Through a miracle of parentage, fate and dual citizenship, I stand astride both sides of the 5,525-mile border that divides the peace-seeking United States from war-happy Canada. Given that reality, I feel it falls to me to explain to you, the American long-term care provider, how things are likely to go when you admit a Canadian into your facility. 

Your first challenge will appear on the initial visit, when you try to explain the nuances of Medicare: 

You: “Here’s how it works. Medicare coverage has two parts.”

Canadian: “Medicare, eh?”

You: “Yes, and also Medicare Part B.”

Canadian: “Eh?”

You: (voice rises) “Yes, and B! Please don’t make me say it again.”

Canadian: “I’m really confused. Sorry, eh.” 

You: “B!” (bangs head repeatedly on desk, weeping)

By the way, that won’t be the last time you hear the word “sorry.” Pacemaker-type devices are implanted into all Canadian infants at birth, designed to trigger a needless apology every 27 seconds for life. So get used to it, and rest assured that at least 42% of the time, it might be sincere. On the bright side, a Canadian is far more likely to seek forgiveness than litigation. 

Regarding the day-to-day interactions of facility life, keep in mind that Canadians mostly don’t like to cause problems. So if you want to offer any sort of care or service, you’ll need to ask at least twice: 

You: “Can I bring you a fresh pitcher of ice water?”

Canadian: “No, this one’s fine. It’s only been sitting out for 8 hours.”

You: “OK, but I’m happy to.”

Canadian: (with a trace of sadness and self-loathing) “No, no, you don’t need to do that for me.”

You: “Are you sure? I’m going that way anyway”. 

Canadian: “OK, (heavy sigh and pained pause, signaling cellular-level reluctance to impose) I guess so. But only if it isn’t too much trouble.”

When it comes to dining, your Canadian’s dietary requirements should be fairly obvious. Maple syrup on Shreddies for breakfast. Poutine at lunch. A platter of Nanaimo bars and ketchup-flavored potato chips for dinner, with a Coffee Crisp or two for dessert. He or she may wish the coffee was as good as Tim Horton’s, but certainly won’t complain about it, choosing instead to just secretly seethe with a smoldering, repressed rage. 

Leisure time activity needs are minimal for any genuine Canadian. No bingo, field trips or chair yoga necessary. He or she will simply and politely wonder if that facility TV could maybe play Hockey Night in Canada, “Trailer Park Boys” or “Schitt’s Creek,” if it’s no inconvenience to anyone else. (Or maybe I’m just projecting my own eventual long-term care viewing preferences here — and since I’m half American, I’ll probably just roll up and change the channel myself, without asking.) 

Mostly though, a typical Canadian won’t cause you or your staff much trouble, and we’re unlikely to complain about the size, comfort or privacy levels of a resident room. Since most of us were raised by wolves and polar bears huddled together in wilderness ice caves, we’ll just be glad to be sleeping indoors.

When winter rolls around, out of force of habit, we’ll probably try to plug in our walkers and wheelchairs overnight, to make sure we can start them up again in the morning. But otherwise, we’ll just be grateful for whatever you do for us.

Oh, but one more thing. At some point, you should be prepared to credibly answer the question most likely to be posed by any Canadian seeking healthcare in the United States:

“Seriously? This isn’t a right? It’s mostly free where I come from.” 

Things I Think is written by Gary Tetz, a two-time national Silver Medalist and three-time regional Gold and Silver Medal winner in the Association of Business Press Editors (ASBPE) awards program, as well as an Award of Excellence honoree in the APEX Awards. He’s been amusing, inspiring, informing and sometimes befuddling long-term care readers since the end of a previous century. He is a writer and video producer for Consonus Healthcare in Portland, OR.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.

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