Front Burner - Military exposes disturbing conditions in Ontario's pandemic-struck nursing homes

Episode Date: May 27, 2020

Cockroaches, rotten food, improper feeding of patients. These are just a few of the disturbing details emerging from a military report into five long-term care facilities in Ontario that were hit hard by coronavirus outbreaks. Today on Front Burner, CBC News correspondent David Common, who has investigated long-term care facilities since before the pandemic hit, walks us through the report.

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. Hi, I'm Pia Chattopadhyay. Last month, Canadian soldiers arrived at five long-term care facilities in Ontario. They were sent to help facilities overwhelmed by COVID-19. And what they found was nothing short of horrific.

It's so disturbing when I read this. It was hard to get through. It was the worst report, most heart-wrenching report I have ever read in my entire life. I had obviously a range of emotions of anger, of sadness, of grief. Yesterday, details of the military's assessments of these homes were made public. Today, I'm talking to CBC News correspondent David Common. He's been investigating conditions at long-term care homes since well before the pandemic. We'll talk about what's in the report and what accountability there might be. And as you can probably imagine, some of the details you're

about to hear about may be disturbing. This is FrontBurner. David, hi. Hello. Okay, David, I want to go through the contents of this report with you, starting with some of the major quality of care concerns. Tell me about some of those concerns. So there's a whole series of them, and they go everywhere from use of personal protective equipment, to the level of staffing, to what people are doing with the residents who are in their care. So let me start there. Instances where staff, either poorly trained or not with enough time, aren't sitting people up to be able to eat or drink. And the result is that they might choke or aspirate. And there is at least one death that is suspicious that the military flags as a result of this in a Toronto area home.

The coroner's office is now investigating a resident's death at Orchard Villa. But the premier says there could be more. The results of these investigations will be shared with police to look into any possible criminal charges. Other instances where people who are confirmed positive, residents who are positive, are allowed to wander through the home. Obviously a huge transmission risk. And wouldn't you worry if you've been locked out of the home that your loved one is in,

finding out about that only through a military report. New staff not being trained, staff being burned out, many who haven't seen their family in weeks, even aggressive behavior in some instances by staff. And some of those examples of aggressiveness that you mentioned, David, that are in the report, examples include aggressiveness when changing incontinence product, not stopping or slowing when resident complained of pain, polling residents, aggressive transfers, degrading or inappropriate comments directed at residents, etc.

says the report. And David, what about the actual facilities? There was a disturbing lack of hygiene as well, wasn't there? Well, instances of cockroaches and flies going going around that was at one facility I was at today and talking to family members unfortunately family members who have lost their loved ones to COVID being particularly shocked about that. Something that's very disturbing to me I don't like that thought at all but the lack of cleanliness and hygiene we we knew to expect that we've been talking about that weeks ago. The stench of rotten food left outside of a resident's room.

All sorts of basic hygiene questions. Residents who have been left for hours in soiled incontinence products, adult diapers. It is a long, long list. It takes 15 pages for the military to explain all of this. And what about the supplies? Because this, as I understand it, extended to medical supplies and procedures like catheterization in terms of being unhygienic. Yeah, so think about this. You're bed-bound, and many people inside long-term care are limited in their mobility, and so they use a catheter to pee. term care are limited in their mobility and so they use a catheter to pee. That catheter drops on the floor. It's not sterile anymore and yet staff were using it again in at least one instance and those kinds of challenges around hygiene kept happening. CAF, the Canadian Forces, also found

nearly a dozen incidents of bleeding fungal infections. Just to, you know, these details are what really illustrate how bad things were inside of these homes, how horrific they are. And that really leads me to the most concerning element of all this. And this is the people who were in those homes to get care. What does this report say about the patients and how they were coping with the treatment and the conditions that they found themselves in? Well, I think the one thing that sticks with me is residents who sat crying for help for 30, 45, 120 minutes, crying for help. That strikes at the staffing challenges, the staffing shortages. And these are in facilities where it's got so bad they've called the military in.

