Front Burner - Her mother survived the first wave in long-term care. Then the second wave came

Episode Date: October 6, 2020

Iona Guindon felt lucky that her mother Perriette's long-term care home in Ottawa was spared in the first wave of the pandemic. But an outbreak that began on Aug. 30 exposed Iona to horrifying scenes inside the home, and left her wondering why West End Villa wasn't better prepared to control the virus. In the spring, long-term care companies and the Ontario government promised they would be far better prepared for a second wave. Now, as outbreaks rip through 50 such homes in the province, advocates say too little has changed.

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. I'm Josh Bloch. This is FrontBurner. I'm Josh Bloch. This is FrontBurner. And, you know, whether others would say it was just inevitable, you know, your mom, she's bedridden and she's diabetic,

so she's immune compromised. And I said, yeah, mom's strong, you know. She's gotten through six months, and that speaks to her vitality and her tenacity and her gumption and that people are doing things right. And I had, I guess, this false sense of security that the home was doing things right. For the first six months of the COVID-19 pandemic, even as the virus ripped through long term care facilities, even as those homes saw 80% of Canada's COVID deaths. Extendicare West End Villa in Ottawa was spared. Iona Gandon felt lucky.

Her mom, Perriette, had moved to the home in 2019. Perriette had dementia and needed help. And Iona felt that her mom's care was wonderful. They called my mom, Mama. They treated her like their mama. They loved on her. They were her family in our absence. Then on August 30th, one resident at Extended Care West End Villa tested positive. And by September 4th, the home sent a letter to families saying that it had spread to 10 residents and three staff. By September 18th, 52 residents had tested positive,

and 26 staff. Nine residents had died. All this in a matter of weeks. And I can't necessarily say they weren't doing anything right. It's just what happened, that thing spiraled out of control so quickly. Outside the home in Ottawa, a similar trend was happening, with cases rising dramatically in the first few weeks of September. The Ontario government cut down the limits on indoor and outdoor gatherings,

but restaurants and bars stayed open. And a chorus of demands for stricter measures to contain the second wave was building. Still, even as the cases kept multiplying, as far as Iona knew, her mother was doing well. But then on Monday, September 21st, Iona had a video call with her mother, and it set off alarm bells. Mom was sitting in a different area, sitting upright in her wheelchair. I could see she was sitting by a window. There was a drape and I was like, oh mom, are you in some new digs? And she said, Iona, I got moved to my own private room. You know, my mom was one of 15 kids, a farmer's daughter, and having a room to herself, she hit the jackpot.

But to Iona, this was a sign that something was very wrong. I'm looking at the environment thinking, why is mom in isolation? And I could see some darker circles under her eyes, and I could see her breathing was a little strained, and her conversation wasn't as active as normal. And I was choking back the tears. You know, I ended the call in fear. I started to think, I'm mom's medical proxy. No one's called me.

Why is it through my observation skills that I can see that my mom's in an isolated room? But no one's contacted me to alert me that there's been a change in her health status. To me, that was a violation of the home's responsibility in communication and to advise me right away. And I found that to be negligent. Iona immediately contacted the home, desperate to figure out what was going on. When they called reception on Monday, I was told everybody's really busy.

It's very crazy around here. So I called back Tuesday and I was unsuccessful getting through to anyone. And I spoke with the receptionist, who's always been very kind. And she said, everybody's busy. Finally, Tuesday afternoon, Iona received a call from a West End Villa employee. And he just said, oh, your mom just has a slight cough and we're just taking precaution. I said, why wasn't I called? Your home is in a dreadful state. And if you're taking measures to isolate mom, we should be concerned. Oh, you know, she was negative last week. We took a test Monday. We're waiting on results.

