Pinecrest Nursing Home in Bobcaygeon, Ont., is ground zero for a novel coronavirus outbreak where 22 residents have died and one-third of the staff members are isolating after coming into contact with COVID-19.
“They’re treating it like a hospice, like there’s no hope like they have stage four brain cancer and they just have to keep them comfortable because there’s nothing they can do,” says Tanya Bartley, whose grandmother passed away at the home at the end of March.
Edna Bowers lived with dementia and began exhibiting symptoms of the virus along with dozens of other residents who have been treated at the home and not transferred to hospital.
Global News has obtained documentation from health officials sent to long-term care homes saying seniors in nursing homes should be kept comfortable if they contract the virus and not taken to hospital as there’s little that can be done beyond comforting measures.
“They don’t play god. Everybody is the same. I don’t care if it’s a two-year-old, a 10-year-old, a 20-year-old, middle-aged, elderly. I don’t care,” added Bartley when she heard of the directive.
The letter, dated March 23, 2020, was written by Dr. Allan Bell, a medical director and chief of emergency medicine at Quinte Health Care (QHC) in Belleville, Ont., a region in eastern Ontario that services hospitals in Belleville, North Hastings, Trenton and Prince Edward County.
It outlines suggestions on how to prepare long-term care administrators for potential COVID-19 outbreaks in their respective homes. It reads in part:
“Having this conversation pre-emptively is very important. It gives families time to digest the information when they are not in a crisis situation and, should an outbreak happen, it is difficult to manage all of the conversations at once.”
The letter outlines why hospital visits are not recommended, citing a lack of medical treatment beyond supportive care and limited options for frail patients.
“Our critical care colleagues are of the strong opinion that ventilator treatment will not make a survival difference to patients who are frail and ventilator support is very unlikely to be offered,” and goes on to state “for those residents who go on to develop respiratory failure, care needs to focus on the provision of comfort to ease suffering at the end of life.”
Global News reached out to Ontario’s Health Minister Christine Elliott, who said she was unaware of the directives, adding that no one would ever be denied health care in an emergency room setting.
“If people are ill enough that they have to go to hospital of course they will be transported to hospital. If they’re showing symptoms of COVID-19, they’ve been diagnosed with it but they can be maintained in self-isolation within the home; we’ll do that too but no one is going to be denied health care if they need it.”
Elliott says no patient has been “blocked” from hospitals, adding: “If they need to be taken there they will be taken there.”
It’s unclear where the directive came from, as several complainants came forward to Global News with similar experiences.
One family in southwestern Ontario says their loved one was asked to sign a waiver agreeing to remain at the long-term care home she resides at in the event of an outbreak.
“I’d like to have that explained, I would like to have a clearer picture of what it would be and I never thought for a minute that they wouldn’t go to the hospital until this issue came up about the letter being given to each patient,” says Wendy O’Neil, whose mother was told she would be best cared for at the long-term care home she lives at.
“The issues in Bobcaygeon are very frightening and that’s a concern everywhere so I’ve been reading and researching about government-funded homes and homes that are private and finding out all I can because from a distance all we can do is make calls and send emails,” adds O’Neil.
Ontario’s top doctor is defending the Ministry of Health.
Dr. David Williams says there are many layers to consider when dealing with nursing home and patient complexities including end-of-life care.
“There’s been no directive not to transfer … there’s just been some heightened concern. If it’s from an outbreak facility in the hospital, they would have it treated accordingly and that’s what the emergency departments and other centres in the hospitals do because they’re getting new cases coming in through the emergency department anyways,” added Williams
“It’s business as usual in the long-term care facilities.”
Health officials say both staff and residents of long-term care homes are being screened twice daily and are running surveillance programs with more intense screening in an effort to curtail and limit the spread of the virus.
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