And the military is now using effectively all of its medical personnel that they have available to go into homes in Ontario and Quebec. That's what it's taken to just try to save lives, and they're not saving all the lives. The one facility I was at today, 77 people have died inside of it. 77 people!

I truly believe, knowing my father as well as I do, that he actually suffered severe dehydration, which led to his death. And I think he suffered probably four to five days before he actually died. What does this report signify to you in this long road? That unfortunately my mother suffered before she passed on April the 20th. Get them out. Get them out as soon as you can. Get them out. You want to see the summer with them? Get them out. What more do you need? What more do you need for a loved one? Why would you leave them in there? And yes, they were in perhaps the final chapter of their life,

but was this death the way they should have gone? Was it premature? Was it awful? Was it necessary? These are the questions that family members who are standing outside the windows are asking. Yeah. One of the quotes that really stood out for me in this report was talking about what happened to patients who were, you know, sad or depressed, and they were given drugs. And the quote reads, it's heartbreaking to get a report about someone who's agitated and difficult and has been getting PRN narcotics or benzodiazepines to sedate them.

But when you talk to them, they just say they're scared and feel alone, like they're in jail. These are people who have lived, you know, long lives in a lot of cases. And to have their final days or their last days like this is heartbreaking. Well, it certainly is for people who have lost family members, and that number just keeps going up, up, up. And these are people who are saying goodbye. I spoke to one woman today who were saying goodbye over an iPad. She asked a nurse, by this point her dad had been transferred to a hospital, to hold his hand.

And she used a phone to say, that's my hand, Dad. I announced I was in the room, and I asked him to squeeze my hand, and he did. So that gave him a sense I was actually there because he had such a fear of death. And very upsetting for her to not be in that room with him. Jacqueline Mitchell joins us from Sudbury, Ontario. Her mom has Alzheimer's and lives in the Eatonville Care Centre in Etobicoke. We do have a camera in the room. We've seen the actions, lack of changing. My mother has not been moved from that bed since March the 9th, as far as I know. So when I hear the premier say it's unacceptable, I could have told him that, you know, like a month ago. Not

reading a report. It's gut-wrenching for me. Every day I can't hug my mother. It is 77 days since I've seen my mother. That is guttural. You know, David, you've been reporting on this for a couple of years now, and the conditions in LTCs were not good, as you exposed over the last couple of years in some cases, but things obviously got worse with coronavirus. It spread through these facilities like wildfire. That's why the military was sent there in the first place. what did the military find in terms of what was being done in these places to prevent the spread of covid like when they walked in what did they see well it's not just that the military found that not enough was doing being done it's that the things that were

being done in some cases actively promoted the spread of the virus. So that might be using PPE multiple times, moving from resident to resident using the same PPE, assuming that, well, two people who have tested positive, what's the point? Or not controlling those who were positive from wandering around the area where people who are not yet infected might exist. Well, that is a recipe for disaster. Generally speaking, when you are COVID positive in a long-term care home, the outlook is very, very poor. CBC News has linked three out of every four COVID-19 fatalities. That's nearly 5,000 lives to Canadian care homes.

And so everything needs to be done around infection control. Everything to try to stop it is key. And if you have staff be done around infection control. Everything to try to stop it is key. And if you have staff who don't know how to use it, if you have staff who are fearful about using it because of the cost that management is telling them that it's too costly, if you have staff who are wearing it multiple times, if you have staff who are going back out to a nursing station while wearing it and then contaminating it and going on and servicing someone else this is how infection spreads and it has spread like wildfire like don't just think that because people are old and frail

that's why they're getting this virus they're getting it because it's a congregate living setting that there's a lot of people living in one place, often multiple people to a room, and the staff are the ones who are bringing the virus from one place to another, for whatever reason. And so what do we know about the conditions in these five facilities as of today, as in the right now? We know that the military, after weeks inside, is saying at two of the five facilities, conditions are improving, have improved substantially. Just think about that, you know, a large military task force with high degree of expertise, bringing in all the equipment they can get their hands on, the backing of the federal government, and they've only got two out of the five homes that they're able to go into in Ontario kind of under control.

