Front Burner - Family stories lead to revelation: 31 deaths inside care home

Episode Date: April 22, 2020

On Tuesday, Front Burner learned that Ontario's Orchard Villa long term care home has one of the highest COVID-19 death tolls in the country — 31 residents have been killed by the virus. We spoke to family members who say the sick weren't segregated, and that they were left in the dark about what was happening inside. Advocates say there are serious systemic problems in Canada's long term care facilities, and that this pandemic is exposing the deadly consequences of allowing those problems to fester for years.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hello, I'm Jamie Poisson and this is Frontburner. Hello, I'm Jamie Poisson and this is FrontBurner. I want to start today by telling you a story about one long-term care home in Pickering, Ontario. The home is called Orchard Villa.

And on Sunday, I spoke to a woman named Clara Burley. Clara had moved her mother, Susie, a dementia patient, into Orchard Villa about six years ago. My mother was a hard worker. She loved her grandchildren and she was tough as nails. She was a short little Italian lady, but she could do anything. Clara and her daughter Angela would go visit Susie all the time. But when the COVID-19 crisis hit Canada last month, they couldn't enter the nursing home anymore. Access was restricted to try and stop the spread. So instead, Clara and Angela would go up to the window and they'd wave, just to make sure Susie was doing okay inside. Then suddenly two weeks ago, they weren't allowed to do window visits anymore. And we knew something was different because there weren't any tables or people in the lobby.

They told us some people had tested positive, and that's where things just unraveled from there. Clara was really desperate for information. She would get occasional calls from staff about how her mom was doing. She would also get these automated phone calls with general updates from Orchard Villa. This is your daily update regarding the COVID-19 outbreak. We continue to work with public health in the land to ensure we have adequate resources to equip us to respond to this pandemic. But she didn't really feel like she knew what was going on inside the home, how many people were infected, or if her mom was really safe.

We have learned since then that for whatever reason, some people had received some emails and or letters. I don't know how they ended up on a list. I've sent emails since then to say I want to be on that distribution list. Never happened for me, though. Before I forget, let me add something. The thing that got us really concerned was the media reporting two deaths on Saturday. The 11th, the day after the window visits stopped.

So this other woman you're hearing, that's Angela, Clara's daughter, Susie's granddaughter. That got us really flustered because up until then, it was just, you know, we have some cases, we're doing everything we can. We started getting automated, general automated calls, but then the reported deaths were just shocking. Which we learned from Googling it. Then one week ago, last Wednesday, they get this call from staff who say that Susie has just been tested for COVID-19. They say results are going to take a few days, but that generally Susie's health is doing well. So other than this confused, little sad, agitated state, we thought that health-wise, temperature-wise, vital-wise,

she was okay until we heard from them Friday morning. So what happened on Friday? Well, Clara says she gets a call from a doctor. This was Friday morning at about 11 o'clock when the doctor suggested we talk to a funeral home and we get things kind of arranged that way because now with everything that's going on, nursing homes have a very short window

to have a funeral home remove the body. At this point, Susie is still alive. And despite hearing that her health was okay just two days earlier, now Clara is being told to get ready for a funeral. He gave me permission to go be with her. And I was with her for six hours. And she passed away. I was fully protected, though.

They were obviously very good to put me in full protective gear. I spent six hours with my mom. And I literally found out as I was leaving after she passed away that she had tested positive. And I want to stop here for a second. Our producer, Ebby, had reached out to some of the people with relatives in this home last week because we had heard about a handful of deaths. But then yesterday, Orchard Villa told us that number is now 31. 31 people dead. That makes the death toll at Orchard Villa among the highest known in the country. And on top of those deaths, there are now nearly 100 resident cases. 24 staff have COVID too.

And here's something else. We obtained a copy of a letter sent to families this past Saturday with COVID updates, and it didn't mention the death toll at all. Now, Clara and Angela were both really clear with us that they love the personal support workers at Orchard Villa. They take very good care of her. You know, it's very obvious they love her. They worry about her. They want her to eat and do better. But they also know that they're overworked and understaffed, and that's led to problems before. There was one instance where we went to go visit her, and she was in the hallway in her wheelchair, and we could see that her hand was swollen and purple

and she had a dislocated finger. It was hanging off of her hand and we freaked out and we had to call a staff over to say, what is going on with her hand? You know, there were many moments where they tried to do their best but their best wasn't good enough. Angela and Clara are not the only ones who feel like Orchard Villa needed to do more for their loved ones. I also spoke to a woman named June Morrison, and she just found out a few days ago that her dad, George, had been sharing a room with a man who was dying of COVID-19.

