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The Toronto Sun CareerConnection


Physician's photographs zoom in on homecare

By Sharon Aschaiek
Special to the Toronto Sun

Dr. Mark Nowaczynski has spent his entire career tending to his senior Toronto patients, treating them at his office at Yonge and Eglinton or making house calls, and watching as they learned to make do with few support services.
Dr. Mark Nowaczynski brings the plight of the elderly to the forefront with his stark photography.

By the late 1990s, however, he'd seen enough of the punishing inadequacies of Ontario's homecare system, as reflected by the sickness, squalor and solitude of his housebound patients.

A long-time photography buff, he began asking them for permission to document their situations.

"Many said no because they were ashamed," says the 45-year-old physician. "Here they are living in grinding poverty, in bachelor apartments, in tattered clothes. I told them it was so important to show that this is the reality in the heart of Canada's richest city."

Deeply passionate doctor

Most of the patients put their faith in their even-keeled yet deeply passionate doctor, and as a result, he has amassed a sizable body of stark, black and white photography of his vulnerable charges, including: George W., a retired postman and WWII veteran suffering from emphysema, chronic bronchitis, heart disease, diabetes and more, who received just two hours of homecare a week; Doris A., who despite living with an ischemic leg, worn out hip joint, osteoarthritis and two former fractures, was forced to make do with just four hours a week; and Constance C., who, at 91 and with heart problems and dementia, was left in the lurch in 2002 when her six weeks of steady, post-acute home care for a broken arm was abruptly cut off.

"It's a group of people that came of age during the Depression, and they are used to sacrificing," Nowaczynski says. "I find it a sick irony that they are being forced to relive the privations of their youth."

On Mother's Day 2001, his private concerns about what he sees as

Canada's silent health-care epidemic gained a powerful public platform when a national daily newspaper published his story and his photography over a three-page spread. The piece generated tremendous public buzz and won an award for excellence in health-care reporting from the Canadian Nurses Association.

Nowaczynski first started experimenting with photography at 16 as a hobby; it has only been in the last few years that he has discovered its ability to expose and address social ills.

"I realized this is a powerful way to get at people. The whole point is to stimulate change."

It's a vehicle that has connected him with numerous homecare agencies, and enabled him to press his arguments with key policymakers. But so far, he says, he has had little luck getting politicians to see the medical and social benefits of increasing spending on homecare.

'Avoiding the issue'

"Politicians are avoiding the issue of letting people stay in their homes and providing services to prevent institutionalization," he says. "I don't think the issue of chronic supportive care is very high on their agenda."

But he says that as the baby boom generation, the fastest-growing segment of society, enters its golden years, spending on homecare will have to increase beyond the current average of 4% of provincial healthcare budgets.

"The majority of the homecare budget goes to post-acute home care -- where does this leave senior citizens who need chronic geriatric home care?" he says.

So far, his photography helped his patient Constance bypass the lineup to land a spot at a Toronto assisted-living facility. It has also landed him at the centre of an entirely new adventure: a documentary produced by the National Film Board that chronicles his work and the personal stories of three of his patients. Called House Calls, the film will premier at the Hot Docs film festival next spring.

"I realized that the movie will be an excellent vehicle to get through doors that are otherwise hard to get through," he says. "It's a tool that will raise a considerable amount of awareness and certainly amplify whatever effort I've made to date."

Meanwhile, the experience has led Nowaczynski to view improving homecare as his life's work, and in January he will make house calls for half of his workload.

"It makes sense to me to do that. All of us are getting old, and we don't want to end up like this."

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