It's just a little bit of a symptom and like totally downplayed it. Iona says a floor nurse Tuesday night gave her a similar picture, that her mom was doing fine and that this was just a precaution. But that is not what Iona saw during a video call she had with her mother that same day. She says Pelliette looked anything but normal. Mom's breath was shorter. She was having a hard time getting her words, and I was alarmed by that. So to hear the nurse from the nurse saying, oh, your mom's fine, she's this, she by that. So to hear the nurse from the nurse saying, oh your mom's fine, she's this,

she's that. I did challenge the nurse and saying, you know, I don't know about your observation skills, but from what I'm seeing, I'm not getting the same message that you're trying to relay to me. I'm concerned about my mom. Well, we'll call you, right? Kind of attitude, and we were done. He had to go, because he was busy. I didn't hear anything Wednesday, and then Thursday came. Around 9 a.m. Thursday morning, Iona got a call from a woman who told her she was a registered nurse practitioner from the Ottawa Hospital Civic

Campus. And that she was called in for patient care to assess my mom. And at that time, she reported that my mom was having some difficulty, that she was in some respiratory distress. You know, her heart was working harder. The nurse was asking Iona's permission to put Perriette on oxygen. Iona said yes. At 12.30, another call. Perriette was still struggling to breathe. Could they increase the oxygen?

Iona said yes. At 4.10 p.m., a third call. Could they increase her oxygen to the maximum? And something else, something even more troubling. And then to inform me that she was then changing mom's status to palliative. West End Villa's COVID protocols barred family members from entering the home. But since Pelliette had been deemed palliative, Iona was given permission to go in and see her mom. She drove down as quickly as she could, suited up in full PPE, and went up to her mom's room.

And what she saw horrified her. Mom was asleep on her side in the bed. She wasn't, you know, I knew she was under the influence of this medication, so I was prepared for her to be in a sleepy state. But what alarmed me was the condition of the room. The room was dirty. The floor was dirty and sticky. My mom had soiled herself. She was dirty. Her hands were dirty from excrement. There was fecal matter on the wall. Her mouth was dry. Her tongue was dry. Iona said her mom had grown so weak that she couldn't eat

or drink herself. And while beverages had been delivered to Perriette's room, all but one were unopened. To Iona, this was a sign that no one was helping her mom drink. So I'm like queuing into this thinking, well, if she's in palliative care and she's in an isolated room, to me, I just deduce that surely to goodness, someone would be in there watching over her and assisting her like we would had we been able to be in the home and help or bring in someone to do that sort of thing. Those weren't the only alarming things. Since Pelliette was a suspected COVID patient and she was in a private room, Iona assumed her room would be fully isolated. But in the door was wide open. My mom's on her bed.

And in the time that I visited, general residents in the population on the fifth floor were entering her room. So, you know, not all were cognizant of where, you know, what they were doing. You know, one poor lady, she was very on in years and in her own jerry gown and a walker. And next thing you know, she's wandering her way into my mom's room. This woman didn't appear to know what she was doing. And there was no boundary. There was no distinction for her to not gain access. It was a free for all portal for her to enter the room.

And that repeated again on Friday. And I thought, my mom's room was dirty. It was a free-for-all portal for him to enter the room. And that repeated again on Friday. And I thought, my mom's room is dirty. Everything she's demonstrating are COVID-like symptoms. And yet, if these people aren't positive and they're wandering the halls and they're entering her room, I did make a harsh judgment call. I thought, what are we doing here? No wonder your numbers are out of control. There's no words for how the victimization, my concern for those individuals, and that it was just a walking time bomb before they too would be the next ones on the

list. On Friday, knowing that her mother would soon die, Iona gathered videos and voice messages from Perriette's kids and her grandkids and great-grandkids, and she went back to West End Villa to play them for her. Hello, my beautiful grandmother. Ah!

Ah! We just wanted to play them for her. Hello, my beautiful grandmother. Yeah. We just wanted to say we love you. Love you. And we look forward to seeing you again soon. You know, you've got to do what you can to get through these next few days. I know you're strong. I know you love your family just as much as I do. And just know we're all thinking about you and praying for you.

