‘Could we please just get them some help’ Toronto care home residents suffer as staffing levels plummet
When Jane Bayly heard the news that a hospital "SWAT team" was volunteering in a Toronto long-term care residence this weekend, she called her parent's Etobicoke nursing home, where more than 100 residents have tested positive for COVID-19, to get an update on reinforcements.
Excited by Premier Doug Ford's announcement last Wednesday that homes struggling with sick or missing workers would get help from hospitals, Bayly expected fresh workers to arrive at Eatonville Care Centre, where her parents, Peter and Micky Green, share a room in the dementia unit. Married for 58 years, they have a "deep connection," and her frail father watches over his wife, who has cognitive decline. Both have COVID-19, but have mild symptoms.
"I was so happy" the home would finally have the help they needed, Bayly said. Instead, she was told Eatonville was struggling to replace its personal support workers, despite a boost from additional new nurses and public health staff. Shortages of front-line workers have reached crisis levels across Ontario, as infected staff stay home or stay away, afraid to work in an outbreak.
"The workers in Eatonville are so lovely, and they are always so kind to my parents. But they need help," Bayly said.
"The personal support workers who are left are worked off their feet. They are exhausted. Could we please just get them some help? They don't have enough time to properly care for my parents and the other residents."
Eatonville said Monday it has 138 confirmed COVID-19 cases with 33 confirmed deaths. Nearly 250 residents live at Eatonville, according to government inspection reports.
Eatonville's executive director, Evelyn MacDonald, said in an email, "In the last few days we have had some extra help" from Trillium Health Partners and the Toronto Central Local Health Integration Network, along with help from geriatricians, extra training on the use of personal protection equipment and "significant support" in the testing of staff. MacDonald said the home has been in touch with provincial officials for help filling staffing gaps.
"The recent attention on our home has, however, made it a challenge to recruit and retain much needed staff," MacDonald said. "The remaining staff have been doing a fantastic job at covering off vacancies, but this will be a challenge to sustain.
"We also have a number of new staff joining us throughout the week including a Registered Practical Nurse, a housekeeper and additional laundry staff," she added.
On Saturday, the University Health Network (UHN) started sending medical staff, including physicians who specialize in psychiatry, kidney transplants and women's cancers, to volunteer as personal support workers at Rekai Centre's Sherbourne Place. UHN volunteers will also work as front-line staff in Rekai's second downtown location, Wellesley Central Place. Both homes have been struggling to find workers after suffering from COVID outbreaks.
A spokesperson for the Ministry of Long-Term Care said five Toronto hospitals, Michael Garron Hospital, Women's College, North York General and Unity Health Toronto, along with Mount Sinai Hospital under the UHN umbrella will "begin to support" 38 long-term care homes in the city. Some hospitals outside Toronto are either helping or assessing the needs of nursing homes, the spokesperson said.
During his daily news conference Monday, Premier Doug Ford was asked whether he is considering calling in the Canadian military to do front-line work in nursing homes. "As of today, no," Ford said, saying that decision could change. "I wouldn't take it off the table."
Angie Hamilton, a retired tax and estate lawyer, wants the military or hospital volunteers to help at her mother's private Toronto retirement home, Bradgate Arms Retirement Residence.
Her mother, June Hamilton, has dementia, and until the pandemic hit, she had 24-hour-a day support from four private-caregivers. Her 99th birthday is in June. She spends her days in bed and until now was turned every four hours by her caregivers to make sure she did not develop pressure ulcers. After her workers started testing positive for COVID, June began spending nights alone for the first time in years, Hamilton said. Her family could not find new workers, and then a family friend, a nurse, agreed to help. But she cannot be there 24 hours a day.
Bradgate Arms, owned by Revera, is on lockdown with seven residents and four Bradgate staff (not including privately hired workers) testing positive for COVID-19, according to an email sent from Bradgate to families. The home said it is working with Toronto Public Health to test every resident and worker.
Revera spokesperson Larry Roberts said Bradgate Arms has had "some issues with private caregivers," hired by families. Many of those caregivers left after either becoming ill or are too afraid to come to work. Bradgate has "stepped in to ensure the basic care needs of the residents are met," Roberts said in an email. He said the home has contracted with a care company to provide 24-hour PSW supports to "backfill expected shortages" from third-party care companies and has "expedited" its recruiting and hiring of new staff.
Hamilton devised a way to watch over her mom, keeping the landline in June's small suite open and on speakerphone, so she can listen. The landline is linked to her husband's cellphone. With dementia, her mother is sometimes confused, and other times lives in the past, like the days when she was marshalling children into class, as a young teacher. "She speaks in full sentences and lives in a wonderful world where everyone she loved is still alive and with her," Hamilton said.
After her final caregiver was diagnosed and left on the weekend, Hamilton said her mother has been crying overnight, calling for her "Mama." Sometimes she cries for her father. Hamilton said she now stays awake all night, to talk to her mother over the speakerphone when she is scared. Hamilton said she tries to calm her by talking about the days when she'd come home after high school and they had tea together.
"Several times now she has told me that I am her favourite child," Hamilton said, laughing.
On a recent night, Hamilton heard her mother saying, "I can't breathe, I can't breathe." She called Bradgate's nurse, who came to help.
Hamilton and her family are now trying to find enough workers to help her mother peacefully, and painlessly, work through the virus, even if she is in palliative care.
"This is the plight that is playing out in so many, many long-term care and retirement homes. It is unconscionable to me that we would not call in the Armed Forces for help."
Michael Hurley, president of the Canadian Union of Public Employees Ontario Council of Hospital Unions, said he admires the "courage and altruism of people going into the homes as volunteers, during an outbreak" but questions why so many older people are left in nursing homes instead of getting care in hospitals.
"Is it not better to remove them and place them in a facility, with all a hospital's resources, that can provide comfort and hopefully in some cases, provide a recovery from COVID?" Hurley asked.
"Do you not think it is odd, that this demographic is not being sent to hospital for treatment?" Hurley said.
"I know of people who are 85 who have told their family doctor, 'I'm not done living, I'm enjoying life. Don't write me off.'"
Moira Welsh is a Toronto-based investigative reporter. Follow her on Twitter: @moirawelsh