Yee Hong Centre The light at the end of the tunnel

The first Yee Hong Centre began in the mind of a young medical intern and resident at Toronto’s Western Hospital where he was receiving his post graduate training.

Dr. Joseph Wong had recently graduated from the Albert Einstein College of Medicine in New York City and had contemplated remaining there but instead decided to return to Canada.

At that time doctors who were on call for various nursing homes could tell the home to send the resident to the emergency room instead of examining the patients themselves.

“The emergency room was clogged with so many patients who should not be there in the first place because they did not have medical problems serious enough to be sent there,” Dr. Wong recounts.

“So we implemented a new system by which anytime anyone wanted to be sent in to the ER, the hospital would send a doctor to ensure they were legitimate cases. As a senior resident, the job often fell on me.”

This was Dr. Wong’s first real exposure to life inside nursing homes and from the outset he saw more negatives than positives in most of the homes he visited, especially for residents of Chinese descent.

“When I was sent to see patients in these nursing homes, whenever I passed rooms in which there was residents of Chinese descent I would often hear them cry ‘uncle’ or ‘brother please come in I want to talk to you,’” says Dr. Wong. The residents would recount for him how they felt they were being mistreated.

Language barriers seemed to be the biggest problem, but cultural differences would also get in the way since nursing home staff would not always be in tune with Chinese customs. Serving residents cold water is a good example.

“The cultural belief of Chinese elderly is if you have a fever or you’re sick and you drink cold water, particularly ice-cold water, it will sap the system and you will get sicker,” Dr. Wong explains.

“So when they asked for water and were not only given cold water but … ice in it as well, this was perceived by the Chinese patients as … being ignored.”

Barriers in language meant emotional needs were also not being met. Residents would have nobody to talk to when they were feeling depressed, isolated or lonely, which in Dr. Wong’s opinion was the biggest obstacle for Chinese seniors.

“It’s not like a hospital where if it’s very bad then you will say at the end of two weeks, ‘I will get the hell out of here,’ because they would have nowhere to go,” Dr. Wong says.

“They did not see light at the end of the tunnel.”

“I thought that someday I would like to build some facilities that would understand the culture and the language and give them an appropriate environment for them to spend the rest of their lives.”

From these humble beginnings grew one of the most unique and culturally diverse living accommodations for senior citizens of Asian descent.

In 1987, with Dr. Wong as the catalyst, a group of thirty like-minded Chinese Canadian friends began pounding on the doors of Queen’s Park. After four years of campaigning the government began seriously looking at the idea of homes for specific ethnic communities.

Along the way the group had difficulties with the Ministry of Health who didn’t see the need for a ethnic specific home. “The ministry is such a huge bureaucracy that it is hard enough to get changes made let alone getting them to accept a whole new concept to senior care,” says Dr. Wong.

“Now it is so logical, it is so obvious. But back then it was not easy. Very often I was told that in Canada you’re expected to speak English and if you can’t, it’s your problem,” says Dr. Wong. “That kind of attitude and perception and the big bureaucracy was the biggest barrier that I encountered.”

Officially opened in October, 1994 in Scarborough, Ontario, Yee Hong Centre for Geriatric Care’s services are rooted in a client centered philosophy that ensures clients' needs and choices are the primary driving force behind every decision. The facility’s goal is to uphold the principles and values of dignity, respect, freedom, privacy, recognition, growth and development.

Florence Wong, Executive Director of the first Yee Hong facility, is the Chief Executive Officer for the centre, and oversees operations at all four Centres. Working with Dr. Wong for about 15 years, she believes one of the most unique aspects of Yee Hong is the relationship they build with residents’ families.

“It’s a partnership we’re trying to promote,” she explains. “We also try to promote the thinking that in the nursing home you are not abandoning your parents you are partnering with us. We take care of your parents in the home but you come in and visit and help out.”

“We stress a lot on the partnership with the family,” says Dr. Wong. “No matter how good Yee Hong is, if the children don’t come to visit this would be a very big problem for us.”

Many people feel guilty about putting their parents in a nursing home, particularly people of Asian descent who have historically cared for their elders and see it as one of life’s duties. Yee Hong has not cured everyone of this natural inclination but when you consider that Mrs. Wong’s own mother is on the waiting list, it’s a sign of the quality of care they hold themselves to.

