Wednesday, July 5, 2017

--no oversight-- no interest --no autopsies and tons of regulations---------Ontario Government does the impossible Post #1-------We want to assure the public that Ontario's 78,000 long-term care residents are safe in their homes. Our oversight system in long-term care specifically focuses on the safety and security of our residents and we will continue to work to ensure all of our homes are meeting the highest standards.-----------------The secrecy over nursing home inspection isn’t new: Ontario Liberals said nothing of plans to scale back inspections until questioned by The Free Press, which learned about it from sources. Under those plans, more than 500 of the province’s 630 nursing homes were designated as low risk and would undergo a full inspection only once every three years. The other two years, those so-called low-risk homes would get what inspectors and home operators are calling a “lite” inspection with one-quarter the manpower and no formal scrutiny of a wide range of key issues, from security to staffing. Asked which homes had been deemed low risk, Jensen initially wrote, “It would be premature to release any information until the classification of the long-term care homes is finalized.” The claim seems odd: Inspectors have been assigned lite inspections in July and August as early as July 11, sources say. And the Ontario Long-Term Care Association says it met June 23 with Health Ministry officials and was told that 84 per cent of Ontario’s 630 long-term care homes had been classified low risk. Just how nursing homes are classified remains murky. The Free Press asked the Health Ministry to explain how homes were classified but the ministry didn’t respond. The secrecy comes three years after former health minister Deb Matthews went public with plans to more than double the number of inspectors so that all nursing homes would get a full, annual inspection.--------“We’re renewing our commitment to annual, proactive inspections, and adding enough new inspectors to get the job done,” she said in 2013.--------The changes to inspections were made after lobbying by owners and operators of nursing homes.---------“I literally stood up and fell down, my legs gave way because I didn’t know how to respond to this,” he said. “We have a camera on him, and even that doesn’t deter him. To me, that’s mind blowing.”------Nassrallah said it was especially troubling to learn the employee who carried out the assault specialized in the treatment of dementia patients. He unleashed both a physical and verbal assault on a man who could neither defend himself nor speak out about his treatment, Nassrallah said. Nassrallah’s grandfather speaks little English; when he does talk, it’s in Arabic. “A person in a state of dementia reverts to childhood. It’s fight or flight. My grandfather can’t fly, he can’t run away, he can’t get away from the situation, he’s immobile. His hands are being held, he’s being demeaned, he’s being thrown around in some instances, he’s not being taken care of properly,” said Nassrallah. “This is torture, this is punishment, this is cruel treatment.” This wasn’t the first troubling incident involving Karam at the long-term care home, Nassrallah alleges.------The nurse “would have signed my grandfather’s death sentence against his express wishes,” said Nassrallah.-----“Everyone should have a camera in the room,” said Nassrallah. “Most substitute decision makers are not here essentially as peeping Toms to watch an elderly individual change. That’s not their purpose. It’s oversight over your loved one.”-


I am puzzled by the actions of the government of Ontario and curious about their decisions to go the Alberta way of more secrecy.
When I am puzzled I try to sort through the public data and think it out in a series. I will think about this case of the about face of the government of Ontario with reference to yearly audits of the long term care system with increased secrecy and think whether this response was not only due to strong lobbying by the long term care association in Ontario but also due to their desire to keep problem cases out of the public eye before the next provincial election.



When I got back from the Riverbend Public Library after returning my library books, I found this post by Velvet Martin on FB. Usually I would never get caught up with all the cases of abuse in the continuing care system without the help of my partners. Velvet Martin is one of my partners.

Anyway I was simply appalled by this case. It's in Ontario. Looking at this case and others in Ontario it is not surprising to me that the folks in the Liberal Party there are fighting for their political survival in the next provincial election and are therefore doing the secrecy stuff. We know all about secrecy in Alberta. It's all about covering your butt.

In any case all this secrecy won't help the political parties. Families are now bypassing government to put up the cameras in rooms, calling the police and speaking on social media. I'm thinking the "No more Silence" position of Velvet Martin is going global now.

In this particular case the family told the facility they were putting in the camera and workers knew but apparently in this case the worker did not seem to mind being filmed assaulting a defenceless senior. Then the family finds out (accidentally) that not only does the facility have workers who do not respect their patients but also there was a Do Not Resuscitate order (DNR)  on the man's file. Sort of like the situation where my sister had numerous DNR orders by successive doctors in the Grey Nuns Hospital. It gets tiresome folks. I mean families are paying for the care of their family members in care. These patients who are called residents in the continuing care system are to be taken care of even if they are not able to control themselves. If the patient isn't able to control himself there needs to be other ways to keep staff safe. Chemical restraints or a second worker present would have helped. But then what am I talking about here? Two workers helping one patient?

While I understand that this dementia patient was hitting the staff member, this was no reason for the assault on the patient.  It appears that not only does the dementia patient lack insight but so does the health care worker helping him.