You're amazing. Being able to bring what they did was a beautiful thing to be able to do. She also recorded messages from her mom to send to the family. You want to say hi? Hi. I love you. I love you. Yeah.

Did you have a good drink of apple juice, Mom? Yeah. Yeah? Okay. On Saturday, September 26th, Iona woke up with a bad feeling. I called, left a message, didn't hear back. Called again at 9, didn't hear back. And in my gut, I felt urgent. It's like, I need to go see my mom. When I did get the call from the nurse,

this individual said, I am so sorry. I've been under an immense demand today. I'm the only nurse on staff, and I'm going between two floors. I haven't gone. I just got in to see your mom. And this was shy of 12 o'clock. And he said, it's bad. Your mom's saturation rate is in the high 50s. Her blood pressure is very low. You need to come in now. Iona called a nephew to meet her at West End Villa,

and she drove there 50 minutes from her home, as fast as she could manage. Got equipped, got upstairs, and we entered the room just as she was passing. You know, there may be some people who may be of the attitude of, well, you know, like I use that word inevitable, it's just a matter of time. You know, they're in a long-term care home, and mom went in there because of the level of care she required, but that didn't mean she was a write-off. but that it didn't mean she was a write-off. And she had value in society, not just because she was our mother, you know, mother to five, grandmother to 12,

great-grandmother to three. She had value. She had value. 19 residents have now died at the facility. The Ottawa Hospital has now taken over resident care at the home. Last week, a Toronto law firm launched a $15 million lawsuit against West End Villa on behalf of residents and their families. And as of Monday afternoon, it's one of 50 homes in Ontario that has an active COVID outbreak. 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. Hi, it's Ramit Sethi here. You may have seen my money show on Netflix. I've been talking about money for 20 years. I've talked to millions of people, and I have some startling numbers to share with you. Did you know that of the people I speak to, 50% of them do not know their own household income? That's not a typo. 50%.

That's because money is confusing. In my new book and podcast, Money for Couples, I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Couples. For people who lost loved ones in the first wave of outbreaks in long-term care, stories like Iona's are infuriating. You know, you feel like crying because we've already lost so many good souls. You might remember June Morrison. We spoke to her back in April when her father was at Orchard Villa, another Ontario long-term care home.

At the time, she was worried because she said that her father was sharing a room with a man who had tested positive for COVID, even after she was told that he'd been moved. Two weeks after our interview, June's father died of complications related to COVID-19. I scattered ashes on the Niagara River and gave him the right of his life in his passing, if you will, to give his spirit some freedom to move. June's now part of a major lawsuit against Orchard Villa, but she's also become a vocal advocate for changing the whole long-term care system in Ontario to make it better for both residents and staff. And I don't want ever myself to be housed in a facility, a warehouse like that where I'm just a number, I'm a dollar sign, I'm a profit. That's all I am. I fill a bed and I'm money in their pockets. I don't want that.

I want life to be different for you and I when we have to go into some kind of care facility. And she's furious that after all the grief that she and thousands of other Ontario families went through this spring, it feels like not much has changed. What's it going to take? What's it going to take? All of the beds to be empty before somebody really looks at this? If you can remember back to the end of May, there really was a national reckoning around the failures to protect the most vulnerable seniors in long-term care.

The military members that went in to help control the outbreaks in the hardest-hit homes in Ontario and Quebec relayed horrifying details of the scenes they saw inside. horrifying details of the scenes they saw inside. Severe staffing shortages, residents who hadn't been bathed for weeks, people left unfed or dehydrated or sitting in dirty diapers, people who lay on the floor for hours because no one came to help them, dementia patients with COVID wandering into other rooms and spreading the virus,

cockroaches, mice, rotting food, people choking because they couldn't swallow their meals. The homes and their parent companies promised they would change and be better prepared for the next time. A July press release from Extended Care, for example, says that, quote, we are preparing for a possible second wave by maintaining sufficient levels of personal protective equipment and enhancing infection prevention, and enhancing infection prevention, and that we continue to commit increased resources to protect against COVID-19, primarily related to increased staff and personal protective equipment.

