{"id":12305,"date":"2020-05-10T16:07:01","date_gmt":"2020-05-10T20:07:01","guid":{"rendered":"https:\/\/www.ontariohealthcoalition.ca\/?p=12305"},"modified":"2020-05-16T16:15:13","modified_gmt":"2020-05-16T20:15:13","slug":"covid-19-why-are-dying-seniors-not-being-taken-to-hospital","status":"publish","type":"post","link":"https:\/\/www.ontariohealthcoalition.ca\/index.php\/covid-19-why-are-dying-seniors-not-being-taken-to-hospital\/","title":{"rendered":"COVID-19: Why are dying seniors not being taken to hospital?"},"content":{"rendered":"

(May 9, 2020)<\/p>\n

By:\u00a0Joanna Frketich, The Hamilton\u00a0<\/span>Spectator<\/span><\/p>\n

\"\u201cThe<\/p>\n

Questions are being raised by unions and advocacy groups about why Ontario seniors with COVID-19 <\/a><\/span>are not being sent to hospitals from long-term care and retirement homes struggling with outbreaks<\/a><\/span>.<\/p>\n

\u201cI have been really concerned about this,\u201d said Natalie Mehra, executive director of the Ontario Health Coalition. \u201cThe hospitals … are not in total crisis. The long-term care homes are in crisis, and a significant number of retirement homes.\u201d<\/p>\n

In Hamilton, one long-term care resident has died in hospital while five died in the homes. At Cardinal Retirement Residence on Herkimer Street, three residents died in hospital while five more died at the retirement home.<\/p>\n

\u201cIf I were in that situation in long-term care and frail, I would rather die at home rather than in a hospital,\u201d said Arthur Schafer, founding director of the Centre for Professional and Applied Ethics, at the University of Manitoba.<\/p>\n

He says most long-term care residents are age 80 or more, physically frail with underlying health conditions, and many are cognitively impaired.<\/p>\n

\u201cThey wouldn\u2019t be admitted even in normal times let alone in pandemic times,\u201d he said. \u201cThe decision not to send long-term care patients to a hospital for potential ICU admission would be understandable and reasonable.\u201d<\/p>\n

However, Schafer\u2019s assessment is based on the home being able to provide end-of-life care and other supports to keep the resident comfortable.<\/p>\n

\u201cThey\u2019re entitled to palliative care and if they will not receive good palliative care in their long-term care facilities, that is a medical scandal and an ethical scandal,\u201d he said.<\/p>\n

The capacity of Ontario\u2019s long-term care homes \u2014 particularly those with large outbreaks \u2014 to provide supportive care<\/a><\/span> is precisely what is raising alarm among the coalition, the Advocacy Centre for the Elderly and the Canadian Union of Public Employees (CUPE).<\/p>\n

\u201cWe agreed that we would be calling much more assertively for people to be transferred to hospital where they can be cared for safely,\u201d said Mehra. She points to a report the coalition did with Unifor in January <\/a><\/span>that found long-term care homes were at their breaking point before the pandemic.<\/p>\n

\u201cThere was total consensus that every home was working short staffed all the time \u2014 every shift, worse on the evening and weekends \u2014 and that was prior to COVID-19. Now it\u2019s indescribable.\u201d<\/p>\n

CUPE announced that it plans to launch a legal action next week on behalf of long-term care residents alleging discrimination on the basis of age.<\/p>\n

\u201cNot everybody has a do-not-resuscitate order and many of the people who do could be made more comfortable,\u201d said Michael Hurley, president of CUPE\u2019s Ontario Council of Hospital Unions. \u201cThere is lots of things that people could do for them in a hospital setting. From our perspective, people in long-term care are undervalued significantly and denied access to some of the quality care that the rest of the people enjoy.\u201d<\/p>\n

But the executive director of Dundurn Place Care Centre <\/a><\/span>on Mary Street, where two residents died in April, says keeping them at the home is about compassion and a dignified death.<\/p>\n

\u201cAlthough hospitals may have more equipment, LTC staff are family to the resident and have been there for that resident for weeks, months, or even years,\u201d said Danny Pereira. \u201cThis is the resident\u2019s home and many wish to live out their days here. By staying in the residence at the end of life, not only are they provided with comfort measures but are also surrounded by the loving care of the people that have been there for them all along.\u201d<\/p>\n