She says her family had been told last week that her dad had been moved and that the sick were being isolated from the healthy. But then just this past weekend, June gets this video call from a family member of that other man, the one with COVID-19. And he was still sharing a room with her dad. This to me is negligence, total negligence on their part. And there's no explanation for this. There's no reason that could explain this the way that you could ignore that this storm wasn't coming. Come on, read the news, read the paper. They're just not getting it. They don't understand how bad this is.

You can really hear that frustration in June's voice. Now, the man who was housed next to her father, he actually died this past weekend of COVID-19, according to his son. And June is really devastated that so many people she got to know at her father's care home are sick and dying, too. It is very upsetting. I've been grieving for a number of people. I'm sorry.

No, June, I'm so sorry that you're going through this right now. I feel the pain for the sons and daughters of their parents or grandmothers, I really do feel the pain for everyone. Orchard Villa told us they're devastated by these numbers, that they're following all public health directives, and that when a resident tests positive, their first priority is to make sure they receive adequate care and that they inform the family. priority is to make sure they receive adequate care and that they inform the family. They also told us they're experiencing staffing challenges, and they're working to address those right now. The facility did not address allegations over failures to separate the healthy from the sick. But these stories, they're just from one nursing home. One example of what has clearly emerged is Canada's shameful legacy of COVID-19, our inability to protect the most vulnerable in long-term care. 69 people dead at the St. Dorothy Long-Term Care Home in Laval, Quebec.

34 dead at Eatonville Care Centre in Toronto. 31 at the Heron Nursing Home in Montreal. Another 29 at Pinecrest Nursing Home in Bobcajan, Ontario. 29 more at Seven Oaks, a City of Toronto run facility. As of Tuesday evening, the CBC has counted 1,195 deaths in long-term care facilities countrywide. But the problems in long-term care homes, they didn't start with the coronavirus. Advocates say there are serious systemic issues here, and that this pandemic is exposing the deadly consequences of allowing those issues to fester unchecked for years.

Today, I'm speaking to Laura Tamblyn-Watts about that. She's the CEO of CanAge. It's a national advocacy organization for seniors. And I'm reaching her in Whistler, BC. Hi, Laura. Thank you so much for joining me today. Pleasure. So if we could start here, I know you just listened to what we put together there at the top of the show.

And what did you think when you were listening to these stories from this one long-term care home in Ontario? I think what it shows is that unlike counting things as cases or testing or deaths, that these losses are real. They're people's mothers, they're people's fathers, they're husbands and wives, and that every single one of these deaths is a tragedy to somebody. I'd like to say I'm surprised at it. I'm not.

We've been horrified at what's happening, but we've been calling out the danger of this for a month now already. It's truly a tragedy. You know, I was so struck listening this week to Angela and Clara and June sort of talk about how difficult it's been for them to receive any kind of clear communication, how in the dark they feel. And I know that this isn't isolated to this one home. Our producer, Mark, also spoke to a woman, Devorah Greenspawn. She's actually a resident at Extendacare Bayview in Toronto,

which is a home that has an outbreak of COVID. As of April 18th, five deaths, 51 cases there. And she says she doesn't feel like she's able to get enough information inside the home. I asked about whether anybody had passed away and nobody could give me an answer. I know that they're busy and I know they have their hands full, but I still feel they need to be more forthcoming. They need to be more transparent and let people know what's going on.

The only way I get information is my son gets emails and he relays the information to me when I speak to him, which is like every night. That's the only way I know what's going on in here. I'm not happy about it. Let's put it that way, you know. I know I can't go and speak to residents because we're not allowed,

we're not supposed to go out of our room. And so how common is that? I think it's tragically common. I mean, part of the issue is that because the staffing levels are so short, because we didn't put in place in most parts of the country, the type of parameters that we needed to, our staffing levels have gone down because staff are sick and some staff are afraid to come to work. And so they are literally scrambling to provide care. It's not unusual to have heard some very well-intentioned homes trying to provide care to, you know, 89 residents in one case that had four staff members on. So, of course, the first thing that drops off is communication. And yet we see how critically important communication is. Right. I'm hoping today we can talk about some of the systemic issues that you're seeing that have been illuminated by the pandemic. Obviously, you just talked about staffing and the problems that that's creating around communication. And what are some of the other big systemic issues that you're seeing illuminated here?

