Eileen Smyth pulled her 88-year-old mother out of her long-term care home on Tuesday.
Smyth’s mother Ethel Lodge was a resident of Roberta Place in Barrie. However, after seeing how COVID-19 has spread rampantly throughout long-term care and retirement residences across the province, the nurse has decided to take drastic measures to protect her mother.
The trouble is, after COVID-19 has moved on, getting her mother back into long-term care could be a challenge due to existing provincial guidelines.
“The sector that is getting hit the hardest is getting the least and that is absolutely crazy,” she said. “The government should help me out in bringing my mother home, not take away from us.”
According to provincial guidelines, once a resident is pulled out of long-term care, their bed is immediately flipped to the next person on the long-term care wait list, which, according to the province, sits at about a one to two-year wait for a bed. While some of the provincial guidelines have been relaxed as part of the province’s COVID-19 response, Smyth feels it isn’t enough.
“The government should be bending over backwards if people are prepared to take their loved one home, but that’s not what they’re doing,” said Smyth.
On Monday, chief public health officer Dr. Theresa Tam said the spread of the virus in care homes has been at the root of half of the more than 700 deaths across the country.
“The number of deaths will increase,” she said at a media briefing in Ottawa.
On Wednesday, Premier Doug Ford announced a COVID-19 action plan for long-term care homes which included “COVID-19 SWAT teams” from hospitals and health units to be deployed to long-term care facilities in order to manage outbreaks. As of Wednesday, Ford said about 114 COVID-19 outbreaks have been reported in Ontario long-term care homes to date.
Smyth’s mother suffers from dementia, and finally got a room at Roberta Place in January after her case was deemed ‘crisis.’ Prior to that, Smyth said her mother had been on the wait list for years.
“It was a long haul and lots of stress to get her in,” said Smyth. “They wouldn’t move her up the ladder until they absolutely had to.”
Smyth says the staff at Roberta Place have been wonderful both before and during the COVID-19 pandemic.
“We’ve been very happy, so to lose the bed is very upsetting,” she said. “The communication with Roberta Place has been excellent. I can call them at any given time and ask to speak to my mother, and I can. The home is great, and I will be very upset if I can’t have her return.”
Simcoe Muskoka District Health Unit Medical Officer of Health Dr. Charles Gardner said Wednesday the decision to pull someone from a long-term care home is complex.
“It’s a complex question because people have to look at their own circumstances,” said Gardner. “There’s potential to do a great deal of harm if you remove someone who needs intensive care and you can’t provide it. If you remove someone from a home, they can’t go back in until the pandemic is over. There’s potential for more spread.
“Undoubtedly, there is danger for residents in long-term care homes at this time. It’s a complicated decision that people have to make for themselves,” he added.
Some of the concerns Smyth has about pulling her mother out are that Lodge doesn’t have a doctor in Barrie; she relies on the doctors at Roberta Place for her care. She’s also nervous about bringing her mother home and subjecting herself and her husband to the spread of germs from the home.
“How can I get my mother tested (for COVID-19)? We’ll do the best we can, but we have no way of knowing if she’s safe. That’s a big concern, because we’re also at risk.”
Smyth herself has a lung condition, and her husband has had a bypass.
“We’re worried because of the close quarters we’ll be in, but we’re not willing to lose my mother the way it’s going through long-term care (homes),” said Smyth. “When I look at the news and see more and more homes being hit by this, and the staff is probably afraid to go to work, the frightening image of your loved one stuck in there would probably stay with you forever.”
Rules for pulling family members out of care are different depending on a variety of factors.
At retirement residences and homes across Ontario, residents must abide by rules under the Landlord and Tenant Act.
Jackie Payne, an administrator at Champlain Manor Retirement Residence in Orillia, sent out a letter to family members of residents last week addressing questions they’d been hearing about removing their loved ones.
“Since retirement residences fall under the Act, the residents are just renting a unit from us. All the same rules apply as if they were renting a regular apartment,” she said. “Under those rules, they can give 30 days notice to move out.”
Payne says there isn’t a wait list to get in to most retirement residences, so residents who choose to leave don’t have to worry there won’t be a spot waiting for them when they return.
“There’s no risk for them really, in that sense. Some might want their particular room so they might be a bit nervous, or they don’t want to hassle of moving all their stuff out and then back in,” said Payne.
Payne said Champlain Manor has had about six residents move out so far due to COVID-19 concerns.
Under new rules instituted this week, Payne said any resident with any symptom of illness that is out of the ordinary is tested automatically for COVID-19. Out of seven tests done at the Champlain Manor so far, Payne says they have all come back negative for COVID-19.
“It’s a good thing, because we are the high-risk group,” said Payne.
When it comes to long-term care, provincial rules apply as most long-term care beds are either partially or fully funded by the province.
On March 24, long-term care homes across the province received new directives from the Ministry of Health and Long-Term Care, which modified the rules around admission and discharges of residents of all long-term care homes in light of COVID-19.
The guidelines are the same regardless if a long-term care home is publicly or privately owned, for-profit or non-profit, as they all receive some form of provincial funding for their beds.
“If families have their loved one in any long-term care home right now and they decide they would rather have them at home, they can have them... discharged from the long-term care home and they won’t be penalized to have to start all over to get back in,” said Jane Sinclair, general manager of health and long-term care for the County of Simcoe.
According to the province, if a person is discharged for less than three months, they will automatically jump to the top of the queue to be readmitted to the next available bed in that home. If the person is discharged for more than three months, the resident will have to go through another assessment before being cleared to be re-admitted.
Re-admittance rules will also vary depending on if the home a resident is returning to has had a health unit-documented outbreak or not.
“As for residents who leave a home that does not have an outbreak, they will be prioritized for re-admission, but their room will not be held because it would be irresponsible to let long-term care capacity sit vacant at a time when it is in such great need,” said Gloria Yip, spokesperson for the Ministry of Long-Term Care.
“At this unprecedented time, it is absolutely necessary that we move hospitalized seniors who are on the wait list for long-term care into more appropriate care settings as soon as possible, both to limit their risk of exposure to COVID-19 and to free up much-needed hospital capacity,” said Yip.
Sinclair said COVID-19 testing has been ramped up at county-owned long-term care homes for both residents and staff, however she has heard of families wanting to remove their loved ones from care.
“I would like to express a lot of caution to families who are considering doing this,” she said. “Despite the fact we’re hearing about certainly tragic situations, I can assure you that we are putting every precaution in place to keep the residents safe in our long-term care homes.”
