'Enough with the guardian angels': Nurses and families say government acted too late to help seniors

As the government scrambles to staff besieged long-term care institutions, families of residents at the Universite de Montréal-affiliated Institut de gériatrie say it’s too little, too late for an overburdened system.

Relatives of residents at Montreal's Institut de gériatrie describe staff struggling to keep up with 'chaos' 

Jean-François Rochon, left, said his mother, Monique Papineau-Couture, a resident of the Montreal geriatric institute's Côte-des-Neiges pavillion, was diagnosed with COVID-19 on April 5. (Submitted by Jean-François Rochon)

Two, three times a day, Jean-François Rochon calls his mother, Monique Papineau-Couture, to check in. 

"Last call I had was this morning, and she was not in good shape," he said one day earlier this week. "She didn't eat breakfast. She was coughing. Her energy was low."

"It didn't sound good."

Papineau-Couture, who has lived in the Côte-des-Neiges pavilion of Montreal's Institut de gériatrie de Montréal for the past 18 months, tested positive for COVID-19 on April 5. 

Officially, there have been no deaths at that pavilion, and five deaths at the institute's other pavilion, Alfred-Desrochers, but internal documents suggest that the death toll in both residences is much higher. 

Those calls to his mother are his principal source of information about what's going on inside, but what he does hear from staff is that they are overwhelmed — constantly "extinguishing fires."

And because of that, anyone who is not yet dying, he said, is made to wait.

Even before the pandemic, said Rochon, his mother could wait an hour and a half for her full colostomy bag to be changed, especially during the night shift, when staffing ratios are paper thin: sometimes just one nurse and a few patient attendants for more than 100 residents.

Now, he said, just getting a glass of water can take two hours.

"I understand that they're doing their best, but they're definitely facing hard working conditions and not enough people," said Rochon. 

And from his standpoint, the government hasn't reacted anywhere near quickly enough.

"I listen to those press conferences every day, and they seem to be stuck in third gear," said Rochon. "I mean, this is a crisis, and they seem to be doing politics and defending the fact that, 'Oh yeah, it's like that everywhere else. We inherited this situation.' This is not the time for that."

Compassion in the midst of chaos

As the COVID outbreak took hold in the institute's Alfred-Desrochers pavilion, Anne Kettenbeil donned protective gear and went inside, to spend a final few days and nights at the side of her partner of 35 years, Solange Arsenault. 

Kettenbeil was allowed in for compassionate reasons and because initially, her partner's illness was being treated as the flu.

Arsenault died March 28, just six days after she had started running a fever, just three days after she had become non-responsive, and just a day and a half after it was confirmed she had COVID-19. 

'She was very dynamic, fun-loving, brilliant,' Anne Kettenbeil said of her partner of 35 years, Solange Arsenault, above, who had Parkinson's disease. Arsenault died of complications of COVID-19 on March 28. (Submitted by Anne Kettenbeil)

Kettenbeil witnessed how quickly residents would go downhill: someone in a neighbouring room passed away the day she arrived, before that resident's test results were even back.

While inside, she saw employees running out of protective gear. 

She saw confused elderly residents roaming the hallways and coughing, as staff, some with protective gear, some without, struggled to coax them back to their rooms.

"These people have been doing a wonderful job in the midst of chaos," said Kettenbeil. "They were empathetic. They were compassionate. They were gentle."

But she said with critically low staffing in the best of times, they were put in an impossible position once the pandemic hit.

"It is inhuman to think that we're expecting this care staff to be able to manage, 10, 15, 20, 25, 30 COVID cases in their units," she said

Slow testing, rapid spread

Kettenbeil, who also heads up the residents' committee at Alfred-Desrochers, believes staff were also constrained by public health directives that were too rigid to respond to the developing crisis.

For example, Kettenbeil was initially told Arsenault could not be tested because she hadn't travelled. Even after she tested positive, there were delays in testing others who had come into contact with her. 

Similarly, Rochon said his mother also spent 10 days in the same room as a symptomatic resident before either was tested. 

The regional health agency that oversees the institute, the CIUSSS Centre-Sud-de-l'Île-de-Montréal, did not grant CBC's request for an interview.

Quebec's public health director, Dr. Horacio Arruda, again Wednesday defended the decision to initially limit testing to travel-related cases, due to a lack of testing capacity and because those who had traveled were deemed most at risk.

But Rochon believes slow testing contributed to the rapid spread in seniors' homes.

"Knowing that they're so vulnerable, it should have been right away," he said. "For some reason, we missed that."

Jean-François Rochon said his mother, Monique Papineau-Couture, was not initially tested for COVID-19 because her case was unrelated to travel. He believes those restrictive testing criteria contributed to the rapid spread in seniors' homes. (Submitted by Jean-François Rochon)

'Enough with the guardian angels'

Françoise Ramel, president of the regional chapter of FIQ, the union that represents nurses at the geriatric institute, said staff are working their hardest to maintain a proper level of care for residents. 

But she's frustrated, saying a crisis like this has been a long time coming.

"If we're in this situation today, it's because of the cuts [governments have] made. It's because of the lack of respect for the work of ... personal support workers, nurses, respiratory therapists," said Ramel.

Thousands of retired health-care workers have submitted their CVs, willing to come forward to help, but many haven't yet been contacted. Health Minister Danielle McCann said Wednesday bureaucrats are working as quickly as they can to process those requests.

"There is hardly any red tape," McCann said. "There are some situations that we would like even to go faster. There are some steps to do. But we're working so fast. What we're doing now, we're doing in a couple of days what we used to do in a couple of months." 

Questioned about whether Quebec needs to now guarantee minimum staffing ratios in long-term care homes, a long-standing request of the FIQ, Premier François Legault said the government's focus right now is to fill vacancies. He said it will look at improving ratios, but that would cost an estimated $1.2 billion.

Ramel, meanwhile, bristles at the term of endearment Legault has often repeated when praising health-care workers. 

"Enough with the guardian angels," she said. "Guardian angels sit up on clouds, and nothing can touch them. We are on the front lines."

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