A personal care worker at a city-run retirement residence delivered 11 punches to the face of an elderly, immobile and largely non-verbal dementia patient, a video…
OTTAWACITIZEN.COM
If you have a dementia patient abused with a camera in the room what will change the situation in the continuing care system in Ontario? On top of the mass murders of citizens by a nurse, we have had other cases of fatality that has resulted in a court case (the Lori Dekervor case) https://www.thestar.com/…/family-seeks-class-action-suit-ag…
In the case of Jones, the claim alleges that while in the nursing home, his health declined rapidly. The suit states he suffered from malnutrition and dehydration, and he fell repeatedly when he couldn’t get help for simple tasks, like going to the washroom. He became “bed-bound” and then developed a serious pressure ulcer (open wound) on his tailbone that was improperly treated, leading to a deep, painful infection. On May 26, 2014, when Jones was found “unresponsive,” a nursing home physician requested he be sent to hospital, the documents say.
“In hospital, Mr. Jones’ ulcer was found to be large, red, infected, smelly, and contained fecal matter,” the claim states.
“It was also at an advanced stage . . . . He experienced excruciating pain from the sacral ulcer.”
In an interview, Derkervor told the Star the discovery of her father’s “9-inch by 4-inch” bedsore at the hospital, and his painful death, left her with “nightmares, anxiety and a lot of depression. It took over my life. I really neglected my family trying to find a way to get some justice.
“This (lawsuit) means that it’s not a secret anymore,” she said.
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Now we also have the astonishing news that instead of beefing up the audits the government of Ontario is going backwards. It is reducing the number of audits after the continuing care industry lobbied the government. The decreased oversight is explained to citizens as freeing up resources that are consumed in audits. What the heck?
Not only are there going to be fewer audits but the government in Ontario is following the secrecy mantra of the GOA and disclosing less. Very troubling.
http://www.lfpress.com/…/health-ministry-wont-disclose-whic…
Just 11 days before Ontario’s Liberal government scales back inspections at more than 500 nursing homes, its Health Ministry has lurched toward darkness and secrecy, saying Thursday it will not disclose which homes get full inspections and which do not.


A personal care worker at a city-run retirement residence delivered 11 punches to the face of an elderly, immobile and largely non-verbal dementia patient, a video…
OTTAWACITIZEN.COM



http://ottawacitizen.com/news/local-news/caught-on-video-elderly-ottawa-man-with-dementia-punched-in-face-11-times-by-personal-support-worker

Caught on video: Elderly Ottawa man with dementia punched in face 11 times by personal support worker