“I think people realize that taking care of their parents in their home leaves them alone a lot with no one to talk to. So they may be able to meet their meal needs and physical needs but they end up very isolated,” says Mrs. Wong. “In a home like this we provide social programs and the residents develop friendships with either their roommates or other people on their floor.”

Before starting at Yee Hong she worked for the Canadian National Institute for the Blind (CNIB) and was constantly visiting clients in senior’s homes. She always dreaded trips to nursing homes the most.

“I hated it,” she recalls. “I really hated going into long-term care homes because of the odour and the despair you see in seniors’ eyes as they’re lining up in corridors, staring up at the ceiling with no hope.”

“It’s not like that at Yee Hong,” she says. “You can walk into our homes any time and there is no odour, it’s very clean and very bright. The whole atmosphere is very uplifting and we stress respect and dignity for the seniors.”

Based on their dedication to supplying unmatched services, Yee Hong now offers one of the most extensive programs in the industry. Residents have 24 hour nursing care as well as day or night access to the attending physician. They receive dietetic assessment and work with a nutrition councilor who continuously monitors their progress. They also offer a lot of services to seniors in the surrounding community. Seniors in the area have access to educational, physical, recreational and social activities and the facility nearest them. From supportive counseling to foot care service, people in the community who meet the eligibility requirements have access to almost all the same programs as residents.

Residents can also receive social work counseling, physiotherapy and occupational therapy as well as a number of on site specialists including cardiologists and geriatricians. On top of this there are over 14 social, recreational, therapeutic and religious programs available every day.

The Markham facility has even dedicated a wing to South Asian seniors.

“We group them together on the same floor and we hired people who understand their cultural background and are able to speak and to communicate with them and a kitchen that would be able to handle their diet in a traditional South Asian way,” says Mrs. Wong.

“When you go to our Markham centre you have the best curry in town,” beams Dr. Wong.

At the Scarborough-Finch Centre, a wing is dedicated to seniors of Japanese descent and the Mississauga facility has a wing with 25 beds for Filipino seniors. Each are staffed and decorated appropriately.

As people age they become more and more frail, making dangerous situations out of almost any daily activity. Yee Hong ensures residents stay fit through scheduled activities and exercises.

“We emphasize lifestyle,” Mrs. Wong says. “In all of our residences we provide a lot of activities to enable them to stay as healthy as possible. Every morning at our Garden Terrace starting at eight o’clock we have Tai Chi classes and exercise classes and every morning we have close to 100 seniors participating.”

Another strong focus at Yee Hong is giving seniors a sense of independence to help improve their mental state and personal psyche. This also gives residents a sense of ownership and responsibility.

“Three times a week we provide them [with] transportation to go shopping, to restaurants. I really think they have the best of, not both worlds, but all the worlds,” she says with a smile.

In Yee Hong’s four buildings there are 805 units, each designed so that seniors can age in place. A plethora of on site services aid in this as well. If residents can’t physically make it to an appointment, the appointment can come to them.

“We found that building a long-term care home doesn’t solve all the problems. We need to provide a whole spectrum of services,” says Mrs. Wong. With the recent SARS scare Yee Hong recognized they needed to be ready for outbreak control. All the facilities have an infection control committee to look at the most up to date methods of controlling and containing infections and viruses. Each home also has an infection control practitioner to monitor daily control measures.

“We’re very advanced in terms of pandemic preparedness,” assures Mrs. Wong. “We have contingency plans for interrupted food supply and power supply, what we do with any staff who become ill, even for garbage pick up we have a plan. We are very detailed in our planning.”

“I always say that sometimes organizations, their policies gather dust,” she says. “In Yee Hong everything has to be followed and we monitor very carefully. Everything we do we are very serious about.”

Dr. Wong often reflects on the seniors that cried for his help all those years ago, and wishes they could see what they inspired: 805 long-term care beds, 438 senior residents units serving over 1500 seniors of Asian descent across the GTA. People who still see hope in life, people who still see purpose; people who can now see light at the end of the tunnel.