For families questioning how their loved ones perished in the pandemic, provincial medical experts offer few answers – and critics say that hampers efforts to hold providers accountable
At her home in Vaughan, Ont., Alessandra Lamanna-La Marca holds a picture of her mother, who died at Hawthorne Place Care Centre in northern Toronto in May of 2020.The last time Alessandra Lamanna-La Marca saw her mother was during a four-minute video call.
COVID-19 has laid bare weaknesses in how deaths are reviewed in nursing homes, also known as long-term care homes. Canada had the worst record for COVID-19 fatalities in these homes among other wealthy countries during the first wave of the pandemic. Medical experts say the pandemic has underscored the need for a more robust system for investigating nursing home deaths. “Time is of the essence,” said Nav Persaud, a family physician and former investigating coroner in Toronto. “Investigating these deaths as they were happening ought to have been a priority.”Families of Orchard Villa residents in Pickering, Ont., hold a candlelight vigil last summer for Elder Awarness Day.
Ontario used to probe every 10th death in nursing homes automatically. A coroner would visit the home where the death had occurred, review medical records, interview family members and staff and possibly examine the body.While no research or statistical analysis was done regarding the efficacy of the automatic probes, anecdotal evidence suggested they did not significantly enhance public safety, Ontario Chief Coroner Dirk Huyerin 2018.
The enhanced oversight protocols were short-lived, however, leaving Ontario out of step with other provinces. In the fall of 2018, just months after Premier Doug Ford entered office, the ministry all but eliminated wide-ranging inspections. Instead, it began to focus on responding to critical incidents and complaints. Only nine of the province’s 627 nursing homes received RQIs in all of 2019, said Jane Meadus, a lawyer at the Advocacy Centre for the Elderly in Toronto.
Ontario went into the pandemic with an oversight regime that left it up to operators of nursing homes to flag any deaths that required investigating. As the virus spread, family members struggled against a system not necessarily interested in working for them, said Samir Sinha, director of geriatrics at the University Health Network and Sinai Health System, and chair of a committee that is developing new national long-term care services standards.
The Canadian Armed Forces provided the first set of outside eyes on what was happening inside Ontario’s and Quebec’s long-term care sectors, after the federal government deployed the military to several nursing homes.released in May of 2020, the military chronicled horrific conditions in five homes in Ontario, ranging from poor infection-control practices to abuse of residents.
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