Published on: July 4, 2017 | Last Updated: July 5, 2017 11:03 AM EDT
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Elder Abuse: Warning graphic content
A personal care worker at a city-run long-term care home delivered 11 punches to the face of an elderly, immobile and largely non-verbal dementia patient, a video obtained by the Citizen reveals.
The high-definition video camera that recorded the attack was installed by the patient’s family and wasn’t even a secret to staff at the Garry J. Armstrong long-term care home on Island Lodge Road where the assault occurred.
Workers were made aware that the video system was being installed in the room of 89-year-old Georges Karam after the family grew increasingly concerned about the number of unexplained injuries he had suffered since moving into the residence two years ago.
The city scrambled to assure other residents and their families in the city-run long-term care home that “the safety and well-being of all of our residents is our number one priority,” after being contacted by the Citizen about the case. “We take our commitment to safety seriously,” wrote Janice Burelle, general manager of community and social services in a letter she sent to Mayor Jim Watson, council and city staff.
The video, which was provided to the Citizen by Karam’s family, shows the elderly man lying in bed as personal support worker Jie Xiao yanks him back and forth while removing his diaper. Karam suffers from Alzheimer’s and Parkinson’s disease and needs a wheelchair to move around.
An agitated Karam took a pair of swipes with a crippled and shaking hand at Xiao during the diaper change.
It was after a third swipe that came closer to Xiao’s face that the 44-year-old care worker unleashed a series of rapid punches with his gloved hand to the side of Karam’s face on March 8.
Xiao frequently paused between the blows, delivering two or three punches at time with his left hand as his right hand took hold of Karam’s arm. The sound of the fist making contact with Karam’s face is clearly audible on the video.
Jie Xiao, 44, and Georges Karam, 89, are shown in still images takes from a video at his care home. The camera was installed by the family of the senior after they could not get answers to questions about his care.
The family of Georges Karam called police as soon as they saw this video. DNG NASSRALLAH LAW
Georges Karam, 89, was repeatedly struck in the face. Jie Xiao, 44, later pleaded guilty to assault.
In between the punches, Xiao frequently raised a closed fist next to Karam’s face. Before delivering the final punch, Xiao appears to be swearing at Karam. Karam then lets out a shout. The whole assault lasts about 28 seconds.
Xiao then briefly leaves the room, only to return 27 seconds later. He then stands next to the bed, pointing at Karam’s hand and his own face, before making a gesture as if Karam should try hitting him again. Xiao then made a fist and pointed at Karam’s face.
Xiao then pulls Karam’s blankets up, closes Karam’s eyelids with his fingers and pats Karam on the head. Xiao then put a finger to his mouth in a shushing gesture before turning off the TV and the lights and leaving.
Last Tuesday, Xiao pleaded guilty to assault. A sentencing hearing is expected to be held later this year.
The assault took place at a time of growing concern about Ontario’s long-term care system. Former nurse Elizabeth Wettlaufer was recently sentenced to life in prison for the murders of eight patients in long-term care facilities. The province has announced a public inquiry, but NDP leader Andrea Horwath wants that expanded to take a broader look at what she calls a broken system.
Karam’s grandson, Daniel Nassrallah, an Ottawa lawyer who set up the camera, said he couldn’t believe what he was seeing when he first viewed the video just after 10 p.m. on the day of the assault. Nassrallah had set up the camera — which is about the size of a baseball, lights up in the dark and had wires running from it — on the wall so he could watch the video remotely over the internet.
“I literally stood up and fell down, my legs gave way because I didn’t know how to respond to this,” he said.
“We have a camera on him, and even that doesn’t deter him. To me, that’s mind blowing.”
Nassrallah said after viewing the assault, he first called his uncle, who is the substitute decision maker for his grandfather, then his brothers. He then headed toward the home in his car, hoping to get there before the shift changed at 11 p.m. On the way, he dialled 911.
The police were already on his grandfather’s floor when he arrived; as he and his two brothers got into the elevator, one of them spotted Xiao leaving through the front door. Nassrallah approached him and asked him to come upstairs with them, which he did. Nassrallah then showed police the video. They arrested Xiao on the spot, handcuffed him and took him to the central cell block.
Karam was taken to hospital by paramedics. A CT scan was performed but there were no serious injuries. He eventually returned to the home.
Ottawa police Det. Hilary Rao with the elder abuse unit said the video was “definitely disturbing.”
Burelle, the city’s head of community and social services, which oversees long-term care homes, called the case “deeply troubling.” She outlined details of the incident and ongoing investigations in the letter to the mayor and members of city council.
“I deeply regret that one of our residents was subjected to this incident,” she wrote. “The actions of this worker are completely at odds with our mission and our commitment to the health and the well-being of our residents. Long-term care will not tolerate any form of abuse of residents. There can be no excuse for even a momentary lapse in the high standards that we, residents and their families expect of the people to whom we have entrusted the care of those who call our facilities home.”
The worker was immediately removed from the home once the allegations were made “and is no longer with the City of Ottawa.” Burelle said she is reaching out to other residents of the home and their families “who may have questions in light of the criminal code conviction.”
She also confirmed the city has received notice of intent to sue from a law firm acting on behalf of the resident’s family.
“I can also advise that staff are currently working with the ministry in response to other complaints relating to the same resident regarding his medical chart and care. This review is ongoing and does not relate to the personal support worker.”
Nassrallah said it was especially troubling to learn the employee who carried out the assault specialized in the treatment of dementia patients. He unleashed both a physical and verbal assault on a man who could neither defend himself nor speak out about his treatment, Nassrallah said.
Nassrallah’s grandfather speaks little English; when he does talk, it’s in Arabic.
“A person in a state of dementia reverts to childhood. It’s fight or flight. My grandfather can’t fly, he can’t run away, he can’t get away from the situation, he’s immobile. His hands are being held, he’s being demeaned, he’s being thrown around in some instances, he’s not being taken care of properly,” said Nassrallah. “This is torture, this is punishment, this is cruel treatment.”
This wasn’t the first troubling incident involving Karam at the long-term care home, Nassrallah alleges.
Nassrallah said they have filed complaints with the Ottawa police and the Ministry of Health and Long-Term Care after the family discovered that a registered nurse had signed a Do Not Resuscitate order for their grandfather without their knowledge or consent.
Nassrallah said it is entirely contrary to the express wishes of the family and the wishes made by Karam in a power of attorney he signed before deteriorating to his current state.
Nassrallah said the family only learned about the DNR order by accident on June 17 after they were contacted by the home after his grandfather fell from his bed. Nassrallah said when they arrived they discovered his grandfather had suffered injuries to his head, however they later found out the injuries were not caused by the fall. They were then given a copy of his medical file. Nassrallah said they were told that the DNR was a “mistake.”
The nurse “would have signed my grandfather’s death sentence against his express wishes,” said Nassrallah.
Nassrallah said the family found evidence of supposed meetings with the facility’s doctor, which were dated before his grandfather had even moved to the home.
Nassrallah said the camera has also caught incidents both before and after the assault of another resident entering his grandfather’s room and going through his belongings. Another personal support worker was also recorded by the camera taunting his grandfather. In one video, he loudly calls him “Mr. George” and “my boss” changing him in front of an open door. The worker also hit his bed and then repeatedly said “inshallah,” an Arabic expression meaning God willing, or if God wills. Karam is Lebanese.
In the second video, recorded just days after the assault by Xiao, the same worker stands next to Karam’s head, repeatedly saying inshallah. He later dances out of the room, repeating the word over and over as he leaves.
Nassrallah said they were told the worker was suspended for two months and assigned to a different floor after they complained.
The video also caught Xiao making a sound that mimicked a squeal made by another resident with health problems on the same day he assaulted Karam, Nassrallah said. Prior to the assault, Xiao failed to properly prop Karam up when he put him to bed to prevent a bedsore from getting worse, and tossed dirty towels he had used to clean Karam’s genitals on the bed, Nassrallah said.
“Everyone should have a camera in the room,” said Nassrallah. “Most substitute decision makers are not here essentially as peeping Toms to watch an elderly individual change. That’s not their purpose. It’s oversight over your loved one.”
Nassrallah said the family made the decision to install the camera in February after their grandfather suffered a cut to his neck. They later discovered a support worker had tried shaving him with disposal razors and cut him, even though the family had provided them electric razors to prevent injury.
“We thought that something was not right,” said Nassrallah. “Over the past six or seven months prior to February 2017, there were several incidents in the home that were unexplained. There would be cuts and bruises to my grandfather, they would claim that he had fallen out of bed. There was a laceration to the top of his forehead. We never had a satisfactory answer given, it was always unexplained facts. That was not satisfactory to us.”
They installed the camera to both monitor their grandfather’s care but also to act as a deterrent, he said.
The management “had full knowledge of the camera, and actually approved of the camera being in place,” Nassrallah said.
Burelle said cameras have been installed in the rooms of two residents at the home. “Residents and their families are free to place cameras in their rooms, and that is a choice that some residents/families make for their own personal reasons,” she said.
Nassrallah said his grandfather fled to Canada from Lebanon’s bloody civil war in the early 1980s. In Lebanon, Karam had been in the military. He later became a staff sergeant in the traffic and circulation division.
He’s a widower now. His wife died in 1993 as a result of the tainted blood scandal.
“My grandfather was tough as nails,” said Nasrallah.
Now, he’s just fearful.
“He begs us to protect him. Literally the translation is: ‘I beg you, I beg at your feet, please don’t leave me, please protect me, something’s not right,'” said Nassrallah.
But despite what’s happened, Nassrallah said the family has been reluctant to move him out of Garry J. Armstrong home out of fear of what might happen to him if he leaves.
“The only reason he’s still there is because you are stuck between a rock and a hard place. An individual in that mental and physical state, he’s accustomed to his surroundings. He’s accustomed to the people who work at the home, he’s accustomed to the food, he’s accustomed to his bed, he’s accustomed to waking up with routine at the home. He’s accustomed to his life at the home,” said Nassrallah. “Removing him at this stage would be extremely detrimental to his health and well-being, both physical and mental.”
In Ottawa and the surrounding area, about 7,500 people are in long-term care beds and another 3,500 are on waiting lists. More than 700 residents are in city-run long-term care homes.
The city says it received 26 complaints related to services at Garry J. Armstrong in 2016, mostly about the home’s services, including housekeeping, response time and food. There was also one confirmed incident of verbal abuse.
The city works with the province to make sure remedial action happens quickly, said Burelle. She noted that all long-term care homes are subject to regular and random inspections done by the ministry and are assessed by independent auditors every four years to make sure standards are being met. City homes, including Garry J. Armstrong, had an overall rating of 95 per cent satisfaction as a place to live by residents and families in 2016, she said.
All staff provide proof of education and undergo police checks and are provided with “comprehensive orientation” before they begin work, including annual mandatory training, including abuse prevention training.
She said staff are now getting additional training on the city’s abuse policy, which will be completed by September.
The assault has left Karam’s family questioning whether other residents may have been victimized.
“I dread to think what happens to other families who don’t have the same resources and capabilities that our family does,” said Nassrallah. “With another patient or another resident who doesn’t have a voice, doesn’t have a family or oversight, that individual is left alone to suffer, because of that; that is what drives me in this.
“I want change and I’m not going to stop until we get change,” said Nassrallah. “The system is broken and it needs change.”
Georges Karam, centre, is photographed with many of his grandchildren in his room at the Garry J Armstrong home in Ottawa.
Georges Karam, centre, is photographed with many of his grandchildren in his room at the Garry J Armstrong home in Ottawa. DARREN BROWN / OTTAWA CITIZEN/OTTAWA SUN
With files from Andrew Seymour

