul. This movie was so powerful. It has brought a deep beauty inside. I am so grateful to have been blessed to see this film. What a wonderful job Dr. Josephine. Bravo. I wish I could have access to this regularly. It has left a profound stamp on my heart. God bless you for taking this initiative to bring Our Lady closer to us in our minds and hearts.” -Teresa
“I just finished watching the film and I don’t have words to express how amazing it was!! WOW, WOW, WOW!!! Dr. Josephine did a wonderful job at capturing our Lady in every aspect of her being. She was able to make us see that she is approachable and she is our Mother that we can always turn to her for hope, strength, and intercession. Wishing her all the success in the world that many people will watch this film and have their lives transformed and that she will lead us all to her son, Jesus.” – Gina
“The film left me speechless! What an incredible gift!!! I hope it will be viewed over and over by many. An extremely valuable tool for reflection. All the sharing by the beautiful women in the film, touched me profoundly and took me deep into my own heart. Dr. Josephine seamlessly navigated everyone through the rosary mysteries as a mother lovingly takes her children through a beautiful garden. I am in awe. So well done. A wonderful tribute to our Blessed Mother and all her successors…including Dr. Josephine Lombardi! The presence of the Holy Spirit was evident. Thank you so very much, Dr. Josephine !!! God bless you.” – Felicia
“Bless you Dr. Josephine and thank you!!! What wonderful work you’ve done–an homage to our Lady!! Daniela always says Our Lady is my favourite person–in less than two hours–based on scripture, personal testimonials and art you were able to transport me to a time of deep reflection–filled with only thoughts of the Mother of our Saviour!! Thank you for sharing the stories of her successors! Women who have experienced joy, sorrow and hope–all with Our Lady’s guidance!! Wonderful and important work!! Thank you and all these women for being incredible teachers…Thank you again and God bless you.” -Linda
“Our beloved Mother Mary has always been a source of safety fo me. Someone I can go to and feel protection and guidance. I often try to stand where She was in Her life and find the peace She must have had to live Her life. You, dear, Dr. Josephine Lombardi, have made our Blessed Mother even more relatable in your incredible film. In showing us that the way these amazing women you interviewed hear and answer the call to encourage other women. To follow in the simple, humble and loving footsteps Our precious Mother left for us. I am grateful to be able to take part in so many beautiful events that celebrate Mamma Mary and this film was by far one of my favourite! May God continue to bless you Dr. Josephine Lombardi with the ability to teach us and allow us to experience our faith in a more mature manner. Thank you! – Carm
“I just wanted to say I was invited to watch the film…and I was amazingly struck in awe of watching this testimonial…Dr. Josephine brought an amazingly new and simple perspective on Our Lady…my heart was touched as the mysteries were explained and made real. I like to think that I always had a relationship with Our Lady however this film brought a new simple way and real way to view Our Lady…I was thinking that something like this should be available to so many for I believe it is valuable. As a man it would be amazing for other men to watch this for it teaches the value of women…I could go on and on but just wanted to say thank you and God bless Dr. Josephine in this work and may Our Lady guide this film in living rooms of many families…God bless and thank you.” -Frank
“That was beautiful and inspiring! You (referring to Mary Luciani) were eloquent and wise. And lovely! How wonderful to have a presentation of an aspect of our faith articulated through the life our Holy Mother and shared by women. The richness and how it resonates in our life as women was demonstrated with such beauty, wisdom, and gentleness. Thank you for sharing this with me.” – Carrie
“What a lovely and inspirational film this was. First Lady, indeed and the one whose faith was bigger than her fear.”
-St. Elizabeth’s Villa, community chaplain.
“All I can say right now is WOW! What impressed me was the superior art work that told the story so well. It must have taken many hours just to search for the art. The art and the dialogue during the mysteries show what a wonderful God we have, how special Mary is and how she always said yes to God’s will. Also, what a loving mother we have in Mary. The quality of the women who were interviewed were amazing–their great faith, their knowledge and life experiences that showed their level of trust and love. The whole script was woven so beautifully together. I can’t even imagine the amount of prayer, work and time that went into this movie. It encouraged me to see these spiritually mature women who are making a difference in religious education at the adult level. I liked the end of the story when the lily bloomed at important times. What a wonderful touch of God’s love. Thank you for this opportunity to see this movie.” – Friend of Patricia Coulter
“Beautiful presentation about our “First Lady”. I was moved by the personal poignant stories. There was a calm peaceful energy throughout. It is such a beautiful and powerful message. My sincerest thanks to Josie for sharing the moving video with us. As a woman, mother and seeker it touched me deeply on many levels. Wonderful! Thank you!” Friend of Patricia Coulter
“What an amazing treat. I loved it. Josie did an excellent job, and her voice is calm. The story of Mary is told in a beautiful way with scripture. There is so much in it I will be thinking about if for a while. It gives praise to God and honour to Mary.!” Friend of Patricia Coulter
Many thanks to all!!! Please pray for the film as I discern next steps.
Film will be available for viewing on http://www.josephinelombardi.com on Monday, May 31, 2021, Feast of the Visitation at 7:00 pm EST for 24 hours.
If you would like to support Dr. Lombardi and any future film projects, consider making a $10.00 donation.
All donations over $10.00 will receive a copy of the e-book, Living with the Rosary (Expanded Edition). The expanded edition includes many narration bits associated with the mysteries of the rosary included in the film. Please note that because this is not a charity, donations are not tax deductible.