The Ontario government promised things would change too. Here's what Premier Doug Ford said two days after the military report was released. And in the event of a surge of a new COVID-19 cases in the community, we will be prepared. My friends, we're sparing no expense. We're stopping at nothing because the stakes are too high. We will do whatever it takes in our power to protect our most vulnerable seniors and ensure they get the care they deserve. That is my commitment to our long-term care residents, to staff who care for them, their families, and to the people of Ontario. I asked Natalie Mara, Executive Director of the Ontario Health Coalition, whether she feels that the government has followed through

on that promise. They haven't. There has been press conference after press conference with clutching of pearls and all of the sympathetic noises about what needs to be done. And nothing has happened. Let me give you some context. recruitment strategy. They put the whole weight of government behind it. They recruited 10,000 PSWs for long-term care. They paid them $21 an hour to train them, $26 an hour to work in the facilities. Now it was announced they're hiring a manager for each long-term care home to pair with an infectious disease specialist, an infection control specialist, sorry, to make sure that the directives and the guidance around infection control, including isolation, including, you know, proper donning and doffing of PPE and access to PPE, all of that is followed. Ontario has done none of those things, none of them. Our question has been, how could nothing have improved since the first wave? What we're hearing from Extendicare's West End Villa is outrageous.

It's just what the litany of terrible conditions that the military documented in the homes that they went into. I mean, our question is this. I mean, our question is this. Why is there no now system-wide process when one or two or a very low bar, right, a low bar of people get infected in a long-term care than BC did. As of September 10th, 1,817 residents had died in Ontario homes compared to 156 in BC. And a few of the reasons that they noted were that BC had more funding for long-term care, it had a better staff-to-resident ratio, and that leaders took quicker and more decisive action. Does that line up with what you've seen? Absolutely. Six months ago, the BC government gave full-time work to PSWs and long-term care and increased their wages to stabilize the workforce. Six months ago. So how is it that we're in October now in Ontario and that has not happened here? We've had over the last week and a

half piecemeal announcements, some improvement in funding, still no minimum care standards, no big recruitment drive to get the staff in, no full time work. You know, all of the long standing issues that led to the very critical PSW shortage prior to COVID-19 still exist. And they're actually worse now because in April, April 22nd, the staff had to choose one home to work in, something that we all, I'm sure, completely support. But then they needed a top up to full time hours or some way to live while doing that. And that didn't happen. And so many have left the sector, many got sick, while doing that. And that didn't happen. And so many have left the sector, many got sick, many have families, you know, and can't continue to provide work in such dangerous circumstances. And so the staffing levels are worse than they've ever been.

Last week, Ontario announced close to $540 million in funding for long-term care, including for staffing and for upgrading facilities. But what's your response to that? I mean, how significant is that money right now, considering the kind of issues that you've been talking about, how dire the situation is? Well, it is a significant bump up, but the money just started to flow in September for June. And the July and August money has not flowed yet. So part of the problem is that the money is flowing very late, long after the announcements. And part of it is a question about whether the money is actually going to go to improving care. In Ontario's long-term care homes, a majority of the homes are for-profit homes. And that means that strings have to be attached

to ensure that the money goes to actually increasing the care, to providing full-time work for the existing PSWs and not just hiring in cheaper, completely not trained staff into the homes to replace PSW hours and so on and so forth. So those things have to happen. That means strings attached to the funding. And there is a question about whether it's enough to cover the homes with large outbreaks. I also saw that the Ontario government announced a $3 per hour pay increase for PSWs in long-term care. How much would that help potentially

in terms of addressing the staffing shortages and burnout that you've been talking about? Well, I think any amount is better than nothing. But the pandemic pay that they had up until the end of August was $4 an hour increase. So it's actually less than that. It's temporary. And if you were a PSW and you lost 20 hours a week of your work because you had to choose one of two part-time jobs, then $3 an hour comes nowhere near replacing those lost hours.