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At least this family had video evidence of the problems at this facility. In the case of Lori Dekervor's dad -Arthur Ross Jones--she only got the bad news of neglect at the end of the journey.  It's hard to understand how a nursing home could miss the significant bedsore on this man and how he was in such agony at the end of his life while staff were around.

What is going on in the system? Is it all about burnt out staff and failures to follow the standards? if so what can be done to fix these problems? Apparently government has no idea of what to do and so families are going the legal route as in this class action lawsuit.



https://www.thestar.com/news/queenspark/2016/10/20/family-seeks-class-action-suit-against-ontario-nursing-home-after-fathers-death.html

Family seeks class action suit against Ontario nursing home after father’s death

Lori Dekervor wants other families to join her lawsuit, alleging widespread neglect by nursing home chain Revera.
Arthur Jones was a creative man and loving father, said his daughter, Lori Dekervor, who filed a lawsuit related to his care in a Revera nursing home.
Arthur Jones was a creative man and loving father, said his daughter, Lori Dekervor, who filed a lawsuit related to his care in a Revera nursing home.  (FAMILY HANDOUT)  
Lori Dekervor has filed a statement of claim against the Revera long term care chain, alleging it neglected her father, leading to a painful infected pressure ulcer on his tailbone. She is hoping that others will come forward and the lawsuit will be certified as a class action suit against the large nursing home chain.
Lori Dekervor has filed a statement of claim against the Revera long term care chain, alleging it neglected her father, leading to a painful infected pressure ulcer on his tailbone. She is hoping that others will come forward and the lawsuit will be certified as a class action suit against the large nursing home chain.  (LARS HAGBERG)  
Arthur Jones was a creative man and loving father, said his daughter, Lori Dekervor, who filed a lawsuit related to his care in a Revera nursing home.
Arthur Jones was a creative man and loving father, said his daughter, Lori Dekervor, who filed a lawsuit related to his care in a Revera nursing home.  (FAMILY HANDOUT)  
Lori Dekervor has filed a statement of claim against the Revera long term care chain, alleging it neglected her father, leading to a painful infected pressure ulcer on his tailbone. She is hoping that others will come forward and the lawsuit will be certified as a class action suit against the large nursing home chain.
Lori Dekervor has filed a statement of claim against the Revera long term care chain, alleging it neglected her father, leading to a painful infected pressure ulcer on his tailbone. She is hoping that others will come forward and the lawsuit will be certified as a class action suit against the large nursing home chain.  (LARS HAGBERG)  
By MOIRA WELSHInvestigative News reporter
Thu., Oct. 20, 2016




A gaping, infected bedsore that led to an Etobicoke man’s death is just one example of systemic failures of care and negligence at a large Ontario nursing home chain, a lawsuit alleges.
As part of an attempt to have the suit certified as a class action case against the Revera chain, lawyers have filed a statement of claim that raises 82 examples, including that of the lead plaintiff, the family of Arthur (Ross) Jones, who died in hospital in June 2014 after 11 months at the Main Street Terrace home in east Toronto.
“Hopefully something will change as a result of this because a lot of people will end up in nursing homes — the boomers are all heading in that direction,” said Jones’ daughter, Lori Dekervor.
Jones, 68, suffered from “sepsis and suspected pneumonia,” and died two weeks after being transferred to hospital from the Revera home. Revera operates 53 long-term care homes in Ontario with 6,000 residents.
The suit claims $200 million in damages on behalf of Dekervor and any future complainants who come forward to join a possible class action lawsuit. Lawyers for the family are seeking to have it certified in Ontario Superior Court. Dekervor will be at a news conference Thursday at Queen’s Park to discuss the case.
The allegations in the lawsuit have not been tested in court.
Revera spokesperson John Beaney said he is aware of the claim and his company will defend it in court. “We do not believe there is merit in the lawsuit.
“We provide care to lots of individuals, often at the end of their lives and families are part of that process,” said Beaney, Revera’s vice-president of operations in Ontario.