Donations can be e-transferred to email@example.com. Please include your full name and email address in the comment box when you prepare to e-transfer. The E-book will be sent to your email address after the premiere. A PayPal option will be available closer to the premiere.
Those who donate using PayPal button below will receive the e-book with payment. Just wait after transaction until you are redirected to the book. Many thanks to all who have already donated.
Josephine Lombardi, Ph.D.
Professor, Author, Consultant
March 29, 2021
In their book Character Strengths and Virtues: A Handbook and Classification, Christopher Peterson and Martin Seligman propose the rediscovery of the study of character and virtue because they believe character can be cultivated. These authors, like Aristotle (384 B.C. – 322 B.C.) and St. Thomas Aquinas (1225-1274 A.D.), writing centuries before them, believe it is worthwhile to take some time to nurture and develop good habits through practice and repetition.
Aristotle, an ancient Greek philosopher, was one of the greatest thinkers on the topic of virtue. According to Aristotle, virtue, the habit of behaving in the right way or in the right manner, is learned or acquired through repetition. Similarly, the Book of Wisdom (8:7) teaches, “And if anyone loves righteousness, her labors are virtues; for she teaches self-control and prudence, justice and courage; nothing in life is more profitable for mortals than these.” Clearly, ancient authors understood the benefit of acquiring cardinal or natural virtues.
Becoming a virtuous leader involves a process, learning foundational habits, which are interconnected and necessary for a leader to become integrated and courageous. Corporate leaders, with a sincere desire to grow and lead with virtue, moving beyond the perceived superficiality of virtue signaling, will benefit from working on the following six habits: humility, magnanimity, courage, prudence, self-control, and justice, habits examined by many classical and contemporary authors. Virtue living involves more than the act of expressing an opinion—it involves discipline, authenticity, and concrete actions.
Definition of Virtue Signaling: “The action or practice of publicly expressing opinions or sentiments intended to demonstrate one’s good character or the moral correctness of one’s position on a particular issue.” (Source: Oxford Language Dictionary, 2021).
Twenty-five years ago, one of my favorite professors asked a classroom of graduate students, “What does it feel like to be in my presence?” This question has stayed with me throughout my professional career. My philosophy professor was training us to be self-aware, cultivating the habit of humility or knowing the truth about ourselves. She was modeling virtuous leadership, showing us humility was the first step toward becoming a virtuous person.
It can be frustrating to work under a leader who lacks self-knowledge, who doesn’t know her presence and behavior make people feel micro-managed at best, paranoid at worst. A humble leader takes the necessary time to work on her self, investigating her thoughts, words, and actions, observing whether they are life giving or destructive, apologizing when she has made a mistake. Sadly, pride keeps some leaders from being vulnerable enough to look within and examine troublesome behavior.
Magnanimity is the habit of striving for excellence. I recall the story of an administrator who experienced great difficulty saying no to new requests. She found herself running from meeting to meeting, struggling to complete projects by deadlines and failing to delegate when she could. After several years, she went on maternity leave and was succeeded by a very competent leader. After the successor’s first year of service to the company, a mutual friend told the predecessor that she spent the year comparing the leadership styles of the two administrators. She told the former that she did ten things 90% and the latter worked on one thing at a time 100%, meaning the successor strove for excellence and precision, asking for help with other tasks. We get sloppy when we try to do too many things without delegating or asking for help. Setting priorities and knowing ourselves, including our gifts, helps us to strive for excellence.
Virtuous leaders work on being brave. Aristotle, in his Nichomachean Ethics, expressed the importance of being habitual when it comes to facing our fears. A brave leader enters the arena, ready to compete and to be victorious. A brave leader resists the temptation to quit, especially when he is afraid. Endurance builds character and helps him to investigate his fears using his ability to reason. When we can face what is fearful, Aristotle says, we can become brave, “and when we have become brave we are most able to endure what is fearful,” (Book II, Nicomachean Ethics). A brave leader, having cultivated the habit of knowing the truth about him self, strives for excellence and resists the desire to be liked by everyone, trusting he has made the best decision. Becoming brave involves a process rooted in truth and clarity, whereas fear can make us irrational.
Brave leaders are prepared to be prudent in decision-making. A prudent leader, according to Aristotle, is someone who is “able to deliberate well concerning what is good and expedient” for herself and the community she serves, (Book VI). Prudence is the habit of reasoning well and the ability to act accordingly. A prudent leader gathers information, seeks advice, and makes a decision after she has investigated and examined competing views, searching for the truth and the best outcome for her community.
A prudent leader exercises self-control when it comes to the expression of emotion and opinions. A leader who has worked on self-control can express anger the right way, without damaging relationships. Impulse control is a necessary virtue in all levels of leadership. An impulsive comment can poison a workplace environment, creating a climate of fear and recklessness. Remember, you can take back a thought; it is increasingly more difficult to take back a comment. Make sure your feedback is rooted in facts. If you are not sure, ask the recipient of the feedback for clarity. Self-control is informed by prudence and humility. Moreover, it takes bravery to confront truthfully, yet tactfully.
