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“A nation’s greatness is judged by how it treats its weakest members” — Mahatma Gandhi
By Yvonne Sam
Contributing Columnist
In the midst of the current pandemic, the words emanating from the lips of relatives, shocked Quebecers, and throughout the Diaspora, following the discovery of 31 deaths (five of which are attributed to COVID 19) at a long-term care facility in Dorval, on Montreal’s West Island, in roughly a 3-week span, has been, Why? Why? How did this happen?
On March 29, when public-health inspectors visited Résidence Herron, the 134-bed private, long-term care facility — considered to be a luxury retirement home, charging each resident up to $10,000 per month for housing and care — they found residents sitting in their own excreta, because their incontinence pads had been unchanged, for days.
There were other residents showing signs of dehydration, disorientation and starvation, not having received food or given their medications. Two patients were also on the verge of death.
No person in authority, except for two orderlies, was present, in the residence, when the inspectors arrived. It was stated, that other staff had abandoned their charges, due to disproportionate wages, poor working conditions and inadequate protection against the Coronavirus. More importantly, one source described the scene as something akin to a concentration camp.
While the questions, raised by the incident, are deeply troubling, and the details sickening, finding the answers are not as complex as might have been originally thought.
How is it humanely possible that in Canada, in the year 2020, the elderly, in licensed long-term care facilities, can be relegated to treatment, worse than canines at a city pound?
How is it imaginable that vulnerable seniors – some with cognitive disabilities and severe mobility issues –could be left to fend for themselves?
How could the owners and operators of the Residence (Katasa Holdings Inc.)that boasts about offering its clients “luxury, comfort, convenience and security”, be so insensitive that they would try to cover up the debacle?
Public health officials had to obtain a court order, to get access to residents’ files, and it was only then, they learned there were 31 deaths.
Notwithstanding, the elderly, who inhabit Quebec’s 2,600 long term care and nursing home facilities, have received relatively little attention from either the research or policy communities.
The said Residence Herron had been the subject of two investigations, by the Quebec Ombudsman, for the selfsame conditions and allegations, as those at present.
However, the main lesson that the Canadian federal and provincial governments must not only learn, but retain, is a swift rethinking of their priorities that whatever is done to protect hospitals during pandemics, needs also to be done for seniors’ facilities — stat!
In 2017, the Quebec Ombudsman ( le Protecteur du citoyen), launched an investigation, after receiving complaints, including inadequate nursing care, a poor approach towards patients with cognitive difficulties, complaints over food and a lack of communication with families.
The investigation found that the facility lacked continuity of care, nursing care, in addition to communication difficulties between management and families. However, the Ombudsman warned, in its report, that management needed to ensure that there was enough suitably-trained staff, given its intention to increase the number of patients.
In 2019, an inspection, conducted by Quebec’s Ministry of Health and Social Services, did not notice any particular problems with clinical practices, but nevertheless, issued recommendations, including the development of a policy to fight mistreatment, as well as improved communication with residents and their families, particularly in the areas of residents’ rights, end-of life decisions and palliative care.
Incidentally, a 2019 coroner’s report, into the choking death of a 94 year old female resident, suggested there were many issues at the seniors’ residence, long before the COVID-19 pandemic.
Thanks to Covid 19, the behavior, meted out to the most vulnerable, by those most able, came, once again, under the microscope and, ultimately, into the limelight. Sources state that a resident of the Herron, on feeling unwell, went to a well-known hospital to be tested for the virus. Pending the results of the test, and in line with existing government protocols, the woman was considered well enough to return to the residence, the same day.
However, the results returned positive, and a nurse at the hospital was unsuccessful in contacting the patient, even after trying to go through the administration at the residence.
The nurse then decided to contact the Montreal Public Health Department to try to find the infected resident. The police also became involved in the effort. The home has since been put under trusteeship, with three separate investigations underway—the Montreal police, the Coroner’s Office and officials from the Ministry of Health and Social Services.
The deaths occurred on March 13. According to Quebec Premier, François Legault, the operator of the facility had refused to comply with health authorities, even withholding medical files, after they stepped in, on March 29.
The Premier further confessed that “there is a lot that he did not know”. The government gets a briefing, every morning, from CHDLDs, but the management from Residence Herron concealed information from him. He was told that there were a few deaths, but not the 31.
On April 11, the Premier said there had been “gross negligence” at the home and he has asked police to determine if criminal charges are warranted.
Definitions of neglect are probably the most disputed of any category of maltreatment of elderly persons. However, in general, neglect is thought of as including “the refusal or failure of a caregiver to fulfill his or her obligations or duties to an older person, including the provision of food, clothing, medicine, shelter, supervision, and medical care and services that a prudent person would deem essential for the well-being of another”
Regrettably, there is substantial evidence of failure to provide goods and services necessary to avoid physical harm, and mental anguish in the nation’s nursing homes. More than anything else, the virus has exposed a crisis that already existed — a crisis of neglect for our elders.
For years, it has been a known fact that the elderly in long-term care homes are vulnerable to infections. It is not exclusive to Covid 19. Both the federal and provincial governments have failed miserably to prepare long-term care facilities to protect the most vulnerable — the elderly — during this pandemic.
The nightmares that have emerged, from the various nursing homes — Ontario (Pinecrest Nursing Home, Anson Place Care Centre, Almonte Country Haven), globalnews.ca/news/6811231/14-deaths-36-infected-coronavirus-outbreak-almonte/; Montreal (Residence Herron, Centre d’hébergement de LaSalle, Ste-Dorothée Long-Term Care Centre;); Calgary (McKenzie Towne Long Term Care Home)calgary.ctvnews.ca/new-restrictions-for-care-workers-after-4-more-deaths-at-mckenzie-towne-1.4891808; North Vancouver (Lynn Valley Care Centre) www.theglobeandmail.com/canada/article-how-the-coronavirus-took-north-vancouvers-lynn-valley-care-centre/ among others, all paint a stark picture of a lack of resources, preparedness and protocols. Plainly put, the ball was dropped.
More than half of the total deaths from coronavirus in Canada have occurred in Quebec, the second most populous of 10 provinces. Additionally, according to Chief Public Health Officer, Theresa Tam, outbreaks at seniors’ homes, across Canada, have caused hundreds of deaths, close to half of the COVID-19-related fatalities in the country.
No finger pointing is necessary, as there is enough blame to go around. The government of Canada literally gave the pandemic the key to reach its aging population. The pandemic is now Canada’s Armageddon. Lesson after lesson will emerge after the virus has abated.
However, the main lesson that the government must not only learn, but retain, is a swift rethinking of their priorities: whatever is done to protect hospitals during pandemics, needs also to be done for seniors’ facilities — stat!
This is not our last pandemic. So the challenge is clear to see; rectify the troubling issues permanently, so that we can better prepared be.
We are all in this together.
Yvonne Sam, a retired Head Nurse and Secondary School Teacher, is the Public Relations Officer of the Guyana Cultural Association of Montreal. A regular columnist for over two decades with the Montreal Community Contact, her insightful and incursive articles on topics ranging from politics, human rights and immigration, to education and parenting have also appeared in the Huffington Post, Montreal Gazette, XPressbogg and Guyanese OnLine. She is also the recipient of the Governor General of Canada Caring Canadian Citizen Award.