You

“When a resident passes away it is often the result of a combination of factors. It is not simple . . . and this can often make it very difficult for their loved ones.”
Increasingly, residents arrive in nursing homes with a complex medical conditions, Beaney noted. “We work to provide care and compassion not just with the residents but with their families as we walk through every stage of their life with them,” he said.
An ongoing investigation of nursing home care by the Star has previously raised the issue of improperly treated bed sores and other issues at various homes across Ontario.
Other instances of alleged negligence at Revera homes listed in the lawsuit include rationing of diapers; filthy, foul-smelling wheelchairs and walkers; and specific allegations including an 83-year-old female resident with dementia who was able to get out of her home and throw herself in a river; and a 100-year old female resident who had an open wound with maggots.
In the case of Jones, the claim alleges that while in the nursing home, his health declined rapidly. The suit states he suffered from malnutrition and dehydration, and he fell repeatedly when he couldn’t get help for simple tasks, like going to the washroom. He became “bed-bound” and then developed a serious pressure ulcer (open wound) on his tailbone that was improperly treated, leading to a deep, painful infection. On May 26, 2014, when Jones was found “unresponsive,” a nursing home physician requested he be sent to hospital, the documents say.
“In hospital, Mr. Jones’ ulcer was found to be large, red, infected, smelly, and contained fecal matter,” the claim states.
“It was also at an advanced stage . . . . He experienced excruciating pain from the sacral ulcer.”
In an interview, Derkervor told the Star the discovery of her father’s “9-inch by 4-inch” bedsore at the hospital, and his painful death, left her with “nightmares, anxiety and a lot of depression. It took over my life. I really neglected my family trying to find a way to get some justice.
“This (lawsuit) means that it’s not a secret anymore,” she said.
“I am hoping people will understand what could happen, what does happen and what to look for to reduce these cases of nursing home neglect and abuse.”
In Canada, lawsuits alleging nursing home negligence usually result in low financial awards, if any, against the home, said Amani Oakely, the lawyer handling the lawsuit for Dekervor, who is the “representative litigant” in the case. “Based on the number of calls that I get (from other families) I believe that Lori will not be alone,” Oakley said.
The statement of claim lists 82 separate allegations at various Revera homes in Ontario, culled from multiple media, including stories in the Toronto Star. (Three stories focused on Revera homes in Alberta.)
Dekervor told the Star that her father was an artistic man who built movie sets and “museum quality” furniture that he once showcased in his Leslieville store, Smith and Jones.
He wintered in Mexico, to be near his children and their families in San Diego, but at the age of 67, when his struggle with Parkinson’s Disease and early dementia proved too much, Dekervor and her two brothers decided he needed extra help. She found him a bed at Main Street Terrace. He moved there in June of 2013.
The lawsuit set out the chronology of the allegations, including numerous falls when he “attempted to get to the toilet on his own, when staff failed to ensure he was taken to the washroom.” Staff also failed to use a mechanical lift to move him, as required, according to the claim.
After these falls, and a trip to the hospital to assess him for fractures, no one at the home looked at his skin for breakdown, the claim states, alleging that nobody at the home addressed his risk of falling. From May 15 to 26, 2014, Jones could not get out of bed but received no monitoring or repositioning to lessen pressure on his skin.
Jones’s chart notes a pressure ulcer on his heel (incorrectly stating the wrong foot) but makes no mention of an ulcer on his tailbone, the claim says.
On his final day in the home, May 26, the wound care nurse wrote that the ulcer on his tailbone was deteriorating “due to incontinence.” The claim says there is “no notation in the chart” indicating that Jones was turned every two hours as required for a resident who can’t get out of bed.
“Had that occurred, his deteriorated condition may have been recognized earlier” than 6 a.m. At that point, he was “unresponsive verbally, his skin was hot to touch, and his vital signs were abnormal . . . .” It wasn’t until the doctor was notified 23 minutes later that the ambulance was called, according to the claim.
Nursing home staff didn’t tell the paramedics or hospital about the bedsore on Jones’ tailbone, which had reached “stage four,” the designation given to the severe ulcers, the claim stated. Jones “experienced excruciating pain.”
Dekervor, living in California, said she received a call from nursing home staff saying her father had been transferred to Toronto East General (now the Michael Garron Hospital) with possible pneumonia. She flew to Toronto.
Dekervor said she could smell something strange in the hospital room, but didn’t know at the time that her father had a rotting ulcer.
“Every time they rolled him over, he screamed in agony. I thought, I don’t know why he would be doing that if it was pneumonia. But that smell, that smell . . . .
“So I opened up his clothes and I have never done that before, seen my father that way, but I rolled him over and there it was, a nine-inch by four-inch black hole. His anus was completely gone. There was white pus. Feces dripping into it.

“From that point on, I’ve never been the same.”


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As if to reinforce the horror of the families involved in the Dekervor lawsuit we had a nurse come forward to give us the sad news of the murder of multiple helpless completely vulnerable patients in the continuing care system in Ontario. Apparently she had told others but I guess no one wanted to make waves and she had to keep yapping and telling folks until the end when she did the only thing she could to be taken seriously which was to yap to mental health folks who may have decided to take her claims seriously.

http://nationalpost.com/news/canada/ontario-nurse-pleads-guilty-to-string-of-nursing-home-murders-using-insulin-to-kill-her-patients/wcm/5ad92abd-6284-422d-8bab-5549da3fba58


Ontario nurse details 'red surge' and 'that laughter' behind slaying of eight elderly patients

Elizabeth Wettlaufer pleaded guilty Thursday to eight counts of first-degree murder, saying she used insulin to kill her former patients and how one fought against the deadly injection