A method I use in my course on counseling is called the sandwich method. This method has been proposed to leaders who have difficulty sharing critical feedback, evaluations, or making requests. The method consists of three steps: critical feedback or a request is positioned between two affirming comments. In giving critical feedback, the leader giving the feedback uses “I” statements, not accusatory “you” statements. Dr. Judith Orloff, M.D. explains the benefits of using this method here: https://www.psychologytoday.com/ca/blog/the-empaths-survival-guide/201807/how-the-sandwich-technique-can-transform-your-relationships
Finally, a virtuous leader is just. Justice, writes Alexandre Havard, author of Virtuous Leadership, is the habit of “giving others their due.” The just leader, says Aristotle, promotes that which is lawful and fair. Giving someone his due can mean praise/ reward or discipline. If an act of mercy, meaning the act of extending graciousness or a second chance whether someone is worthy of it or not, does not change someone for the better, a correction is in order. A just leader knows how to manage the tension between justice and mercy. Possessing self-knowledge and prudence, he is able to read character, knowing when someone is exploiting his good nature or is ready to learn from their mistakes. A wise leader has nurtured his intuition and has acquired knowledge of the human condition.
In conclusion, Aristotle claims, “no one who is to become good will become good unless he does good things,” (Book II). Happiness, he says, is the result of virtuous living. After much practice, a virtuous leader makes the transition from virtue signaling to virtue living.
Josephine Lombardi (c) 2021
How does one explain synchronicity and coincidence in spiritual terms? From time to time, we are excited to share various experiences, noting how they touched us and got our attention because the timing was in sync with an anniversary, a feeling, or a search for answers. These special moments can mean, among other things, one of two possibilities. One the one hand, they can represent confirmation of what we are doing and thinking. Doing God’s will means doing the right thing at the right time and in the right way. Receiving or experiencing some type of sign or serendipitous moment could be confirmation that our behaviour is in harmony with God’s divine laws. This leaves us open to noticing small and big signs, indicating certain moments were designed and planned specifically for us. Author, Squire Rushnell, speaks of these moments in his book, When God Winks.
On the other hand, these moments can be attention grabbers, meaning God is trying to get our attention. Prayer connects us, helping us to participate in God’s omnipresence, one of God’s divine attributes. Our prayers or the prayers of others for us, like those of a caring parent or another loved one, including the saints, can inspire a sign, special moment or warning through which God can get our attention. God is asking us to be awake and aware, praying for the spiritual sight needed to notice His communication with us. Pray for the grace to pay attention!
Blog post found at http://www.josephinelombardi.com
Recently, Dr. Lombardi presented at St. Augustine’s Seminary’s “Preaching Stewardship Conference.”
Please share this post with any friends or colleagues who are interested in learning more about possibilities for lay preaching in the Catholic Church. The video is also found on the Better Catholic Preaching Youtube channel.
“Do not cast me off in the time of old age; do not forsake me when my strength is spent.” (Psalm 71:9)
Today, Dr. Merrillee Fulerton, Minister of Long-Term Care, announced that the provincial government is launching an independent commission into the province’s long-term care system. The commission will start in September, hoping to give some answers to families who lost a loved one residing in a long-term care home. NDP Leader Andrea Horvath has been calling for a public inquiry into the situation, saying, “Families with loved ones in long-term care are demanding answers. They deserve those answers, and they deserve a full public inquiry that is non-partisan to give them those answers.” Expressing similar frustration, Charles C. Camosy, Associate Professor of Theological and Social Ethics at Fordham University, in a recent opinion piece for the New York Times, writes: “We tend to see this as a public health failure, but it is also a moral failure.” Our Church’s moral teaching calls us to affirm the dignity of the person at all stages, challenging any practice or ideology that compromises the integrity of the person created in the image and likeness of God. Our God-given conscience should prompt us to ask questions regarding past and present living conditions in long-term care homes.
During the recent virtual 2020 National Mass for Life, Archbishop Prendergast of Ottawa reminded Canadians that the March for Life is a celebration to “witness the God given dignity of the human person from the moment of conception until natural death.” He went on to affirm the “right of care for elders” and the need for compassionate palliative care. No doubt, the concern over end of life issues applies to the current COVID-19 crisis happening in many long-term care facilities.
This past April Canadians and people from around the world, remained in shock, horrified at the discovery of 31 deaths at Montreal’s Herron Nursing Home. Reports indicate that just two nurses were left to care for 130 elderly residents after caregivers left their workplace amid a coronavirus outbreak. Various reporters discovered that residents were found dehydrated, “lying listless in bed, unfed for days, with excrement seeping out of their diapers.” Upon hearing about the condition of their loved ones, family members became sick to their stomachs. The horror of these tragic deaths has prompted an investigation into allegations of extreme neglect.
Over the past few months access to long-term care facilities and other senior residences has been restricted, leaving many to wonder about the living conditions of their loved ones, with or without COVID-19, perhaps wondering if neglect fuelled the perfect storm that took their loved ones. Have the very restrictions put in place to create an “iron ring” of protection for the vulnerable contributed to this perfect storm?
Many people have expressed concern for seniors who are shut-in, lonely, living alone at home or living in a retirement residence or in a long-term care facility. Day by day we receive troubling reports of seniors and other hospital patients dying alone, without the presence of loved ones or someone to speak on their behalf. Although we have focused so much of our attention on protecting physical health, has anyone thought of the collateral damage caused by loneliness, emotional, and spiritual isolation? Dr. John Cacioppo, a researcher from the University of Chicago, has found that loneliness is harder on the body than smoking, drinking, and obesity. It would be interesting to study whether loneliness and isolation are harder on the body than some of the symptoms related to COVID-19.
Notwithstanding the excellent efforts put forward every day by dedicated health care workers who are battling on the front lines of the COVID-19 crisis, they too have suffered greatly. Regrettably, their ability to publicly express concern over the management of COVID-19 in their place of work might be impacted by the recent actions of the Provincial Government issuing an Order under the Emergency Management and Civil Protection Act on March 21, 2020 that applies to hospitals and other “Health Service Providers” and which effectively allows Health Service Providers to suspend certain provisions in collective agreements with trade unions.