You know, David, I think in a lot of people's minds, these institutions are these kind of faceless, quasi-medical entities. But who are they actually run by? Who is actually in charge at these facilities like the ones detailed in this report? We don't think about long-term care until we actually have to put someone in it. We ignore it completely until that point. That's simply the way things have gone in Canada for a very long time. And so we don't know how long-term care works. We don't know how difficult it is to get in. We don't know that many of the facilities are run by for-profit companies. And if they don't own and run them, then they are running them perhaps on behalf of a not-for-profit entity. And there are people now

questioning whether it's right for the most vulnerable in our society to be taken care of in that sense. Joining me tonight is Pat Armstrong. Pat is one of Canada's foremost thinkers on long-term care. Which homes do better, for-profit or government-run? Well, we just finished a study earlier this year for the city of Toronto, and those city homes, they have a lot more care in the sense that they have more people providing care, significantly more. Your profit has to come from somewhere.

So health care falls under provincial jurisdiction. And today, Ontario's Premier Doug Ford held quite a lengthy press conference to respond to this report. Quite emotional. You know, I think it's appalling. I think it's disgusting what has happened. Not being cleaned. These are just standard operating procedures. Kind of in a nutshell, if you can, David,

remind us what the Premier said. So the Premier calls it shocking. Shocking to be able to see something like this happening in Canada. He says there will be accountability. There'll be justice for these residents and their families he says this is something that's decades in the making no I inherited this system the buck stops with me I take full ownership but my job is to fix a broken system that's been broken for decades and Doug Ford is absolutely right when he says that, that this is decades in the making in the sense of underfunding.

Most of the facilities that we have in Ontario only meet a 1972 building standard. What that practically means is a lot of people are housed in rooms with multiple residents. That makes infection control rather hard. We know that long-term care has been in deep, deep trouble, that it's effectively been on the edge of the cliff for years, and it took just a kind of little breeze to push it over. COVID was huge. But David, is it fair to say that this government that is currently in place in Ontario is blameless? Andrea Horvath, she's the leader of the official opposition NDP in Ontario.

It rings a little hollow when the premier was telling us weeks and weeks and weeks ago that they had everything under control. And true, it's been happening for many, many decades. But this is a government that in its first budget cut $34 million from long-term care. Because we know, for example, that just last year, Ontario scaled back their comprehensive annual inspections of nursing homes. You reported this, that only nine out of 626 long-term care facilities in Ontario received such an inspection in 2019. This was under Premier Doug Ford's stewardship. Yep, they made a choice and that was to end these proactive unannounced inspections where inspectors would just suddenly show up,

you didn't know when they were coming, and they would do a detailed inspection of a long-term care facility. Instead, they've gone to a risk-based one. In other words, when something goes wrong, then the inspectors will come, and that things go wrong often enough in Ontario's 600-plus care homes that it means the inspectors are actually in there annually. It's just that the staff and the management tend to know the inspectors are coming because something's gone wrong. It will trigger an inspection. That was this government's decision, but other governments have actually done the same thing. Previous Ontario governments have gone back and forth about what to do, how to do it,

and they have, almost regardless of political stripe, repeatedly heard warnings inside the long-term care system. And I would point out, Pia, that there actually has been a public inquiry. The one that came about after Elizabeth Wettla point out, Pia, that there actually has been a public inquiry. The one that came about after Elizabeth Wettlaufer, a nurse, killed a number of residents inside long-term care. It flagged a lot of issues. The report was released. It makes 91 recommendations saying the long-term care system in that province is strained. It calls for more staffing in care

