May Mikhail remembers the moment when she realized that her 94-year-old mom Isabelle probably wouldn鈥檛 survive the COVID-19 outbreak in North Vancouver鈥檚 Lynn Valley Care Centre.
It was the day after families had been summoned to a meeting and assured their loved ones would be isolated in their rooms and looked after.
Mikhail鈥檚 first concern had been whether there was enough staff to help feed residents in their rooms. Families were reassured that extra staff would be coming in.
Mikhail and her partner Althea Gibb-Carsley got Isabelle settled in her room that day and fed her dinner. Then they went home.
They returned to check on Mikhail鈥檚 mom about 24 hours later.
The scene that greeted them was shocking.
Isabelle was in the same position as when they鈥檇 left her. Her unchanged diaper was bulging. 鈥淪he was cold, shivering and she was disoriented,鈥� said Gibb-Carsley. Untouched breakfast and lunch trays were piled up.
Mikhail says her mom never truly recovered from that.
鈥淪he was frail. She had just turned 94,鈥� said Mikhail. 鈥淎nd so we knew that she probably would not be able to recover from COVID. And people were dying every day.鈥�
On March 18, Isabelle Mikhail became the eighth resident of Lynn Valley Care Centre 鈥� and in Canada 鈥� to die of COVID-19.
In early March, the Lynn Valley Care Centre was the first care home in the country to become an epicentre of the virus. Before the outbreak was declared over two months later, 53 elderly residents and 26 staff contracted the virus and 20 residents died.
Over 129 deaths 鈥� or 69 per cent of all COVID-19 deaths 鈥� since the beginning of the pandemic in 小蓝视频 have been among people over 80 years old, according to 小蓝视频鈥檚 Centre for Disease Control. Deaths in care homes have made up 72 per cent of the total.
A group of daughters whose parents all contracted COVID-19 in the Lynn Valley Care Centre outbreak are now speaking up, describing their experiences in a care home system that was ill-prepared to handle the added stresses of the virus in an environment of chronic understaffing.
The women said in light of the deficiencies that COVID-19 revealed in the long-term care system, both provincial and federal governments need to take a serious look at the way long-term care is funded and supported. So does the public, they say.
On March 7, families had arrived to the meeting to find medical health officers from Vancouver Coastal Health along with the director of care for the Lynn Valley Care Centre present. A number of care centre staff were also there, lined up against a wall. They looked frightened, said the women.
Kelly Shellard, whose 82-year-old father Bill Shellard has dementia and lives in the care centre, went to the meeting. Afterwards she went back to her Lynn Valley home and stewed. She stayed home for a few hours, then decided she had to go back to the care home to check on her dad.
There were no extra staff, as promised. In fact, many of the staff who were scheduled to work that day hadn鈥檛 shown up for their shifts.
鈥淭hat was the first day that we ended up having to hand out food to the residents because there were so few people that showed up to work,鈥� said Shellard.
鈥淲e realized on Sunday that the help was not there,鈥� said Gibb-Carsley. 鈥淎nd there was not much time to think about whether we would or would not participate, because we were thrust into this situation.鈥�
Family members said rather than extra cleaning they might have expected, there was little evidence of even regular cleaning for the first week of the outbreak. 鈥淪o instead of enhanced cleaning it was reduced cleaning. Because the [cleaning staff] didn鈥檛 come in,鈥� said Gibb-Carsley.
Shellard said she went to one man鈥檚 room to help 鈥渁nd he had peed all over the floor. And it was there the next day because there was no cleaning. It wasn鈥檛 until a week later that they actually brought in a cleaning company to come every night and fully clean the place.鈥�
Debra Drew, whose 96-year-old dad Graham Drew lives in the care centre, said some staff who turned up were clearly uncomfortable being in the care home at the time of the outbreak. 鈥淥thers couldn鈥檛 leave after their shifts because there was nobody to replace them. 鈥� People were working 16-hour shifts.鈥�
鈥淎ll the while we鈥檙e hearing [Health Minister] Adrian Dix say everything鈥檚 been taken care of,鈥� said Drew. 鈥淔or us, what we were seeing did not jive with the official report.鈥�
In response to issues raised by the families, both Vancouver Coastal Health and Lynn Valley Care Centre issued statements.
鈥淟ike other care facilities, the COVID-19 pandemic ravaged our facility, spreading at an alarming rate, which added to our challenges of getting ahead of the outbreak,鈥� according to the statement from the care centre. 鈥淧rofessional replacement staff was brought in as soon as possible, following a short time when we had some staff shortages.鈥�
According to Vancouver Coastal Health, in the early days of the outbreak, the Lynn Valley Care Centre 鈥渆xperienced staffing shortages because some staff were sick, and others, afraid of becoming infected, did not come to work.鈥�
A rapid response team to deal with infection control was put in place and 鈥渆xtraordinary measures were put in place to restore and maintain staffing levels,鈥� according to the statement.
Putting their parents in care had not been easy for any of the families.
Shellard and her son lived with her dad for almost four years until Bill鈥檚 health deteriorated and his dementia worsened. When her dad was found wandering down the street in the middle of the night, Shellard said it was clear she could no longer manage his care.