On March 23, 2020, an additional Order was enacted by the Province with respect to licensees within the meaning of the Long-Term Care Homes Act, 2007 and, to a municipality or board of management that maintains a long-term care home. This order extends the right of employers to suspend certain collective agreement obligations as in the earlier Hospitals’ Order. While the intention of the Orders is to contain the spread of the virus, employers are challenged by the requirement that part-time employees choose to work at only one facility, making it difficult to replace workers who choose to work elsewhere. The very Orders created to protect the vulnerable may have created a new scenario, reducing the number of available health care workers or personal support workers. Unfortunately, the attempt to control outbreaks in the community has left us with the unexpected—collateral damage, including mental anguish and loneliness, not to mention the economic devastation experienced by small and large business owners, and workers in a variety of sectors.
There are numerous accounts circulating on social media and various news feeds regarding the care of the elderly and other vulnerable persons during this period of restrictions:
- Family members lament the lack of access to their loved ones who are patients in hospitals or are seniors living in retirement residences or long-term care facilities. Reporters from various news outlets have shared stories regarding patients who are left feeling vulnerable, making decisions without the good counsel of loved ones who are able to speak on their behalf, monitor their level of care, and question policies and procedures that raise doubt. Are advanced health care directives being followed? People are frustrated because, for many, so much is unknown regarding the care of their loved ones. Of course, the situation will vary from institution to institution, with some having more access to their loved ones than others.
- It appears fewer individuals/patients are seeking help for emergency situations or other medical issues. Some have expressed fear of contracting COVID-19 by visiting an emergency department of a hospital. On a daily basis tweets and announcements from local hospitals encourage people to seek medical assistance if they are experiencing physical distress.
- Some physicians, local and abroad, have voiced concern regarding economic uncertainty and the future of their clinics, whether they will survive the lengthy period of restrictions and billing limitations brought about due to the reaction to COVID-19.
- Others have expressed frustration due to the inability to see their family physician in person. Elective surgeries have been canceled, leaving many stressed by conditions that are not being treated.
- Some of our elderly relatives who live alone have expressed concern over the restrictions on public and private gatherings. One mother reportedly said this to her adult daughter: “I’m going to die of loneliness, not COVID-19.”
- Many people of faith have lamented the limited access to the spiritual care needed to support them during this difficult time.
- Advocates for homeless persons have raised awareness regarding the harm done by physical distancing by-laws
- Recently, reporters have wondered why cleaning services and babysitting services are allowed access into Ontario homes, but seniors cannot have members of their own families visit and care for them in their own homes. Where’s the common sense?
The Need for Common Sense
A recent visit to a local grocery store magnified the need to approach these restrictions with common sense, justice and mercy. I observed an encounter involving an elderly woman, struggling to manage her scooter, her puppy, groceries and the coffee she had just poured into a cup, and a “Good Samaritan” watching a few metres away, physically distancing, yet fully engaged in the moment. A few store employees were standing in the distance, staring, seemingly paralyzed with fear, not knowing what to do. Finally, the “Good Samaritan” asked the senior if she needed any assistance, asking permission to approach, re-sanitizing her hands in her presence. The woman welcomed the help, telling the lovely lady who helped her that she was not worried about her touching the lid for her coffee cup, sharing more concern over the lack of medical attention she has received due to restrictions resulting from the province’s response to COVID-19. I overheard her saying she had suffered a stroke, resulting in blindness in one eye and problems walking. She lamented that she has gone several months without any proper care or access to specialists, including her family physician. She said this angered her more than the virus. No doubt, she was expressing the pain associated with the collateral damage of COVID-19. She thanked the woman for noticing her need and offering to help. This same woman approached the manager who was standing by, observing the interaction, and told her she was given permission to approach and touch the lid to seal the coffee cup, to which the manager replied, “Thank God you helped her. I am happy you did. We don’t know what to do in these circumstances. We are struggling to follow the by-law regarding physical distancing.” The woman used her common sense, the same common sense Premier Doug Ford has advised us to use in similar situations.
The woman managing her scooter and her grocery needs is not alone. Sadly, there are many other individuals who have lamented the lack of common sense when it comes to the care they have or have not received when they are in need of medical assistance, especially when their medical needs are deemed non-essential. Although everyone is in agreement we need to protect the vulnerable, these same restrictions are creating more vulnerability. Others who have fallen ill and have needed emergency assistance have complained about being left alone in the hospital, without any support or anyone to speak on their behalf. Surely, there are exceptions with the dying, or with childbirth, but accounts abound regarding seniors and other vulnerable individuals with language or other social barriers, left alone to struggle.
I felt similar distress over the past few months watching the anguish on my daughter’s face when she could not be present with her husband who had been admitted to hospital on several occasions due to kidney stone complications. He expressed his desire to have her accompany him and she expressed her pain, not being able to be present and assist him with any interactions with health care staff. Although he received excellent care, it is frightening to think people are left all alone, possibly unconscious, or palliative, without the support of loved ones. I’ve heard horrifying accounts of children and spouses not being allowed to say goodbye to loved ones who are terminally ill, or others being reduced to limited access to loved ones in the final hours of life.