homes and more investigations into the deaths of residents. We cannot continue to do the same things in the same ways in the long-term care system. They're the same issues being flagged by the military now. The blueprint for what's broken in Ontario has been written before. Jane Philpott is the former federal health minister for the Liberals. We've got to stop focusing on who we're going to blame and say, we all had a part in this. I mean, we all elected the governments that are leading us. We didn't feel responsible for making sure that it had the same quality of care that we would expect in a hospital. And one of the solutions that people speak of is setting national standards. 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. Well, we are talking about just five homes in this report that came out today. But early in this crisis, you know, and you say, you know, in Ontario, but earlier in this crisis, we heard of a similar sounding situation at Heron Residence in Quebec. And of course, we know the vast majority of coronavirus deaths in our country have been in long-term care facilities, no matter the jurisdiction. So how representative do you think it is, David, that these horror stories that we learned of today are only in Ontario, only at these five homes?

Or are they also, do you think, at other long-term care facilities? I think they're almost certainly at other long-term care facilities because previous inspection reports have documented some of these very same things happening in care homes across Ontario, and we've heard accounts of them from care homes across Canada. This is a national problem, and the federal government has suggested perhaps it needs to come with some sort of national solution. We need to take action as a country. The federal government will be there to support provinces

in their jurisdictions on dealing with this as we move forward. Not to say that there aren't good homes. There are many of them that are well run, where people feel very good about being there. Families are comfortable with their loved ones there. Even in some of the homes that are experiencing deep problems, there are some very good overworked staff. I'll admit there was good people that cared about him and cared about others. But then there's another element. Mom's primary PSW was a wonderful woman. She did her best, but they're understaffed. But there's also a recognition that as a sector, as a whole, long-term care has been in trouble for quite a while.

This is not entirely new, as you just said. It's been ongoing. And coronavirus has just really amplified and exposed existing problems in the long-term care model. And I'd argue made more people, you know, give a damn about them. The premier was asked today if he would consider having the government take over long-term care. And he said, look, everything's on the table. I'm not ruling anything out. I'll do whatever it takes.

If that's what it takes, that's what we will do. Is that the solution? Well, you have to think about what taking over a care home would mean. It's a repudiation of the way in which management has handled things. And how do you then go back to that same management company? How would you hand it back over? Many of these companies are very politically connected. They have lobbyists, many of whom have connections to the existing provincial government in Ontario, the federal

government in Ottawa. There's a deep well of political connection between long-term care and governments. Is it likely that they're going to take them over? I don't know. If they haven't done it now, then what would it take for it to actually happen? David, you know, your mother and my parents are at the age, ages that many of the people in these long-term care facilities are. There's so many concerned children and spouses and grandchildren who either have their loved ones in these facilities or think about maybe one day they might have to or might want to. What would you say to them?

Well, the way things are right now, I certainly hope I never end up in long-term care if things don't change it's too awful in too many places and um i have seen that through hidden camera investigations we've done inside i've heard that from people who have lost loved ones under really awful, horrifying circumstances that shouldn't have happened. And I talked to those who really watch the long-term care sector, various organizations. We are past the point that it's no longer sustainable. The big question is, have we learned here? Do we care enough? And the nuts and bolts of this are pretty awful when you boil it down.

Do we care about old people? Do they deserve to live? I mean, they're uncomfortable questions, but they're the ones that we are answering with our actions every single day. David, thank you. And thank you for your extensive reporting on this the last number of years. It's appreciated by so many.

Thank you, Pam. Before we go, I want to let you know that late in the evening yesterday, many of the homes at the center of this report began to issue statements. They all echoed the same themes, that they are saddened by the loss, and that COVID-19 drastically reduced their workforce, either through infection or fear of it. Also, that they asked their partners and others for help. Some came, they say, but not enough. They say they are committed to taking the concerns raised in the report seriously

and to take necessary action. Also, a spokesperson for the Federal Minister of Public Safety said there will be a second report coming, one focused on what the military observed in long-term care homes in Quebec. That's all for today. Thanks for listening. Talk to you again tomorrow.