British Columbia·Go Public

Restrained and medicated senior spends months 'warehoused' in hospital

The family of an 86-year-old says that after living successfully in a home for seniors with similar physical and psychological problems for years, she was 'kicked out' and then 'warehoused' in a B.C. hospital for months, often restrained and medicated.

Mentally ill patients 76% more likely to be restrained in a general ward vs. psychiatric hospital, study finds

Elizabeth Rinke, left, in better times, before she was admitted to a long-term care facility for her mental health issues six years ago. Rinke spent seven months 'warehoused' in hospital after a mental health episode, during which time she lost her spot in a long-term care facility. (Ralph Rinke)

The son of an 86-year-old B.C. woman says his mom spent months "warehoused" in hospital, moved to five different units, and was restrained so often that her mental and physical illness worsened.

"People go there to get better and leave. It shouldn't be her place to live. She has nothing there, no clothing or anything, just shoes and a sweater," Norm Rinke told Go Public about this mother Elizabeth Rinke.

"She has a gown and that's how she lives."

Elizabeth Rinke has a history of mental health problems and suffers from schizoaffective disorder: a condition in which a person can experience hallucinations, delusions, mania or depression.

After living successfully in a home for seniors with similar issues for years, her family says she was "kicked out" and then "warehoused" in a hospital general ward, often chemically and physically restrained in her bed.

'Mental health episode' turns senior's life upside down

Last March, Rinke had what her son calls a "mental health episode" and became agitated during a dinner out. She ended up in hospital.

"She'd been there before with episodes in the past. We figured she'd be assessed, maybe some medication changed, then she'd be fine to go back to the care facility. This is what we were led to believe," Norm Rinke said.

Elizabeth Rinke's hands show bruises her family says came after she was chemically and physically restrained by hospital staff. Fraser Health officials say bruising can occur when seniors are injected and that their policy is to only use restraints as a last resort. (Ralph Rinke)

Two weeks after being admitted to hospital, Rinke says doctors signed off on his mother's release back to the home.

That's when he discovered she had nowhere to go.

The home she came from wouldn't take her back.

"We get a call from the care home saying they closed her bed, basically kicked her out, and she's been warehoused in the hospital since," Rinke told Go Public.

Hours spent restrained and drugged, says family

Elizabeth Rinke spent the next seven months being moved around to different departments within Surrey Memorial Hospital in B.C.

Norm Rinke says her mental and physical condition deteriorated the longer she stayed. He says staff in the medical ward didn't know how to handle her psychological issues.

"Because of her paranoia, she's more comfortable seeing regular staff and a regular routine. She's been moved to five different rooms and three different buildings in the hospital, so it just agitated her even more," Norm Rinke said.

As a result, Elizabeth Rinke was chemically and physically restrained.

Norm Rinke spent months trying to get answers about his mother's care. (CBC)

Officials with the Fraser Health Authority, which runs Surrey Memorial, told Go Public Elizabeth Rinke was cared for in a unit with "staff that are trained to deal with some of the issues that older adults and seniors are facing." 

Adding, when it comes to using restraints, each patient's situation is looked at individually by a team that includes a psychiatrist.

A spokesperson told CBC News that Fraser Health is a "least restraint organization" where that kind of intervention is used only as a last resort.

A study on restraint use by Canadian Institute for Health Information found patients admitted to a general hospital for mental illness were 76 per cent more likely to be restrained than those in a psychiatric hospital.​

No one in charge

Norm Rinke says he couldn't get answers from hospital officials and no one seemed to be in charge of finding an appropriate place for his mother.

"We don't know the system, so we try and work with the system but there is no communication. You feel like you're getting the run around," he said.

At one point, he says hospital officials told him his mom was on wait-lists for five different places.

Over her seven-month stay, Elizabeth Rinke was moved between five areas and three different buildings within Surrey Memorial Hospital. (Ralph Rinke)

Patient's 'complex needs' delayed move, hospital says

According to Norm Rinke, it was only after Go Public contacted Fraser Health that the hospital said anything about moving his mother out of hospital.

The health authority told Go Public it was waiting until Elizabeth Rinke's condition stabilized before moving her.

After a seven-month stay in Surrey Memorial hospital, Elizabeth Rinke was moved to a new residential care facility on Nov. 2. (Ralph RInke)

In a written statement to Go Public, health officials said, "We understand how hard this must be for the patient and their family. No one wants to see their family member in the hospital longer than necessary," a spokesperson for Fraser Health wrote.

"This patient came to our hospital with a medical condition that required treatment. While treating this condition, her complex care needs prevented her from being transferred back to the original facility where she lived. These needs were such that they also delayed the assessment process for the specialized support she needed in the community."

"For patients that are in hospital and awaiting placement, we need to first stabilize their medical and mental health needs to the greatest degree possible, to ensure that the right supports in the community are identified and result in a successful transition."

In the end, Elizabeth Rinke was moved before she stabilized. Two weeks ago, health officials moved her to a facility with "stabilization units" for seniors like her, and which her family says is much better suited to her care.

'Warehoused' seniors impact entire health system

Elizabeth Rinke's extended stay in a hospital was not unique, according to Debra Walko, the Director of Seniors Services for LOFT Community Services in Toronto.

After 7 months in hospital, Elizabeth Rinke was moved to a residential care facility for mental health patients. (Ralph Rinke)

Walko says situations like this one are happening across the country. "Research shows, especially for seniors, if they remain in the hospital longer than what their acute needs are, their health, their fragility, and all kinds of things will get worse the longer they remain in hospital," said Walko, whose organization works to find suitable support and housing for seniors with mental health issues.

She says staff in general hospital wards will resort to restraining mentally ill patients to keep everybody safe, including the patient.

However, Walko says the more those kinds of interventions are used without treating the behaviour issues associated with the psychological disorder, the harder it is to return seniors to long term care facilities that don't use restraints.

"It's nobody's fault. It's really how our system has evolved, but it has really left seniors who are living with mental health challenges out of the planning for seniors' care."

The number of seniors with mental health issues is expected to spike by 2026, according to the B.C. health ministry report Guidelines for Elderly Mental Health Care and Planning.

It found the elderly population in Elizabeth Rinke's province of B.C. will increase by more than 120 per cent in over the next three decades, faster than any other demographic. 

Among those elderly, 25 per cent will have mental health issues and need support from the public healthcare system.

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Rosa Marchitelli is a national award winner for her investigative work. As co-host of the CBC News segment Go Public, she has a reputation for asking tough questions and holding companies and individuals to account. Rosa's work is seen across CBC News platforms.

With files by Jenn Blair


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