The cancellation of non-essential medical treatment has left patients anxious over the postponement of procedures deemed “non-essential”. In the first weeks of CBC’s coverage of COVID-19, a reporter interviewed a woman diagnosed with breast cancer. I watched with horror as the woman sobbed on national television, expressing fear of the cancer spreading, feeling abandoned and helpless. Some of the procedures considered non-essential are considered essential, life-saving procedures for those who need them. People in need of organ transplants come to mind. Apparently, these procedures were put on hold as well, decisions leading to more collateral damage. Case in point, Chris Walcroft, a 50 year-old man from B.C., father of two, died on April 15 after a scheduled surgery to prepare for kidney dialysis was canceled. Clearly, someone determined that his procedure was non-essential, a procedure that would have extended his life, giving him more time with his wife and children.
Sadly, the very restrictions put in place to protect the vulnerable are putting them at risk for other issues: mental and spiritual distress, sickness or possibly death due to canceled or postponed procedures, lack of touch and physical intimacy that would have been provided by loved ones permitted to visit and accompany seniors and other patients in hospitals or homes. Many surviving family members and close friends are left with many questions, possibly anger and regret over not having been given the opportunity to care for their loved ones. Policies regarding access or visitation remain confusing, robbing many people of the opportunity to say good-bye to their loved ones.
Moreover, questions remain regarding the quality of care received by loved ones living in long-term care homes.
The Need for Accountability and Transparency
On April 15, 2020, the Ministry of Health published version 2 of “COVID-19 Outbreak Guidance for Long-Term Care Homes (LTCH). Here’s a link to the document: http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/LTCH_outbreak_guidance.pdf
There are a few alarming details in the document, including details on page 4 regarding the regulation of medications, calling for the “switching of medications to less frequently dosed formulations or reducing dosing frequency, if safe.” And, “reassessing the need for non-essential medications.” Who is determining what is essential or non-essential? Do the family members know this is going on? Concerned about transparency and access to loved ones, I read over the document searching for any references to external visitors. Page 5 of the document refers to “essential visitors.” Although these facilities remain closed to visitors, there seems to be some allowance for people deemed “essential visitors.” The following is an excerpt from page 6 of the document regarding directives and precautions pertaining to essential visitors:
Managing Essential Visitors
As LTCHs are now closed to visitors, accommodation should be considered for essential visitors who are visiting very ill or palliative residents, or those who are performing essential support care services for the resident (i.e., food delivery, phlebotomy testing, maintenance, family or volunteers providing care services, and other health care services required to maintain good health).
- Essential visitors must be screened on entry for symptoms of COVID- 19, including temperature checks and should not be permitted to enter if symptoms are present.
- Essential visitors must wear a surgical/procedure mask during the entire duration of their visit to the LTCH.
- Essential visitors must attest to not experiencing any of the typical and atypical COVID-19 symptoms.
- Essential visitors should be limited to one person at a time for a resident.
- Essential visitors must only visit the one resident they are intending to visit and no other residents. Visitors providing essential support care services for more than one resident should consult with the home.
- Staff must support the essential visitor in appropriate use of equipment for source control (i.e. mask) and PPE if required, based on the health status of the resident:
- For source control, essential visitors must wear a mask while visiting a resident that does not have COVID-19.
- Essential visitors in contact with a resident who has COVID-19 or suspected COVID-19, must use PPE as required in Directive #1 for droplet and contact precautions.
(End of excerpt)
It sounds like there are possibilities for family members to be considered “essential visitors.” Who is monitoring this policy? Are loved ones being made aware of this policy? Does it vary from institution to institution?
I am not aware of the policy in Quebec regarding visitation, but it’s been a few weeks since military personnel were deployed to long-term care homes. See https://montreal.ctvnews.ca/military-deployed-to-care-homes-in-quebec-to-help-curb-spread-of-covid-19-1.4904742
Would it not have been easier to ease some restrictions and allow loved ones to visit with their elderly relatives? Is there any guarantee military personnel are healthier than the family members of the residents?
In Ontario, Education Minister, Stephen Lecce, announced that the provincial government reached an agreement with Ontario school boards and unions, allowing for the “voluntary” redeployment of education workers to long-term care homes, hospitals, and shelters struggling with the novel coronavirus pandemic. Would it not be helpful to include family members who wish to be voluntarily deployed? Although it is obvious that those who are invited to consider this deployment are qualified to offer specialized care, family members can help ease the load by sitting with loved ones overnight or assist with feeding and other tasks that are permitted.
If some family members can be considered “essential visitors” why not ask family members to volunteer to sit with their loved ones, monitoring their quality of care, including the ratio of personal support workers to residents. Will the new commission investigate whether family members were informed regarding the recommendations made in the Ministry of Health document? Did anyone investigate whether the long-term care homes followed through with recommendations regarding “essential visitors?” What was the ratio of care before and after COVID-19?
Ratio of Care
In 2017, Dr. Jill Aitken prepared a handy fact sheet for families considering long term care options for elderly relatives. You can find that document here: https://retireathometoronto.com/5-answers-about-long-term-care-homes-in-ontario/
She reports that the ratio of personal support worker to residents is 1:10 during the day and 1:14 for overnight care. The ratio may vary from home to home.
Will the new commission ask the following questions?
- What is the current ratio?
- Can these institutions verify this level of care?
- Do family members have access to this information?
- Are they dying due to COVID-19 related symptoms or is it due to neglect, resulting from health care workers who have been asked to stay home, following the direction of their union representatives expressing concern about their safety?