Handout/Citynews Toronto/CP/File
Postmedia Network
June 1, 2017
5:43 PM EDT
Last Updated
June 2, 2017
11:05 AM EDT
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WOODSTOCK — Killer ex-nurse Elizabeth Wettlaufer called it ‘the red surge.’
In bone-chilling evidence Thursday, the health care serial killer’s crimes were detailed in a Woodstock courtroom as she pleaded guilty to using insulin to murder eight seniors in her care at Woodstock and London nursing homes.
The deaths occurred between 2007 and 2014. Wettlaufer’s admission Thursday gave some insight into what motivated the crimes that have made her the worst killer in the history of Canada’s health care system.
“(I felt) that red surge that she was going to be the one,” she said, recounting the death of Gladys Millard, an 87-year-old patient at Woodstock’s Caressant Care nursing home.
She also recounted the murder-by-insulin of Helen Matheson, 95, another person under her care in Woodstock. Wettlaufer told the court of Matheson’s love of pie, and how she gave her a piece.
Peter Power/ The Canadian Press
She then decided the elderly woman should die. She bizarrely described her feeling — she got “that laughter,” she said — as she injected her with insulin.
During a morning recess, the victims’ family, silent throughout Wettlaufer’s admissions, hugged each other and wept.
Wettlaufer’s lone murder victim outside Woodstock was Arpad Horvath, 75, at London’s Meadow Park nursing home. He was suffering from dementia and could be difficult, she told the court.
Handout
“Enough was enough,” she said, recalling an outburst by the patient.
Horvath tried to fight off the insulin shot she’d prepared.
“Eventually, I got it into him,” she said.
Dressed Thursday in a white shirt and black pants, Wettlaufer, 49, pleaded guilty to 14 charges in all involving people under her care — eight first-degree murders, four attempted murders and two cases of aggravated assault.
Her admissions mark the latest twist in one of the biggest mass-murder trials in Ontario history.
Police started investigating Wettlaufer last September after Toronto cops learned of information she’d given during a stay at a Toronto psychiatric hospital.
A month later, she was charged with killing eight residents of the two homes, seven at Caressant Care in Woodstock and one at Meadow Park in London, with police alleging she used drugs to kill seniors over a seven-year period ending in 2014.
Court documents, included in a search warrant obtained by The London Free Press, pointed to the administration of insulin overdoses to the patients.
Then, in January, six additional charges were laid against her related to seniors in her care. Court papers allege she injected them with insulin.
The murder victims are: James Silcox, 84; Maurice Grant, 84; Millard, 87; Matheson, 95; Mary Zurawinski, 96; Helen Young, 90; Maureen Pickering, 79; and Horvath, 75.
The four attempted murder victims are Wayne Hedges, 57; Michael Priddle, 63; Sandra Towler, 77; and Beverly Bertram, 68.
Charles Vincent/Special to Postmedia News
Wettlaufer is also guilty of aggravated assault against Clotilde Adriano, 87, and 90-year-old Albina Demedeiros.
Redacted court documents made public in March indicated Wettlaufer was fired from Caressant Care in Woodstock amid accusations of repeated medication-related errors. Her departure came just days after the last suspicious death there. Police search warrants indicated the nurse was frequently suspended from her job at the Woodstock home, where seven of the eight suspicious deaths happened.
Wettlaufer had been a nurse since August 1995 but surrendered her licence last September, simultaneous to the start of the police probe.
An advocacy group, the Canadian Association for Retired Persons (CARP), on Thursday called for a public inquiry into the state of long-term care facilities nationwide.
“It’s time something was done,” said Wanda Morris, the group’s vice-president of advocacy.
Morris noted inquiries were called after deaths at Toronto’s Sick Kids’ hospital and in Walkerton following that Ontario town’s fatal tainted-water crisis.
“Are those deaths worth more (than these seniors)” she said. “We have heard so many stories of neglect and abuse in long-term care facilities, and it’s time to make a change.”

— With files from Heather Rivers
*****
The government of Ontario orders an inquiry but in my experience based on the fatality inquiries on folks in both the child welfare and continuing care system in Alberta---this is simply a placebo solution.

The government of Ontario knows what it has to do which is more intensive auditing more frequently and publish the results for the public but instead of this we're going the other way.


But before we go into the reversal of the yearly auditing business by the government of Ontario--- here is the placebo public inquiry the Liberals called---that the folks at CARP say will be the necessary medicine for the system to swallow to get all well again. Baloney.

https://news.ontario.ca/mag/en/2017/06/statement-from-attorney-general-and-minister-of-health-and-long-term-care-on-a-public-inquiry-into-t.html

Statement from Attorney General and Minister of Health and Long-Term Care on a Public Inquiry into the Circumstances of the Elizabeth Wettlaufer Case

June 26, 2017 2:15 P.M.
Today Attorney General Yasir Naqvi and Minister of Health and Long-Term Care, Eric Hoskins, issued the following statement:
"On behalf of the Ontario government, we want to express our deepest condolences to the victims, their families and the communities in Woodstock and London and the surrounding areas.
What happened was a tragedy. That's why we are establishing an independent public inquiry to look into the circumstances in this case.
Our next step is to formally establish the public inquiry through an Order in Council. The order will set out the scope of the inquiry and appoint the commissioner who will lead it. The government is actively engaged in finalizing these details and, once approved, will make them available to the public.
We want to assure the public that Ontario's 78,000 long-term care residents are safe in their homes. Our oversight system in long-term care specifically focuses on the safety and security of our residents and we will continue to work to ensure all of our homes are meeting the highest standards.

It is our hope that through the inquiry process, we will get the answers we need to help ensure that a tragedy such as this does not happen again."
***
The irony of the statement issued by the government of Ontario is not lost on me. They say that folks are safe and yet right after they say this we have this case where a senior is beaten and no one would have known without the family protecting him. Yeah right.

