A day after a former Woodstock nurse was charged with eight counts of first-degree murder in the deaths of eight nursing home residents in Woodstock and London, healthcare and senior care advocates say they hope the allegations spark much-needed changes to the province’s long-term care home system.
Speaking on AM980’s The Pulse with Devon Peacock on Wednesday, Natalie Mehra, Executive Director of Ontario Health Coalition, said she heard the same complaints from staff members at every long-term care home she visited: that poor funding and chronic understaffing was leaving residents vulnerable and making it hard for staff members to provide adequate care.
“That’s the chief complaint,” said Mehra. “When staff are away on sickness or absence, they’re not replaced. In any case, the staffing levels are too low for what they call the acuity, or the heaviness of care of the residents.”
In addition, Mehra says staff members tell her they may be dealing with dozens of calls at any given point and time during their shift.
“There’s a lot of complaints about being distracted and having too much to do,” Mehra said. “Workload pressures, I think, are very serious pressures in long-term care homes. That’s certainly something that accords with what we hear very, very frequently.”
“I think if there’s any kind of small silver lining here, it’s that it is shining attention on what happens at these care facilities, and frankly, that light needs to shine,” said Wanda Morris, President of Advocacy and COO of CARP, the Canadian Association of Retired Persons. “The province of Ontario does publish some indicators, some health quality indicators, and they show high levels of uses of antipsychotics for residents without a diagnosis of psychosis. It’s basically a type of chemical restraint.”
According to those same statistics, Morris says reports of falls and bed sores are also commonplace.
“I think that there are issues with staffing at the lower levels, the personal support worker levels, meaning that these vulnerable people, probably 90 per cent of whom have some type of cognitive impairment or dementia, aren’t getting the care they need,” Morris said.
According to a 2016 pre-budget report from the Ontario Long-Term Care Association, long-term care homes in the province have lower staffing levels than in other jurisdictions, both across Canada and internationally.
“Not only has the care of individual residents grown more complex, these health conditions are requiring a greater volume of information and reporting as health data requirements also grow,” reads the report, adding that in five years the level of bed mobility support required by patients increased by 11.6 per cent, while support for toileting and personal hygiene increased by 8.9 per cent and 7.2 per cent, respectively.
In addition to recommending increased staffing levels, the Association also recommended increased funding for Behavioural Support Ontario and called for the rehabilitation of nearly half of the province’s long-term care facilities which it says were built to accommodate design standards dating back to the early 1970s.
“Ontario has cut more hospital beds than any other province in the country” Mehra said. “We have the fewest left, and all the chronic care hospital patients have been moved into long-term care homes without adequate staffing. That is a systemic issue, there’s no question.”
Morris said the government was providing some very helpful tools, but added “there’s such a shortage of long-term care beds, and of course, such pressure to move people out of hospitals – very expensive care – into long-term care facilities.”
Elizabeth Tracey Mae Wettlaufer, 49, of Woodstock remains in police custody, facing eight counts of first-degree murder in the deaths police say took place between 2007 and 2014. Provincial police allege a drug was administered to the eight patients at two nursing homes.
While police have yet to release what drug was allegedly used by the accused, Wettlaufer was placed under a peace bond earlier this month before she was charged. One of the conditions prohibited her from possessing Insulin unless prescribed for personal use.
Some of the other nine conditions of the peace bond include continuing treatment for mental health, as well as prohibitions on possessing or consuming alcohol, providing services as a care giver to anybody, and attending any nursing homes, retirement homes, long-term care homes, “or hospital except as necessary for your own personal health matters.”
Staff members at long-term care facilities in the province are required under the Long-Term Care Homes Act to report any neglect and abuse suffered by residents, Mehra said. While homes are required to report every death to the coroner, the Ministry of Health is only required to be notified of “unexpected” deaths.
“In Ontario there are systems in place that cover everything. Long-term care homes are supposed to report critical incidents, (and) those reports go to the director in the Minister’s Office, so if there’s a problem in a particular home, it’s supposed to be flagged,” said Mehra. “There’s a duty to report neglect and abuse for all staff now … in addition, there’s a whole system for governing medication, administration, and management, and everything is recorded.”
“In this situation, all of the standards and protocols in place to protect against medication errors, or misuse in medication, it’s not clear how they were circumvented or what happened in this particular situation.”
Morris told AM980 she wondered whether the allegations would have taken so long to come to light had the victims been sick children instead of elders. “This crime is no less odious just because it’s happened to people near the end of life,” she said.
Though the province’s Long-Term Care Home Quality Inspection Program (LQIP) says all homes are inspected at least once a year and investigations are undertaken as a result of complaints, concerns or critical incidents, the London Free Press reported in June that the province was planning to scale back full home inspections at 84 per cent of the province’s long-term care homes to once every three years, with light inspections the other two.
“It concerns be deeply,” said NDP health critic France Gelinas in an interview with CBC News in July. “We have such little choice as to where our loved ones end up going that I want every long-term care home to guarantee safe and good quality care, and right now we don’t have that in Ontario.”
At Queen’s Park Wednesday, Premier Kathleen Wynne and the Liberal government were grilled over the state of Ontario’s long-term care homes. Wynne responded her government was open to an independent review of the province’s facilities.