- Is it possible that some residents have COVID-19, but as in the Montreal case, it is the consequences of neglect that could be the alleged cause of death?
- Who is monitoring this tragic situation, especially if family members cannot access their loved ones nor assess their living conditions? The perfect storm has been created for residents, concerned family members, and health care workers. Justifiably fearful, health care workers are worried they will get sick, possibly feeling overworked, without proper support or supervision.
Residents and staff are dying without any accountability or answers for loved ones. Health care workers are demanding answers as they struggle to understand the number of deaths among residents and staff. A few recent actions are sounding the alarm for transparency and inquiry into long-term care home environments.
Demands for a Public Inquiry
No doubt, recent demands for a public inquiry have inspired the recent announcement regarding the creation of a new commission. Recently, it was reported that the Ontario Nurses’ Association wants an inquiry into COVID-19 outbreaks at long-term care homes. See https://barrie360.com/ontario-nurses-association-wants-public-inquiry-into-covid-19-outbreaks-at-long-term-care-homes/
Moreover, the union representing more than 60 000 health care and community service workers is calling for a public inquiry into the rising number of deaths of residents and workers in long term care homes. (https://www.cbc.ca/news/canada/toronto/union-long-term-care-inquiry-1.5556136)
The CBC reports (see article above) that the union is calling for:
- A public inquiry by the provincial government into the rising number of deaths of residents and front-line workers at long-term care homes, to be commissioned immediately.
- Criminal negligence investigations by Toronto and Peel Regional Police at a yet-undisclosed number of long-term care homes and home care providers.
- An investigation into the deaths by Ontario’s Office of the Chief Coroner.
On a daily basis, reports of family members joining class action law suits against long-term care facilities are growing in numbers.
Similarly, orders of nurses and physicians will be calling for an investigation into the horrors discovered in some Quebec long-term care homes. See https://montreal.ctvnews.ca/orders-of-doctors-and-nurses-to-investigate-long-term-care-centres-in-quebec-1.4905054
Health care professionals, concerned citizens, and loved ones of the deceased want answers. Steve Paikin, in a recent article, expresses similar frustration when he asks, “Is it too much to ask for a direct answer to a direct question?” See https://www.tvo.org/article/is-it-too-much-to-ask-for-a-direct-answer-to-a-direct-question
On the issue of transparency and accountability regarding answers to direct questions and the request for a public inquiry into the rising number of deaths of residents and workers in long term care homes, he writes:
But the premier’s (Premier Doug Ford) most questionable moment came earlier this week when the official opposition and journalists asked a simple and direct question: Given that most of the COVID deaths have come in the long-term-care sector, would the government please call an independent, full-scale public inquiry to get to the bottom of why the system has failed so badly?
For the first time since the pandemic hit, Ford blatantly obfuscated in his response. He promised an investigation. He promised change. But he pointedly declined to commit to an independent public inquiry. That’s his prerogative. But he consistently refused to explain why. And the awkwardness of his tap dancing was noticeable for all to see.
It became painful to watch when CBC Queen’s Park reporter Mike Crawley asked the coup de grâce question during one of the premier’s daily briefings. Crawley had done his homework: one Indigenous protestor was killed at the Ipperwash Provincial Park in 1995; six died from tainted water in Walkerton in 2000; eight seniors died at the hands of a serial-murderer nurse named Elizabeth Wettlaufer between 2007 and 2015; and 44 died during the SARS outbreak in 2003. In all those cases, independent public inquiries were called. Why, when we’re approaching 2,000 deaths in Ontario from COVID-19 are you, premier, resisting calling a public inquiry?
It was a devastating question, and Ford didn’t help himself with an answer that was utterly non-responsive.
Surely, senior lives matter and deserve more than this response. Hopefully, the new commission will give us some answers.
Who will be held accountable?
The Long-term Care Utilization Report (February 2019) prepared by the Ontario Ministry of Health and Long Term Care reports that of the 626 homes licensed and approved to operate in Ontario, 58% of homes are privately owned, 24% are non-profit/charitable, and 16% are municipally owned. Who are these owners? Are they accessible? Who’s holding them accountable?
On Tuesday, May 12, 2020, Dr. Theresa Tam, Canada’s chief Public Health Officer, reported that roughly 20% of all confirmed cases of COVID-19 in Canada are linked to long-term care facilities, but 80% of the people who have died from COVID-19 were seniors living in these homes. The next day, Premier Doug Ford announced the Ontario government now has the power to take over management of long-term care homes. Will this new management improve the quality of care of our seniors? Similarly, will the new commission consider the following questions?
- Was it a mistake to isolate seniors, limiting access to loved ones willing to sit at their bedside, assisting with feeding, offering comfort and care, advocating on their behalf?
- Were family members made aware of the policy regarding “essential visitors?”
- Were loved ones advised of the recommendation to modify doses/medication that was deemed non-essential?
- Who determined what was to be considered non-essential medication?
- What were the criteria?
- When some health care workers were advised to stay home by their union representatives or employers, avoiding contact with COVID-19 or self-quarantining, what was the remaining ratio of personal support worker to residents?
- What was the ratio after part time workers were told to choose one place of employment?
- The Employee Standards Act (2000) was amended to give employers/employees flexibility regarding self-isolation, absenteeism/care for loved ones at home due to COVID-19. What was put in place to ensure the ratio of one personal support worker per 10 residents continued to be in place?
- Were family members informed of any new ratio?
- Were there any inspections that took place regarding alleged reports of neglect?
- Are loved ones encouraged to seek legal recourse?
