After setbacks that had him go from Invermere to Cranbrook and Calgary, a local man has returned home. And though Interior Health (IH) have cut back on some of the services he needs, his family hopes they will come through on what they have promised.

Norm Gagatek suffered a brain stem stroke more than a year ago leaving him bedridden in a condition some have referred to as “locked-in” syndrome.

In short, mentally, Norm is fully aware of his situation despite his complete loss of physical functions.

Earlier in the year, Norm developed a pressure ulcer on his lower back and as a result has spent time in both Cranbrook and Calgary receiving treatment. In the meantime, IH made cuts to some programs, including speech and language pathology (SLP), that Norm has been a part of as part of his rehabilitation.

As a result of his SLP work, Norm had managed to be able to speak the names of his kids, something he couldn’t do at first.

But upon arriving back to Invermere this month, IH has changed its approach to SLP, cutting in-house specialist visits to once ever few months and substituting them with tele-conferencing.

But a care worker from a valley facility who asked not to be named feels that this is not enough.

The worker, who we’ll call Florence, said she has seen the work done by speech pathologists and does not feel that it can be done with just a video.

“I don’t see that as being able to help in any way,” she said and described what might happen during an assessment of a person with advanced Alzheimer’s. “When (a speech pathologist) does an assessment on somebody, he sits at a table with that person. And because the person generally has advanced dementia, there’s not much conversation. He’ll sit there and have a cup of coffee and watch the person, how they eat, what their throat is doing, how they’re working their tongue.

“You cannot do that with tele-health. And that’s the only way to assess someone like that.”

She also said that putting any of that responsibility on care givers and nurses is not a good idea either.

“Most of our care givers have got a six-month course, they can’t make a proper assessment,” she said.

Jason Giesbrecht is the program administrator for rehabilitation for IH. He said that the onus will not fall to nurses to do this work.

“Nursing probably isn’t the group that would provide the rehab assistance,” he said. “It would be someone like a rehab assistant. Someone with experience and a background in rehabilitation.”

“There are absolutely things that you cannot do by video, where you need to feel and touch. When those activities are required we will need to deploy someone to come face to face,” said Giesbrecht, who said that the video support will be given more for activities that require coaching of verbal support.

He said that, collectively, IH has doubled its rehabilitative services over the past two years.

But Florence said that despite this, there are still areas that people with family in long-term care are having to pay for themselves.

For example, she said that things like lifts on toilet seats that allow people with mobility problems to sit and get up easier from the toilet have to be bought by service users. As well, she said that wheelchairs and oxygen machines also have to be bought, sometimes at a cost of upwards of $5,000.

For someone like Norm, the services are necessary for him to do even the most simple things as swallowing and despite the setbacks, Norm’s fiancé Kim is trying to remain positive.

“Though the SLP services are being cut, the good news is preschoolers will be receiving speech therapy here in Invermere,” she said.