Who’s responsible for the tragedy at Quebec senior homes?

It all started unravelling like a badly built Jenga tower. One volunteer nurse blew the whistle, journalists started probing, family members started talking and the entire stack of blocks came crashing down in front of our horrified eyes.

Since March 13, at least 31 residents have died at the CHSLD Herron, a privately owned long-term care facility for seniors in Dorval. By the time the amplitude of the criminal neglect there was revealed, more stories were surfacing. There were reports of Verdun CHSLD staff being locked in to extend their working hours. Then staff at the CHSLD Laflèche, where at least 22 residents have died, started speaking anonymously about fears of reprisals if they spoke publicly about their work conditions.

Who’s to blame?

How did Quebec senior homes become the province’s Achilleas’ heel in its fairly successful fight against coronavirus? Whose fault is this irredeemable mess? I can tell you whose fault it most definitely isn’t: those overworked and underpaid essential workers scrambling for weeks to contain a pandemic that swept down like a tsunami on a healthcare system that’s incurred so many cutbacks over the years that it’s operating like a seawall made of see-through cheesecloth.

Premier François Legault, Public Health Director Horacio Arruda and Health Minister Danielle McCann have been reminding us daily that 99 per cent of the 360 deaths registered so far in Quebec are people over the age of 60 — almost all of them with pre-existing health conditions.

Those reminders are, of course, helpful in narrowing down the scope of the danger and emphasizing that the virus tends to primarily lead to serious health complications and death in senior populations; particularly in those 70 and older.

But those reminders are also a kind of absolution, a loophole, if you will. The unspoken message is that young people are not dying, the government is doing its job in protecting most of us and that older people were already vulnerable and closer to death than the rest of us. Not quite expendable, but, hey… pre-existing conditions had already laid the groundwork for their vulnerability, their demise, their inability to effectively fight COVID.

Let’s talk about pre-existing conditions, shall we?

The writing was on the wall

In the summer of 2019, two coroners had sounded the alarm about the lack of personnel and qualified staff at a senior homes in Gatineau, Quebec where three seniors died, according to a Radio-Canada report. The residence was owned by the Katasa Group, one of seven it operates across Quebec, including Maison Herron. A few months before, following a resident’s death, a coroner had also alerted the regional health authority about Herron. Many families and patients’ advocates issued complaints about inadequate care at the facility and the West Island CIUSSS had been notified yet failed to do anything about it.

Despite the warning signs, the Katasa Group was able to continue operating senior homes and continued to obtain certifications of compliance and operating standards as laid out by the Quebec Health Ministry. How low are those standards if the Katasa Group continued to be assessed as meeting them?

After the government tallied up the dead at Herron last week, a visibly shaken Premier Legault publicly declared that what happened there was “gross negligence” and promised Quebecers that those responsible would be punished and our seniors protected.

“Those responsible…” Who’s responsible, though? Who’s ultimately to blame in this nightmare scenario where people at their most vulnerable had been left to sit in their own excrement and their own pee-soaked diapers for days, urine bags dripping, some so dehydrated they could barely speak? Who dropped the ball?

Passing the buck

Are the Katana Group owners to blame for seeking to profit on the backs of our most vulnerable by denying them basic dignity and essential services they and their families paid dearly for? Of course. But how was it possible that a for-profit company, sanctioned in the past for callously mistreating seniors, was able to operate not one, not two, but seven senior homes across Quebec, under the approval and certification of the Ministry of Health and Social Services?

Is the West Island CIUSSS responsible for not doing a better job of monitoring these private places? In Monday’s presser, both Premier Legault and Minister Blais seemed to defend the West Island CIUSSS, but persistent questions remain.

How, if they’ve been there since March 29, did they not notice an average of one body bag per day leaving the facility? How do they claim they separated residents to stop the spread of COVID-19 in these facilities when there is video footage from April 1 showing residents still congregating in common areas? When Lynne McVey said that all the families of the residents at Herron had been contacted immediately, I know that’s not true because I’m personally aware of at least two (one whose mother passed away and one whose mother was transferred to a hospital) who were never called back, despite repeated attempts to get information.

In recent weeks the facility had become overwhelmed and understaffed, simply unable to tackle the additional demands of COVID-19, but who failed to get the needed help? The CIUSSS claims they received no cooperation from the facility’s management. The management, in turn, claims they received no help from the CIUSSS despite numerous pleas for assistance. Three separate ongoing investigations will, no doubt, uncover many unsavoury details, and I suspect when all is said and done there will be plenty of blame to go around.

Is Seniors’ Minister Marguerite Blais, who promised to improve the standards in these private facilities, to blame? Yes. A lot has been said over the years and little has been done.

When 32 seniors burned to death in a major fire in a private senior home in l’Isle-Verte, Quebec in 2014 because of a lack of sprinklers, Minister Blais said all private residences would be obligated to install them. Seven years later, a little under half have done so and the requirement has been delayed until 2022. Imagine having large facilities with slow-moving or incapacitated seniors and not considering sprinklers an urgent necessity?

While often very costly, private residences have not proven to be safer for our seniors. Gilles Duceppe’s family is currently seeking $1.14-million from a private residence after his mother Hélène Rowley Hotte was found frozen to death outside the home in January 2019.