- Will loved ones be allowed more access to sick relatives in hospitals or long-term care facilities?
- Will the government guarantee transparency?
- Will the rights of vulnerable persons, including the homeless, be respected?
What would the Good Samaritan do?
On April 3, 1968, the day before Martin Luther King was murdered, he gave his last speech, “I’ve Been to the Mountaintop.” He referred to the parable of the Good Samaritan (Luke 10:31-37) to make a point regarding the support needed by sanitation workers in the Deep South. He spends some time giving context for the scene of the parable, reminding the crowd that the road to Jericho is a “winding, meandering road. It’s really conducive for ambushing.” He proposes that the priest and the Levite are aware of the possibility of ambush and say to themselves, “If I stop to help this man, what will happen to me?” But then the Good Samaritan came by. And he reversed the question: “If I do not stop to help this man, what will happen to him?”
Let us apply the lesson of the parable to today’s current crisis with COVID-19 and long-term care homes. If we do not speak up and call for accountability, transparency, and a public inquiry, what will happen to the most vulnerable among us? If we do not allow access to loved ones in hospital or other settings, what will happen to the most vulnerable? If we do not supply an “iron-ring” of people inspired by common sense, truth, and courage to protect our loved ones, what will happen to us in the future?
“Religion that is pure and undefiled before God, the Father, is this: to care for orphans and widows in their distress, and to keep oneself unstained by the world.” (James 1:27)
Here are some quick facts from the Long-term Care Utilization Report (February 2019):
Ontario’s long-term care homes (February 2019)
- 626 homes are homes licensed and approved to operate in Ontario
- 58% of homes are privately owned, 24% are non-profit/charitable, 16% are municipal
- About 40% of long-term care homes are small, with 96 or fewer beds
- Of these small homes, about 45% are located in rural communities that often have limited home care or retirement home option
- 77,257 long-stay beds are allocated to provide care, accommodation and services to frail seniors who require permanent placement
- 669 convalescent care beds are allocated to provide short-term care as a bridge between hospitalization and a patient’s home
- 321 beds are allocated to provide respite to families who need a break from caring 24/7 for their loved one
- Approximately 300 of the province’s long-term care homes are older and need to be redeveloped (more than 30,000 beds)
- The average time to placement in long-term care, as of February 2019, is 161 days
- The waitlist for long-stay beds, as of February 2019, is 34,834
Sources: Long-Term Care Utilization Report, February 2019, Ontario Ministry of Health and Long-Term Care; Ontario Long Term Care Association, internal database, 2019.
Josephine Lombardi © 2020
May 19, 2020, Personal Support Worker Day
Please watch this video featuring Dr. Josephine Lombardi, Stronger Together While Physically Apart:
May God continue to guide and strengthen us as we pray for the balance to be restored in our families and communities, preparing us to enjoy the fullness of our faith life when we have the opportunity to gather and worship as one, no longer apart, but together.
The stress of COVID-19 has a lot of people wondering about the possibility of a “new normal” in the near future. What does this mean for Christians who continue to celebrate Jesus conquering sin and death with his death and resurrection? Where is hope to be found in the midst of restrictions, physical distancing, job loss, grief, and fear of illness and death?
St. Paul, in his letter to the Romans, calls us to “Rejoice in hope, be patient in suffering, (and) persevere in prayer,” (12:12). Hope, as a key virtue, is the habit to be mastered during the Easter season, the habit of waiting and praying with joy, patience, and perseverance. The Easter season is a celebration of the “new normal” brought about by Christ, meaning new life and new freedom. St. Paul, whose life and ministry magnify this process, gives us an insight into the “new normal” to which Christians are called.
St. Paul was a Greek speaking Pharisee who happened to be a Roman citizen. He did not meet Jesus in the flesh, but is known to have persecuted his followers, denying Jesus was the long-awaited Messiah. His conversion experience on the road to Damascus turned his life upside down, leading him to abandon his former life and embrace his “new normal” in Christ. He went on three great missions, proclaiming Christ to the Gentile world.
About 23 years into his public ministry, St. Paul had the courage to write: “I have been crucified with Christ; and it is no longer I who live, but, it is Christ who lives in me,” (Galatians 2:19b-20a). He went on to write that he lives by faith “in the Son of God who loved” him and “gave his life” for him. Revitalized by the new life he received due to the grace of Jesus Christ, St. Paul is strikingly aware that he has become a new creation!
If we do not believe that we can become a new creation, “then Christ died for nothing,” (Galatians 2:21).
His “new normal” was brought about by his new life in Christ. In early accounts of his life and in his own words, he is introduced to us as a blasphemer, a man of pride and arrogance, and an accomplice to murder. An encounter with the light of Christ, a light that casts out darkness and falsehood, blinded him, causing him to lose his physical sight, allowing God to restore his spiritual sight. The power of Christ’s light caused him to be submissive, trusting and still, allowing for Christ’s grace to work in him, disturbing his conscience and facilitating an encounter with the Son of God, the long-awaited Messiah whom he rejected and persecuted in his attack on Christians. Jesus chose a persecutor of Christians, working through him, despite his past actions and weaknesses, to be the greatest missionary of all time.
The call to live as another Christ, however, did not spare him from any suffering or trials. Throughout his missionary experience, St. Paul went on to suffer like Christ, (2 Corinthians 11:16-33), proclaiming, “I consider that the sufferings of this present time are not worth comparing with the glory about to be revealed in us,” (Romans 8:18). No doubt, St. Paul had hope for his future and ours.
