Nurs­ing home deaths re­vealed

To­tal of 11 sim­i­lar cases have oc­curred since 2008

Cape Breton Post - - Cape Breton / Province -

Newly re­leased coro­ner’s re­ports have re­vealed two pre­vi­ously un­re­ported deaths of Nova Sco­tia nurs­ing home res­i­dents injured when they were pushed down by res­i­dents with de­men­tia.

The cases, ob­tained through a free­dom of in­for­ma­tion re­quest to the med­i­cal ex­am­iner, bring the num­ber of such deaths since 2008 to 11 in the prov­ince.

“Those num­bers are con­cern­ing,” said Eilon Caspi, a geron­tol­o­gist who has re­searched res­i­dent-on-res­i­dent nurs­ing home abuse for 25 years in Canada and the United States.

“Would we ac­cept a few deaths a year if we were talk­ing about tod­dlers in a child care set­ting?’’

The two newly re­vealed deaths, both since Jan. 1 last year, are the lat­est ex­am­ples of such fa­tal­i­ties oc­cur­ring with­out the Health De­part­ment or po­lice no­ti­fy­ing the pub­lic.

A third death dur­ing that pe­riod did be­come pub­lic: the case of 79-year-old Gor­don Birchell was re­ported last year to The Cana­dian Press by a fam­ily friend and later con­firmed by the RCMP.

Last year, The Cana­dian Press pub­lished re­ports of eight deaths since 2008 and found five had never been re­vealed to the pub­lic ei­ther by po­lice or the prov­ince, and that one case wasn’t in­ves­ti­gated by the Health De­part­ment un­til the pub­lic rev­e­la­tions.

The lat­est cases oc­curred at Har­bour View Haven in Lunen­burg, while the other was at the Shan­nex Or­chard fa­cil­ity in Kentville, with no po­lice news re­leases in ei­ther case to in­form the pub­lic that homi­cide in­ves­ti­ga­tions were launched and later dropped.

The heav­ily edited re­ports say that in one case, “the dece­dent was found on the floor by nurs­ing home staff after suf­fer­ing a fall ... an­other client was seen push­ing dece­dent caus­ing (name redacted) to fall.’’

In an­other case, the per­son who died was “pushed by an­other res­i­dent ... fell on the floor strik­ing (name redacted).’’

Dr. Matthew Bowes, the chief med­i­cal ex­am­iner, said in an email he’s re­viewed the cases and based on com­ments from in­ves­ti­ga­tors he be­lieves all of the cases are “de­men­tia re­lated,’’ adding he isn’t au­tho­rized to re­view the med­i­cal records of the people who pushed the res­i­dents.

Nei­ther home re­turned calls and emails re­quest­ing fur­ther in­for­ma­tion.

Caspi said the con­tin­u­ing flow of push­ing deaths shouldn’t be re­garded as normal or un­avoid­able: “This is dev­as­tat­ing for fam­ily mem­bers.’’

Caspi has fol­lowed some of the deaths in Nova Sco­tia, and in an aca­demic jour­nal ar­ti­cle he quoted from the case of Dorothy Stultz, who died when a male res­i­dent with de­men­tia pushed her to the ground in 2012.

After the case was pub­li­cized, Stultz’s daugh­ter crit­i­cized the prov­ince for fail­ing to in­ves­ti­gate.

The toll of push­ing deaths has qui­etly con­tin­ued since last year’s rev­e­la­tions, along with pub­lic crit­i­cism of the nurs­ing home sys­tem’s over­sight of people who have ag­gres­sive out­bursts.

Birchell’s wife told The Cana­dian Press she per­son­ally wit­nessed the at­tack on her hus­band by an el­derly woman with de­men­tia, and said it came after pre­vi­ous in­ci­dents of the same res­i­dent go­ing after her spouse.

Caspi said re­search sug­gests higher staffing lev­els and im­proved pro­grams at nurs­ing homes can help re­duce res­i­dent-on-res­i­dent abuse, as leav­ing res­i­dents alone and with­out ac­tiv­ity can in­crease their ag­gres­sion.

He added that pre-as­sess­ments of res­i­dents need to be thor­ough and up­dated in or­der to as­sist staff in tak­ing pre­ven­tive steps to avoid mix­ing people in­ap­pro­pri­ately.

“We need to raise aware­ness and train staff to min­i­mize this,’’ he said.

Mary MacDon­ald, ex­ec­u­tive di­rec­tor of risk mit­i­ga­tion in con­tin­u­ing care in Nova Sco­tia, said the prov­ince has 11 con­sul­tants who are ex­perts on chal­leng­ing be­hav­iour who can coach and train fa­cil­ity staff.

Nurs­ing home staff can also re­ceive in-ser­vice train­ing on the ways chronic ill­nesses af­fect be­hav­iour in the el­derly, de­men­tia care and non-vi­o­lent in­ter­ven­tion, said MacDon­ald.

She said she was un­aware of how many staff in the li­censed homes have re­ceived this train­ing.

“These in­ci­dents are ex­tremely tragic and they’re all taken very, very se­ri­ously. We fol­low up with cor­rec­tive ac­tion,’’ she said dur­ing an in­ter­view.

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