You know, part of the big issue is that Canada has no national strategy, no national standards for long-term care, which surprises people. And because there's no strategy or standards, there's also no staffing level requirements in long-term care. Provinces kind of make their own way. In Ontario, there's only the obligation for one registered nurse per long-term care home. Again, that's really shocking to most people. And sometimes we see cases where personal support workers who are often scrambling to make ends meet themselves, very lowly paid, sometimes between sort of 15 and 20 or $22 an hour, can't get full-time hours, can't get benefits. And so they're going to several different locations and providing care. We see at a systemic level also that these mostly women, over 90% of personal support workers are women, many of whom are racialized,

and many of whom are new Canadians, are really the lowest paid on the wheel. And yet they're the ones that are doing the heavy lifting and heavy support. Another piece that's really important to remember is that we pay incongruently less money for medical workers the farther that you get away from a hospital. So if you are in a hospital, a nurse or a licensed practical nurse, for instance, gets paid much more. They typically get full-time hours and benefits. If they go into home care or into long-term care, they can get, you know, half the salary in some cases, and often they can't get full-time hours and they can't get benefits as well. And part of that is also because hospitals are federally regulated.

And so because they're under the Canada Health Act, there are more requirements and restrictions. So at a big picture systemic level, we need to be able to look at paying medical staff the same, to be able to look at paying medical staff the same, no matter what the location is. That's incredible to hear. I didn't realize that there was such a disparity in compensation. And also, I had no idea that only one registered nurse was required per facility. We've been talking about how a lot of these PSWs, the workers in these homes, have to piece together multiple jobs to make ends meet. Why is it exactly that they're only able to get part-time work in these facilities? You know, we have been stripping money out of long-term care and indeed aged care, care for older people, for years now. And it comes from somewhere. And the costs that organizations

who are providing care have to bear, you know, has to come from somewhere. There is a piece here as well, which is kind of an uncomfortable reality in our Canadian sort of socialized healthcare system, that a lot of long-term care is run privately. So they get transfers of funds from the government and then they're top-ups, but they're private businesses. And I'm not saying it's right or wrong. I will say, however, that not-for-profit homes sometimes have a different mandate than for-profit homes. And if you're a for-profit home, you know, you've got a bottom line and shareholders that you have to answer to. Right. So this issue that, you know, there are private long-term care homes as well, you know, I think it's probably worth mentioning here. I'd

like to get your reaction. You know, we spent some time looking into the company that owns Orchard Villa, the home that we were talking about at the top of the episode, and they are privately owned by a company called Southbridge Care Homes. They manage 37 long-term care homes and retirement and independent living communities across Ontario. And we also found that three of their homes, including Orchard Villa, they're on a list of the top 20 Ontario nursing homes with the most staff to resident abuse in 2016. That's from a CBC Marketplace investigation. Now, we've reached out to Southbridge for comment. We haven't heard back yet. But, you know, what do you think when you hear that? You know, many, many homes are wonderful places, and many of them are staffed with fabulous staff.

But like anything else, there are some bad actors in the system. And when we cut down on things like inspections, or we reduce the amount of oversight, or we don't have actually fines that are robust enough to change behavior, those bad actions or bad actors that any system can have can continue on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. So you mentioned cutting back on inspections. This is something else that I'm hoping that we can talk about as well. There's this one story out of Ontario that I want to discuss with you,

you know, according to a recent CBC investigation. So last year, Ontario significantly scaled back their annual quality inspections of nursing homes. So in 2017, about 85% of nursing homes in the province were inspected, and then just over 1% in 2019 for a total of nine. Pinecrest last faced a resident quality inspection in June of 2018. Eatonville last checked in September 2017. Seven Oaks, June 2018. And so we asked the Ontario government for comment on this, and they said they actually did tons of inspections last year. But what seems to be an issue here is that these more robust quality inspections

are the ones that have been scaled back. Am I correct to say that? And is this happening all over the country? So you're right. It is the more robust, what we call comprehensive RQI type of inspections. Premier, I'd ask you to make sure that you please talk about the comprehensive annual inspections, not inspections in response to complaints. Well, it's better answered by one of my ministers here. We moved to a risk-based inspection process, really to make sure that the homes that were at highest risk were getting the attention that they needed.