Only the grace of Jesus Christ and cooperation with the power of the Holy Spirit can convert a “man of violence” to a man with a life giving mission, abandoning his old ways and becoming a new creation. He allowed Christ to live in him, making him another Christ, proclaiming the Good News and celebrating the gift of authentic freedom that comes with doing God’s will—loving God, and loving one’s neighbor as oneself, (Matthew 22: 36-40).
His “new normal” consisted of transformation and a great mission rooted in courage and persistence. He exchanged the lie of a life enslaved by fear for the truth of God; unlike some of the inhabitants of the communities he visited who had exchanged the truth of God “for a lie,” (Romans 1:25). God refined St. Paul, not depriving him of his great zeal and passion for the truth, but rather redirecting that zeal and passion for the expansion of God’s kingdom. His strengths were disciplined and surrendered to magnify God, encouraging him to examine his weaknesses with humility and increasing his trust in God’s mercy.
If we do not believe that God can forgive us and use us to magnify Him, “then Christ died for nothing,” (Galatians 2:21).
Christ did not die for us to continue to be anxious and afraid, surrendering to an uncertain future without any hope for restoration and authentic freedom. He did not die for us so that we can remain enslaved by fear or by any crisis. Later, in the same epistle, St. Paul writes, “For freedom Christ has set us free. Stand firm, and do not submit again to a yoke of slavery,” (5:1).
This means God desires authentic freedom for us, achieved through cooperation with the power of the Holy Spirit and Christ’s grace. Cooperating with God’s will and the power of the Holy Spirit should yield fruit: joy, peace, love, generosity, patience, faithfulness, self-control, kindness, and gentleness, (5:22). Allowing ourselves to be guided by the Spirit, we will be led to interior freedom, including inner peace, helping us to be still and trust God and His providence. Jesus taught us the only fruitful response to a crisis or emotional storm is to be still, to not rock the boat with frenzy and irrational responses. Take some time to read Psalm 37 and Psalm 46, especially verse 10: “Be still, and know that I am God! I am exalted among the nations, I am exalted in the earth.” Similarly, God reassured St. Teresa of Avila that if she took care of his business, he would take care of hers. Do God’s will and be still in your spirit, waiting for the fruits of the Holy Spirit to be made manifest in your surroundings.
“New normal” for Christians cannot mean more fear, anxiety, and despair. We cannot settle for darkness, diminishing our value and worth. During the Easter season we celebrate Christ’s light overcoming the darkness, vindicating all pain and suffering, reminding us of the great power of the Holy Spirit to create newness and hope. Celebrating the assurance of God’s protection, the Psalmist proclaimed, “He will not let your foot be moved; he who keeps you will not slumber,” (Psalm 121:3). If we truly believe that faith can move mountains (Matthew 17:20), we cannot accept anything that is contrary to God’s will, which is illuminated by the presence of the fruits of the Holy Spirit. Examine the outcome of any decisions, and discern whether the fruit is life giving or not. God’s plan for our lives includes our restoration, not our enslavement. Faith in God’s plan for us sustains us during these difficult days.
Faith—believing, knowing, and trusting God—is “the assurance of things hoped for, the conviction of things not seen,” (Hebrews 11:1). Faith gives us access to the unseen, preparing us with hope for God’s victory over death and darkness.
We cannot accept a “new normal” that does not respect the dignity of the person, nor offer any hope for the restoration of the balance in our lives, care for the vulnerable, public safety, and the freedom to worship publicly, even if some restrictions continue. God loves us too much to leave us where we are at, without a plan for full recovery of our faith experience and safety for all. In one of his statements on COVID-19, Cardinal Collins writes: “It is important to follow carefully the provisions of health authorities, but it is also essential that our spiritual life be enhanced and strengthened all the more during this crisis.”
The whole person requires spiritual strengthening during these difficult times. Sacraments feed our souls, offering nourishment and spiritual strengthening, encouraging us to go out and address the spiritual, emotional and physical needs of the most vulnerable members of the Body of Christ, people who are suffering, homeless, unemployed, addicted, sick and lonely.
Physical care administered by spiritual care providers for the “least of these” is just as important as mental health support because we provide care for the whole person—body, mind, and spirit. Christians have no choice but to care for their neighbors, addressing all their spiritual and physical needs. On this topic, St. John Chrysostom asks: “Do you wish to honor the Body of Christ? Then do not disdain Him when you see Him in rags. After having honored Him in Church with silken vestments, do not leave Him to die of cold outside for lack of clothing. For it is the same Jesus Who says, “This is My Body” and Who says “I was hungry but you would not feed Me. Whenever you refused to help one of these least important ones, you refused to help me.” Homily 50, On St. Matthew Ch.3. A “new normal” that does not allow for this level of care contradicts the Christian vocation.
Recently, Italian Bishops declared, “It should be clear to all that the commitment to serving the poor, (which is) so significant to this emergency, stems from a faith that must be nourished at its source especially the sacramental life.” We must remain hopeful that there is a way to fully comply with all health guidelines and regulations, while not compromising respect for freedom of worship and ongoing spiritual support.
The “new normal” experienced by St. Paul and countless other saints and mystics, is the acceptance of this truth. We must remain hopeful, waiting and praying with joy, patience, and perseverance.
If we accept despair, discouragement, anxiety and fear as our “new normal” “then Christ died for nothing,” (Galatians 2:21).
Josephine Lombardi © 2020
April 29, 2020, Feast of St. Catherine of Siena