Then mysteriously after ordering the public inquiry that won't solve anything but will give the appearance of the Liberals doing something other than sitting on their rumps --we  have the back pedalling on the audits.

http://nationalpost.com/news/canada/ontarios-move-to-scale-back-full-annual-inspections-at-nursing-homes-means-less-eyes-on-elderly-advocate/wcm/25fc44b5-20e0-4a73-a921-c8ac7d1565db

Ontario's move to scale back full annual inspections at nursing homes means 'less eyes' on elderly: advocate

Sources say provincial Liberals pulling the plug on yearly inspections at more than 500 homes, just three years after being found in violation of own law

Mark van Manen/Vancouver Sun
Postmedia News
June 27, 2016
11:12 PM EDT
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LONDON, Ont. — Three years after it vowed to do more to protect nursing home residents, Ontario’s Liberal government is quietly pulling the plug on yearly inspections at more than 500 homes, Postmedia News has learned.
Starting next week, 84 per cent of Ontario’s 630 long-term care homes will get a full inspection just once every three years, and a “light inspection” the other two years, say sources that include the Ontario Long Term Care Association, which met last Thursday with bureaucrats in Ontario’s Health Ministry.
In the years that they don’t get full inspections, homes will face inspectors with half the manpower, half the time and new limits on what they can do, sources say. Whereas full inspections involve three or four inspectors and last two weeks, the “light” versions will involve just two inspectors for five days.
Inspectors interview 40 residents at full inspections but will be able to question only 20 residents and will no longer be permitted to interview family council members during “light” inspections.
Many of the key activities inspectors formally observe in full inspections will also be out-of-bounds, including security, emergency plans, quality improvement, staffing levels, personal support services, dining, home responses to aggressive residents, hospitalization and changes in health conditions.
The changes please Candace Chartier, chief executive of the Ontario Long Term Care Association, who said the annual inspections drained too much time and resources from nursing homes and the ministry alike. The time saved can be used in other ways to improve care, she said.
Bruno Schlumberger/The Ottawa Citizen
But an advocate for the elderly says the Liberal government has taken a step backwards from its 2013 pledge to protect residents of nursing homes.
“I’m very concerned about the changes,” said Jane Meadus of the Toronto-based Advocacy Centre for the Elderly. “There will be more issues at homes because there will be less eyes on those homes.”
The changes in how Ontario will inspect nursing homes landed in the lap of Health Minister Eric Hoskins two weeks ago, when Premier Kathleen Wynne shuffled her cabinet and assigned him responsibility for nursing homes that had been looked after by an associate minister, Dipika Damerla.
Asked by The London Free Press if fewer full inspections would harm residents of nursing homes, Hoskins issued a statement, saying that changes were needed but nothing had been finalized — the latter claim at odds with what the Long Term Care Association said it was told by ministry officials at last week’s meeting in Mississauga.
“Our government is committed to ensuring that Ontario long-term care homes are both safe and accountable, (which) is why we mandated annual resident quality inspections in every home and in the past year added 100 new inspectors,” Hoskins wrote.
“Moving forward, all long-term care homes will continue being subject to an annual (inspection). We are currently working with our inspection team and consulting with external partners on ways that we can strengthen this program.”
Bartek Sadowski/Bloomberg
But Meadus suspects the scaling back of inspections is about cutting costs — the ministry doesn’t have enough inspectors and doesn’t want to spend more to hire more.
“It’s because they are not able to (do full, annual inspections) with the staffing they have,” she said.
It’s not the first time a Liberal health minister has been singed defending how nursing homes are inspected.
Hoskins’ predecessor, London North MPP Deb Matthews, claimed for nearly a year that no full inspections were required even though her government passed a law in 2010 that required just that.
Matthews reversed course in 2013, announcing the ministry would spend $12 million to more than double the number of inspectors.
“We’re renewing our commitment to annual, proactive inspections, and adding enough new inspectors to get the job done,” she said at the time.
But the additions weren’t enough. While each home received a full inspection last year, that stretched inspectors so thinly they delayed by months investigations into critical incidents and complaints by some of the homes’ nearly 78,000 residents.
Backlog of inspections triggered by complaints and critical incidents doubled between December 2013 and March 2015
“Backlog of inspections triggered by complaints and critical incidents doubled between December 2013 and March 2015, from 1,300 to 2,800,” Ontario Auditor General Bonnie Lysyk wrote last year.
Lysyk also noted the ministry had inspected many homes with better track records before it inspected those with worse track records. She suggested priorities should be switched and recommended analyzing how frequently full inspections should be done.
But rather than inspect higher-risk homes more often, the ministry has opted to inspect so-called lower-risk homes less often — a perilous decision, Meadus said, because it’s difficult to determine which homes are the riskiest.
Some homes trigger fewer complaints because vulnerable residents can’t speak up for themselves. “It’s very difficult to tell, based on statistics where the problems lie,” she said.

• Email: jsher@postmedia.com | Twitter:
****
I don't understand why audits would consume so much time for facilities in the Ontario long term care system. If the facility is in compliance would this not mean that there would be very little to do? It's puzzling and seems like a response designed to cover the exposed behinds of the Liberals as they go into a provincial election. There is nothing like seeing abused seniors in the care of the system to get voters riled up.


In any case, folks in Ontario who are seeing this move by government as a copy cat of the secrecy business in Alberta aren't staying silent. But soon after they got the bad news that the government of Ontario was caving into lobbying by the Ontario Long Term Care Association the folks in Ontario find out how traitorous the government hires can actually be. Not only are doing fewer inspections they are also doing less revelations of the problems.


http://www.lfpress.com/2016/06/30/health-ministry-wont-disclose-which-long-term-care-homes-get-full-inspection

Health Ministry won't disclose which long-term care homes get full inspection

By Jonathan Sher, The London Free Press
Thursday, June 30, 2016 4:36:09 EDT PM
Earls Court Village at 1390 Highbury in London, Ont. on Wednesday May 25, 2016. 
Mike Hensen/The London Free Press/Postmedia Network
Earls Court Village at 1390 Highbury in London, Ont. on Wednesday May 25, 2016. Mike Hensen/The London Free Press/Postmedia Network