Public senior homes in Quebec are often no better. In 2018, the province’s ombudsman, Marie Rinfret denounced the situation in public residences, calling them “a public disgrace” and said that services for the elderly or persons living with disabilities in long-term care homes are chronically “deficient and flawed.”

People say that private and for-profit health facilities shouldn’t exist. Sure. They shouldn’t. So where do you put a parent who needs constant care when there’s a five-year waiting list to get into a public seniors’ home?

Chronic issues

The reason there are more than 1,200 private senior homes in Quebec, housing approximately 125,000 people, is because they are needed to fill the gaping holes in our public health system, where funding has been deeply inadequate for decades. What happened at Herron is a symptom of a much larger malaise.

The blame lies in chronic underfunding. The blame lies with a society that routinely ignores seniors and our most vulnerable until something tragic happens to make us remember. The blame lies with ageism and capitalism and a way of life that seems to have no room for seniors, unless it can make a buck off them.

The blame lies with Philippe Couillard’s and Gaetan Barrette’s austerity measures. The previous Liberal government left Quebec with a major surplus, but slashed its healthcare budgets past the fat, down to the bone. That administration also removed whole layers of bureaucracy that may now be painfully proven to have served a purpose. Remember who the Seniors’ Minister was under the Liberals? Marguerite Blais, who apparently did such a bang-up job she was invited to take on that same role with the CAQ.

The Parti Québécois before them imposed their own set of austerity measures. François Legault also served briefly as Quebec’s Health Minister when Bernard Landry was Premier. None of these players can claim ignorance of these healthcare files. These are not recent problems, but chronic issues that were ignored until a crisis of epic proportions pushed them to the forefront.

Promises that weren’t kept

Speaking of Legault, remember the platform he was elected on almost two years ago? A huge part of it was presenting solutions for Quebec’s broken health system and revamping the province’s network of seniors’ homes. The CAQ pledged to overhaul the system, replace the government-run CHSLDs with a network of 30 smaller and more humane seniors’ homes at a cost of $1 billion.

Almost two years into their mandate, the list of people waiting for government-run long-term care has in fact grown. New Quebec senior homes were scheduled to be delivered in 2022. Minister Blais said that the lands they would be built upon would be purchased by the government this spring. Given the current circumstances, I’m not sure if that promise will be expedited or delayed.

What did the CAQ choose to focus on instead, since coming into power? Identity politics, like immigration and faux secularism, something that requires no injection of cash and reaps maximum partisan loyalty at minimum financial cost. Au Québec, c’est comme ça qu’on vit.

Healthcare and seniors were, once again, relegated to the backburner because what average voter gets excited about unsexy issues like ensuring seniors get baths twice a week or are fed a nutritious meal? By the time they do care, they’re too old to matter to most vote-pandering politicians. And the cycle repeats itself.

Quebec has now issued a province-wide inspection of all public and private senior homes. It’s a start, but much remains to be rectified.

Pre-existing conditions

When we speak of pre-existing conditions in people, it communicates that there are underlying issues that make them more vulnerable to disease, to a virus, to an attack.

But the biggest pre-existing conditions that killed most of Quebec’s seniors were the unresolved weaknesses in our healthcare system that enabled so much to go wrong. These weaknesses were only amplified and exacerbated by this unprecedented global pandemic.

The lack of resources in public services and the health network in government-run senior homes in Quebec, including privately run residences, was never a secret. Healthcare workers’ and nurses’ unions have been decrying them for years to anyone who would listen.

We can’t suddenly pretend that we have no clue how this happened. You can’t keep cutting away at budgets and not face the dire consequences of such choices. You can’t keep offering shit pay and crappy work conditions and a dangerous lack of protective equipment and expect not to have staff shortages. You can’t issue orders for Omerta-type silence among nurses and healthcare workers sounding the alarm, even going to the extent of penalizing them financially for blowing the whistle on unsafe practices, and then wonder why you’re dealing with a tired, demoralized, burnt-out workforce that isn’t interested in coming back to risk their lives for a temporary bonus.

Put your money where your mouth is

The pandemic isn’t a great equalizer. It’s a mirror showing us every single one of our collective failures as a society. And the way we treat our seniors is not unique to Quebec. This is a societal problem that goes beyond our borders.

There’s a proverb that says, “When the fish stinks, it’s from the head down.” When an organization fails, it is the leadership that is the root cause. But that leadership, in a democracy, is a direct reflection of the people’s will and the people’s priorities. You want to blame someone? You can start with us.

We’re aging. In less than a decade, Quebec will have one million seniors. That number will include many of our parents and many of us. When the dust settles, we need to take a good hard look at what we consider to be priorities and how much money and attention we, as a society, are willing to allocate to honour them.

Saying “our seniors deserve to be taken care of” is the easy part. Doing something to make that materialize requires more than meaningless platitudes. It requires a plan, serious financial investments in resources and well-trained, well-paid staff that prioritizes their dignity and well-being, and a population that votes for politicians that follow through on their promises — and quickly removes them from power when they don’t. ■

Read more editorials by Toula Drimonis here.

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