Mikhail鈥檚 mom had moved out from Alberta 15 years ago and bought a condo close to her. She had 10 good years before being diagnosed with Alzheimer鈥檚. 鈥淪he wasn鈥檛 managing her medications very well. So I had to take that over,鈥� said Mikhail. Medical staff eventually suggested Isabelle needed to move into care.
But at the care home, staff were often stretched, especially during the night shift.
鈥淒ad would fall and nobody would find him,鈥� said Deanna Harlow, Debra Drew鈥檚 sister. Often they didn鈥檛 know how long it took until somebody noticed.
鈥淗e couldn鈥檛 get up himself and he doesn鈥檛 know to push the call button or maybe the call button was too far away.鈥�
Staff never had enough time 鈥� to help with brushing teeth or even simple tasks like turning on a TV.
Gibb-Carsley said she saw care aides wheel residents from one room to the next without even telling them what was happening.
鈥淵ou don鈥檛 just move someone,鈥� she said. 鈥淏ut you do if you鈥檙e in a hurry.鈥�
Baths or showers for residents were infrequent and minimal, say the women. Shellard said her dad went three months without a shower.
There was little time for conversation.
鈥淲e are not saying that these are bad people. They are people who try really hard to do their best,鈥� said Shellard. 鈥淚t鈥檚 a really hard job.鈥�
It鈥檚 an impossible job when there aren鈥檛 enough people to do it, she said.
When COVID-19 hit the care centre in March the same caregivers 鈥� already stretched to their limits 鈥� had to deal with residents who were now sick and dying in some cases. 鈥淭here鈥檚 another skill set that needs to come into play but it just wasn鈥檛 there,鈥� said Mikhail.
The women acknowledge not all families with parents at the care home had the same experience. Some only wanted information from official sources. Some seemed angry and uncomfortable at the questions they raised.
鈥淢y own thinking is that if you have a loved one in there ... you have to do certain things psychologically, to make peace with that,鈥� said Gibb-Carsley. 鈥淎nd one of those things is minimizing the difficult information.鈥�
鈥淎 lot of people don鈥檛 want to know the truth about elder care in this country,鈥� she said. 鈥淚t鈥檚 a very difficult truth. It鈥檚 very inconvenient. And that plays a role in what we have done for years in this country with regards to elder care.鈥�
Gibb-Carsley said in her opinion, while the long-term care residents who died of COVID-19 were medically vulnerable, they were made more so 鈥渂y the level of care that鈥檚 inadequate鈥� in care homes.
鈥淲hen my mom was dying, there was one [licensed practical nurse] on for 92 patients, running up and down the stairs because ... the elevator wasn鈥檛 operational,鈥� said Mikhail.
Although Isabelle was supposed to have a minced diet, at the end of her life 鈥渙ften sandwiches would show up or things that she was not able to chew or swallow,鈥� said Mikhail.
鈥淭hey were getting lunches in a bag and muffins in plastic wrap that 90 per cent of the people there couldn鈥檛 open.鈥�
Mikhail and Gibb-Carsley cared for Isabelle for 10 days until she died.
She didn鈥檛 have COVID-19 symptoms until the very end, they said, when they would frequently have to seek out nurses for pain medication.
鈥淗ad we not been there she would have died really struggling,鈥� said Gibb-Carsley.
The parents of all the women who spoke to the North Shore News for this story contracted COVID-19 at the care centre. All except Isabelle survived.
At various points when their parents were not expected to survive, family members were allowed in to the care centre to see them.
Kathie Lloyd said in the case of her 82-year-old mom Donna, she鈥檚 convinced family help probably made the difference to her mom鈥檚 survival.
One of the concerns about the recent lockdown on family visits to care centres is that it has meant there have been no independent observers in the nursing homes, say the women.
鈥淭here are no neutral parties that are checking to make sure how things are going,鈥� said Gibb-Carsley.
Several weeks after her mom died, Mikhail was told she could come and get Isabelle鈥檚 possessions. Staff came down with a trolley with some of her mother鈥檚 things, she said, but many items were missing, including family photos that had been on a bulletin board in her room and all her mother鈥檚 clothes.
A caregiver told her she had thrown Isabelle鈥檚 clothes in the trash.
Mikhail later received an apology letter. 鈥淚t felt pretty flat,鈥� she said.
The women say their experience with COVID-19 revealed fault lines in the care of the elderly that need to be addressed.
鈥淚t鈥檚 not going to go away,鈥� said Drew, who adds she questions why for-profit care homes are allowed and is aghast that 小蓝视频 Premier John Horgan doesn鈥檛 see the need for a public inquiry.
Harlow said she wants to see elder care added to the Canada Health Act to ensure national standards. She鈥檇 also like to see an examination of care for the elderly in other parts of the world.
Not all nursing homes are the same, said Gibb-Carsley, 鈥渂ut the problem is the standards and the expectations across the board are very low.鈥� The system tolerates that, she said, 鈥渂ecause there aren鈥檛 enough resources to go around.鈥�
Drew hopes what the pandemic revealed about elder care will be a catalyst for change. 鈥淚t鈥檚 such a fragile system. And so how do we fix it?鈥�
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