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Just 11 days before Ontario’s Liberal government scales back inspections at more than 500 nursing homes, its Health Ministry has lurched toward darkness and secrecy, saying Thursday it will not disclose which homes get full inspections and which do not.
The decision came hours after the ministry said it would delay disclosure until it finalized which homes get a full inspection only once every three years.
“I would also like to update some of the previous information given to you. We will not be releasing information on the classification of long-term care homes,” ministry spokesperson David Jensen wrote in an email to The Free Press.
It also appears the ministry may not disclose on public inspection reports whether a probe was the full deal or the scaled-back version — Jensen didn’t know what was planned.
The secrecy over nursing home inspection isn’t new: Ontario Liberals said nothing of plans to scale back inspections until questioned by The Free Press, which learned about it from sources.
Under those plans, more than 500 of the province’s 630 nursing homes were designated as low risk and would undergo a full inspection only once every three years.
The other two years, those so-called low-risk homes would get what inspectors and home operators are calling a “lite” inspection with one-quarter the manpower and no formal scrutiny of a wide range of key issues, from security to staffing.
Asked which homes had been deemed low risk, Jensen initially wrote, “It would be premature to release any information until the classification of the long-term care homes is finalized.
The claim seems odd: Inspectors have been assigned lite inspections in July and August as early as July 11, sources say. And the Ontario Long-Term Care Association says it met June 23 with Health Ministry officials and was told that 84 per cent of Ontario’s 630 long-term care homes had been classified low risk.
Just how nursing homes are classified remains murky. The Free Press asked the Health Ministry to explain how homes were classified but the ministry didn’t respond.
The secrecy comes three years after former health minister Deb Matthews went public with plans to more than double the number of inspectors so that all nursing homes would get a full, annual inspection.
“We’re renewing our commitment to annual, proactive inspections, and adding enough new inspectors to get the job done,” she said in 2013.
Matthews ordered the annual inspections after insisting for nearly a year they weren’t required — a claim The Free Press showed contradicted internal government documents.
But the new inspectors weren’t enough. Though each home received a full inspection last year, that stretched inspectors so thinly, they delayed by months investigations into critical incidents and complaints, a problem highlighted by Ontario Auditor General Bonnie Lysyk.
As to the most recent secrecy, the Health Ministry said it would not disclose the risk levels of nursing homes because those assessments may change over time. “This information is constantly changing as the risk level of long-term care homes is continually assessed and adjusted to respond to on-going inspection results and other contributing information,” Jensen wrote.
The changes to inspections were made after lobbying by owners and operators of nursing homes.
“We’re very pleased the Ministry of Health listened to our sector,” Candace Chartier, the chief executive of the Ontario Long-Term Care Association, said in June. Annual inspections drain too many resources from nursing homes and the ministry alike, she said, and the time saved can be used to improve care.
The Toronto-based Advocacy Centre for the Elderly warns fewer full inspections will cause more problems for vulnerable people who live in nursing homes, and that the changes are meant to save money, not to protect more than 78,000 residents in nursing homes.
The province should inspect higher-risk homes more often rather than lowering the bar for lower-risk homes, because it’s difficult to determine which homes are the riskiest, the advocacy centre says.
Concerns about care in nursing homes were heightened in London after two facilities were recently rocked by regulators: Registered practical nurse Susan Muzylowsky admitted mistreating 19 residents at Mount Hope Centre in 2014, telling one: “You haven’t seen rough yet. I’ll give you something to cry about."
Earls Court Village was ordered to stop taking new residents after inspectors found 37 violations, many endemic since the facility opened in 2014.
jsher@postmedia.com
Ontario’s Health Ministry will scale back inspections of 84 per cent of the province’s 630 long-term care homes. Instead of a full inspection every year, they’ll get one every three years. In the other two years, inspectors will do a “lite” inspection, as follows:

  • Two inspectors will visit the home, rather than three or four.
  • Inspections will last five days, rather than two weeks.
  • Inspectors will interview 20 residents, rather than 40.
  • Lite inspections won’t examine many areas probed by full inspections, including security, emergency plans, quality improvement, staffing levels, personal support services, dining, home responses to aggressive residents, hospitalizations and changes in health conditions.

****
So this is getting so confusing. Let me try to clear the government thicket from my mental landscape.

1) Earlier than 2013 the government of Ontario was found to be non-compliant with its own requirement to do annual inspections.
2) In 2013 the government says it has hired more inspectors and will do the annual inspections.
3) In 2017 after horror stories emerge in the media we have the Liberals pulling up their socks to deliver an obligatory public inquiry to soothe the fears of the ageing populace that may soon end up in the continuing care system.
4) Soon after the public inquiry is order the Liberals fold in response to the industry:
http://www.lfpress.com/2016/06/30/health-ministry-wont-disclose-which-long-term-care-homes-get-full-inspection

http://www.lfpress.com/2016/06/30/health-ministry-wont-disclose-which-long-term-care-homes-get-full-inspection

The changes to inspections were made after lobbying by owners and operators of nursing homes.
***

So isn't the latest about face by the Liberals contrary to their public promises of good oversight?

It is getting muddy in my head.
5) And then from this article I find out about yet another case of abuse in the system:

http://www.lfpress.com/2016/06/30/health-ministry-wont-disclose-which-long-term-care-homes-get-full-inspection

Concerns about care in nursing homes were heightened in London after two facilities were recently rocked by regulators: Registered practical nurse Susan Muzylowsky admitted mistreating 19 residents at Mount Hope Centre in 2014, telling one: “You haven’t seen rough yet. I’ll give you something to cry about."
Earls Court Village was ordered to stop taking new residents after inspectors found 37 violations, many endemic since the facility opened in 2014.
****
I will have to stop here as I am completely mystified by the ostensible willingness of the Liberals to protect the most defenceless citizens in the long term care system which is completely contradicted by their actions of reducing the number of audits, limiting them to "high risk" facilities (how do you know which facility is high risk?) and then their final decision to go the secrecy route of Alberta.




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