He says the home is \u201ccapable of providing comfort measures to ensure that the resident is free of pain and suffering\u201d despite having three infected staff as well as nine residents.<\/p>\n

\u201cThe dedication and compassion that I\u2019ve seen in recent weeks is invaluable,\u201d he said.<\/p>\n

Heritage Green Nursing Home<\/a><\/span>, where four residents died \u2014 including three at the home \u2014 and Cardinal did not respond to requests for comment. Some residents from the Cardinal outbreak were sent to hospitals when the home could no longer cope.<\/p>\n

The province says neither the Ministry of Long-Term Care nor the chief medical officer of health have directed homes to keep residents out of hospital.<\/p>\n

\u201cThe decision of whether to send residents who have COVID-19 to hospital is made on a case-by-case basis by a physician in consultation with the resident and their family,\u201d the minister\u2019s office said in a statement. \u201cIf residents who tested positive for COVID-19 require medical attention that the long-term care home is unable to provide, these residents are transferred to hospital to meet the health-care needs.\u201d<\/p>\n

The Advocacy Centre for the Elderly has questioned when advanced directives were signed, indicating that residents don\u2019t want to go to hospital<\/a><\/span>.<\/p>\n

\u201cWe\u2019ve heard of homes \u2014 and I don\u2019t know if there is any in your area \u2014 that the administrator has made a blanket policy that they are not sending people to hospital who has COVID and that\u2019s just illegal,\u201d said Jane Meadus, staff lawyer for the centre.<\/p>\n

She also said directives signed when a person entered a long-term care home \u2014 long before COVID-19 \u2014 are also not informed consent.<\/p>\n

\u201cIt\u2019s meaningless,\u201d she said. \u201cThey\u2019re out of context.\u201d<\/p>\n

At Dundurn Care Centre, Pereira said discussions happen more than once \u2014 on admission, annually and with a resident\u2019s status change.<\/p>\n

\u201cDecisions are fluid and not made in stone,\u201d he said. \u201cThey adapt to the resident\u2019s needs in consultation with family, palliative experts, doctors, nurses, nurse practitioners and the resident him\/herself if able.\u201d<\/p>\n

CUPE says it has been a long-standing issue that residents of senior\u2019s homes are not sent for hospital care.<\/p>\n

\u201cEven before COVID, there was a resistance to transferring long-term care residents who were acutely ill to hospital and that was linked to the lack of capacity in the acute-care system we believe,\u201d said Hurley. \u201cAnd now with COVID, you have to ask yourself how many of these residents in long-term care are being offered the opportunity to be cared for in hospital.\u201d<\/p>\n

Hamilton\u2019s hospitals, which currently have resources available because they have not seen the expected surge of patients, did set up a 24-7 line during COVID-19 that connects long-term care homes to doctors and other health-care providers to help keep residents in their home.<\/p>\n

\u201cSince the beginning of the pandemic, we have received long-term care and retirement home residents with COVID-19 into our hospitals and will continue to do so as needed,\u201d said Dr. Wes Stephen, chief operating officer at Hamilton Health Sciences. \u201cIn addition, LTC homes can now connect with ED physicians and other medical specialists 24-7 through virtual and telephone access, and we have started the process to deploy staff to LTC and retirement homes as the need arises in our community.\u201d<\/p>\n

Hamilton was back to having double-digit increases in cases for the first time in a number of days with 14 new confirmed cases Friday bringing the total to 483 plus five more probable.<\/p>\n

Ontario also saw a larger-than-normal increase of 477 infected to 19,598 confirmed cases.<\/p>\n

Click here for original article<\/a><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

(May 9, 2020) By:\u00a0Joanna Frketich, The Hamilton\u00a0Spectator Questions are being raised by unions and advocacy groups about why Ontario seniors with COVID-19 are not being sent to hospitals from long-term care and retirement homes struggling with outbreaks. \u201cI have been really concerned about this,\u201d said Natalie Mehra, executive director of the Ontario Health Coalition. \u201cThe […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21],"tags":[],"class_list":["post-12305","post","type-post","status-publish","format-standard","hentry","category-ohc-in-the-news"],"yoast_head":"\nCOVID-19: Why are dying seniors not being taken to hospital? - Ontario Health Coalition<\/title>\n<meta name=\"description\" content=\"(May 9, 2020) By:\u00a0Joanna Frketich, The Hamilton\u00a0Spectator Questions are being raised by unions and advocacy 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