Seniors arriving at hospitals from CHSLDS are dehydrated, malnourished
Last week, Charna Bonin’s 89-year-old mother, Alyne Singerman, tested positive for COVID-19 and was admitted to the Jewish General Hospital with dehydration, among other symptoms.
The case of Singerman — who was transferred from the Donald Berman Jewish Eldercare Centre — appears to be typical of patients arriving from CHSLDS. According to information received through nearly a dozen interviews with the families of patients, doctors and advocates, short staffing is to blame, as patients who need help feeding themselves are often not getting that assistance.
“At the hospital, we’re seeing patients (from CHSLDS) arriving completely dehydrated and with kidney deficiencies because they haven’t had enough to drink for several days,” Vinh-kim Nguyen, an emergency doctor at the Jewish General Hospital, told the Journal de Montréal on Thursday.
Now, a week later, Singerman’s hydration levels have returned to normal, and her condition appears to be improving. Bonin says doctors have said they would like Singerman to be transferred back to the Jewish Eldercare. However, that’s a nightmare scenario for her, as staffing levels at the centre have not drastically improved, despite promises by Premier François Legault that more doctors and nurses would be sent as reinforcements this week.
“It’s a miracle that they’re even improving, these 90 year olds, and now they want to send her back to the epicentre? I’m begging (for her to stay in the hospital),” Bonin said.
The son of another patient from Eldercare said his mother was also admitted to the hospital for treatment of COVID-19. However, the only real treatment she received was an IV drip to rehydrate her, and a nurse who would sit with her and help her eat meals.
“The doctors told us (she was malnourished),” said the man, who didn’t want to be identified for fear that his mother would face discrimination. “It could have been a function of the fever, but it could have also been that she just wasn’t eating or drinking.”
He said his mother was on oxygen treatment while in her residence, and she arrived at the hospital with severe dehydration, high sodium levels and organs that were shutting down. Within a few hours of being admitted to the hospital, she no longer needed the oxygen, and her condition improved tremendously. She was transferred back to Eldercare five days later.
“I think she ended up in the hospital because she was rejecting her food, and they assumed it was because of the COVID,” he said, adding that he fears that if staffing levels at the Eldercare don’t improve, the situation will repeat itself and his mother will have to be transferred back to the hospital.
Mario Giambattista said his mother Raffaela, 75, — who was living at the St. Andrew’s long-term care centre on Cavendish Blvd. in Notre-dame-de-grâce — seemed unresponsive when he organized a Facetime call on April 15 to wish her happy birthday.
She was sent to the Jewish General later that day, and also rehydrated with an IV. Nurses had told Giambattista it had taken his mother 45 minutes just to finish a piece of banana.
“We’ll never know if she was fed and hydrated properly,” said Giambattista’s wife, Cecilia, adding that communication with staff had been spotty since the centre barred all visitors last month.
Raffaela Giambattista died of complications of the illness on Wednesday night.
The stories are all too familiar for Lucio D’intino, a board member of the Regroupement provincial des comités des usagers, which represents users’ groups at health establishments throughout the province.
“We are hearing the services in some places simply isn’t there because there’s not enough staff,” he said. “People need help (to eat) and the service just isn’t being given to them.”
He said the staffing levels at long-term care centres have been so dire, that patients aren’t getting even their basic needs met. He has heard of patients going weeks without a bath.
“The situation is deplorable,” he said. “The dignity of these patients is totally gone, and their rights have been totally violated.”
Speaking for the Jewish Eldercare Centre, Dr. Mark Karanofsky explained that the virus itself causes dehydration and loss of appetite, and that has added to the workload of a staff that’s already overloaded.
“You end up with people who would normally be able to eat, all of a sudden need to be fed,” he said. “The staff do as much as they can, and part of (patients being dehydrated) was staff (shortages), and part of it was the virus. How much of each? I don’t know.”
He said staffing levels are improving.
“It’s still tight; I won’t lie, but it’s better than it was three days ago, and better than it was a week ago,” Karanofsky said.
Dr. Mitch Shulman, an emergency room physician at the Royal Victoria Hospital, said he is also seeing a lot of elderly patients presenting with dehydration, but he can’t say whether it’s the virus or malnutrition that is to blame.
“The disease itself really does set you up for profound dehydration, either because of the fever, or the fact that you are feeling sick, and you don’t feel like eating or drinking, or if you’re having nausea, vomiting and diarrhea,” Shulman said.