And what we're hearing is that in some of the homes, they're not topping up the PSW hours, they're hiring in completely untrained people who would be cheaper, less expensive for the home, rather than increasing the hours of the existing staff. So that's why we're saying, I mean, there needs to be strings attached. These are for-profit homes. They operate to pull profit out of the system. You know, they're agnostic generally as to whether or not the care that my mother or your mother gets is good. And through the entire pandemic, they've been paying out dividends to their shareholders, even while the staffing crisis has intensified and become just a river of grief and tragedy.

We've heard throughout this story, and so often in others like it, that staffing at these centres is so crucial for adequate care. But there's another important part that doesn't get a lot of attention. Many of the PSWs who stuck around are now facing a second wave, and they're burnt out. That's something we heard from a personal support worker in the Ottawa region. I know when this second outbreak happened, some staff who had stayed during the first one said, I can't do it again, and chose to go to their other jobs.

This is Susan Bourse. She works at another extended care facility called Laurier Manor. That is a huge issue, and it needs to be acknowledged by government, the amount of stress. And as much as they're trying to recruit new people in, they need to do something about the people that are still there because people are going to leave. People can't keep doing it again. Laurier Manor is also going through an outbreak right now. But unlike at West End Villa, this one is relatively mild. Susan thinks that's because they learned a lot from the first outbreak back in the spring

when 25 residents died. 38 staff members also got the virus, and many others left. It was nightmarish. I have never experienced anything like that again before. I never want to see it again. We learned a lot. I would say our facility learned a lot, everybody, from the first wave. But even if their infection control measures are way stronger now, Susan says that the staff who made it through the first outbreak are now experiencing serious PTSD from the second.

When we hit the second outbreak, it brought things back. People were having nightmares. People were having panic attacks. It was very stressful. People need to know how stressful it was on us. I had a meltdown, I'll be honest. I had a meltdown. It happened to be the floor that I work on so some of the staff that I work with had already tested positive so we were already short of staff. So yeah, I had a bit of a meltdown. I just felt like I can't do this again. June Morrison, the woman whose father died at Orchard Villa, is still planning to keep pushing

the Ontario government for change. For her, it's a way to honour her dad's legacy. I am his voice and I'll continue to be his voice so I can see change happen because I've got his DNA and heaven forbid if I end up with Alzheimer's, dementia and Parkinson's and I'm not married and I don't have children, oh my god, I could just, I would rather pick a date on the calendar where I take a blue pill and I say goodbye to the world or jump off a bridge. But I don't want to go into a long-term care home as they are today. In a statement, Extendicare told us that backlogs and COVID testing results in the Ottawa region have made it harder for them to identify who at West End Villa has the virus, therefore making it harder to separate the sick from the healthy or send staff home to isolate. They also said that prior to the outbreak, West End Villa was actually overstaffed,

but that that changed after more than 40 employees at the home contracted COVID-19. They say as of October 1st, West End Villa is fully staffed again. They also said that the staff work extremely hard to prevent dementia patients from wandering. We asked about the conditions in Perriette's room. They would not comment, citing privacy. We also got a statement from the Ontario Ministry of Long-Term Care. A spokesperson told us that the ministry is working to have a comprehensive staffing plan by the end of the year, and they've taken significant actions to increase flexibility and funding to shore up staffing supply in long-term care homes. The spokesperson also told us that the government

has and continues to take action to prepare for the impact of COVID-19. And in regards to the comparison with long-term care deaths in BC, the ministry noted that, quote, Ontario is three times the size of British Columbia, and general conditions of the spread of COVID-19 have been very different between the two provinces. That's all for today. I'm Josh Bloch. Thanks for listening to FrontBurner.

I'm Josh Bloch. Thanks for listening to FrontBurner.