And another point that's really important is when you know that there's an inspection, kind of like when you know your mother's coming for dinner, you tidy up everything and you make sure that everything looks just so. When you know that there is an inspection, kind of like when you know your mother is coming for dinner, right? You tidy up everything and you make sure that everything looks just so. And it's quite a bit of a different thing when somebody comes over as a surprise and is evaluating you. So those surprise components have been really withdrawn as well. Okay. And is this happening across the country as well?

What are we seeing in other provinces? Yes. I mean, across this country, there have been cutbacks to seniors care. And we're talking now about long term care, but this is equally true of home care at a systemic level. And so when inspections go down, when you're trying to cut budget, you know, you'll cut from anywhere. And that, of course, increases risk. So is Ontario alone in this? No, they're not. OK, this isn't the first time that we've heard sort of horrendous stories coming out of these long term care homes.

I want to talk about Elizabeth Wettlaufer for a second. This was the nurse in southern Ontario who murdered eight elderly patients with insulin. And she tried to harm six more. The families and friends of those harmed had the chance to set eyes on her. I'm just picturing my father as her patient and what he went through and how he couldn't talk and how he couldn't say help and how nobody cared and how he lied in that bed and had to die with nobody there. There was this big report that came out of that case last year. I remember though I suppose like most reports I'm not really sure what happened to it afterwards. And did that report address some of the systemic issues that you brought up with me today?

And has anything been acted on? So Justice Galiz did a fabulous inquiry. It was extremely robust and wide ranging. 4,000 pages came out of that report. 91 recommendations. Among them, nurses should be educated about the possibility of health care serial killers. Also, stronger medication management, more staffing in care homes, and more investigations into the deaths of residents.

Have there been the systemic changes that we need? No. No, there haven't. Occasionally something gets tweaked, but have the recommendations from Justice Galizia under the wet law for inquiry been taken up? No. Okay, and so I think that's where I want to end this conversation with you today.

What you think needs to happen here for some real and meaningful change? You've mentioned a few times during this conversation that there needs to be some sort of national framework. We haven't talked about the federal government yet. But I couldn't help but notice that they released some guidelines last week around COVID-19 that felt like at best common sense to me. It's stuff like use hand sanitizer and clean properly and limit visitors. And there's no teeth on these guidelines anyways. And so if we're really going to tackle this challenge, if we're actually going to try to address, you know, what I think will be the legacy of this country coming out of COVID-19, this shame that has emerged. What do we need to do?

Viruses don't care about provincial, territorial, and federal divisions of power. And it's important that we stop pointing fingers and saying it's the other person's job. We have been calling at CanAge and other organizations involved in seniors issues for a robust national standards. So not just a framework, but actually national standards with teeth attached to it. And some of the things that have to happen really are systemic change. Things like staffing quality ratios, things like mandatory vaccines. We get flu every year. And right now, only seven provinces and territories have even ordered the high-dose flu. We need to make sure that the federal and provincial governments work together so that we don't have not just COVID, but the predictable epidemics that come through. We need to make sure that the housing

stock is refreshed. We will have more infection because we cannot keep people who are 25 persons to a bathroom or showering area infection-free. We can't keep people who are in ward rooms with four beds and a curtain between you infection free. And in the end, the last thing that we need to really think about is looking at the structure. So we know that our population is rapidly aging and right up to hospice palliative care. Because if we can have more robust home care, which most people want, then we can actually relieve some of the pressure on the high needs folks that otherwise would be put into long-term care. If one thing comes out of this terrible pandemic and loss of life, may it be this system change in long-term and aged care for Canada. Okay.

On that note, Laura Tamblyn-Watts, thank you so much. Thank you. Okay, so just to reiterate here, we reached out to Southbridge on those inspections, also noted that they recently issued emergency orders to stop people from working in multiple care homes. This goes into effect today. They've also released $243 million in funding, which will help with staffing. Ontario follows the BC government, who started doing this last month. Unlike BC, Ontario says the government will not be taking over privately run homes. You heard Laura talk about the need for a national approach here. We also reached out to the federal

government to the office of Deb Schult, the Minister of Seniors. They reiterated that long-term care is the responsibility of the provinces and territories, but that they're working with them with a, quote, Team Canada approach to help keep residents and staff safe. We also asked them why the federal government only released non-binding guidelines for long-term care in COVID, but we didn't get an answer on that front. All right, that is all for today. Thank you so much for listening to FrontBurner, and we'll talk very soon.