Montreal Gazette

Alzheimer’s patient ‘essentiall­y homeless’

- AARON DERFEL

A Côte-St-Luc resident suffering from Alzheimer’s disease has been expelled from the Maimonides Geriatric Centre for aggressive behaviour despite the centre’s own Code of Ethics, which promises to “Provide assistance and protection to users when they demonstrat­e behaviour that is dangerous to themselves or those around them.”

The man was transferre­d more than two weeks ago to the Jewish General Hospital — whose mandate is to provide acute care, not long-term psychiatri­c attention to those with dementia.

The man’s family is blaming budget cuts for Maimonides’s decision to transfer him out, and they’re worried that he’ll be stuck in limbo at the Côte-des-Neiges hospital.

“It’s outrageous and disgusting,” said Michael Birnbaum, the man’s son.

“I think they’re used to older, less mobile individual­s at Maimonides and my dad is relatively young at 71.”

Birnbaum, a psychiatri­st who practises in New York City, despaired that his father is now “essentiall­y homeless.”

“As a psychiatri­st, I know exactly what happens with the elderly who are aggressive,” Birnbaum added. “They sort of play PingPong (with these patients) between the emergency room, the in-patient unit and the nursing homes.”

The plight of Birnbaum’s father highlights the struggles of Quebec’s long-term care centres, which have been criticized by the provincial ombudsman for systemic mistreatme­nt of patients.

The case also underscore­s the difficulti­es in caring for patients with dementia who are aggressive, with research showing 30 to 90 per cent of such individual­s suffer from behavioura­l disorders ranging from anxiety psychosis to disinhibit­ion involving sexually inappropri­ate gestures.

Birnbaum noted his father was admitted to a behavioura­l unit at Maimonides in September. About 85 per cent of the residents at the government-run facility have some form of dementia.

Despite knowing of his father’s sometimes aggressive behaviour, the medical staff at Maimonides never adjusted his medication, Birnbaum said.

“In his entire time there, they never once had him seen by any psychiatri­st who could adjust his medication. During one family meeting, they articulate­d that there are essentiall­y limited (financial) resources.”

Birnbaum declined to have his father’s name published because of the sensitivit­y of the issue.

Maimonides is overseen by an umbrella health authority known as the West-Central Montreal CIUSSS. The CIUSSS is also in charge of the Jewish General.

Carl Thériault, a spokespers­on for the CIUSSS, did not respond to a series of emailed questions about Birnbaum’s father.

“In compliance with the Quebec law on protecting patient confidenti­ality, we are unable to comment,” Thériault said in an email on Friday.

Birnbaum shared with the Montreal Gazette correspond­ence between his family and the CIUSSS confirming that his father was expelled from Maimonides.

“Please know that any decision to close a resident’s bed while they are admitted to acute care is not taken lightly,” says a Jan. 9 email by Jennifer Clarke, a Maimonides co-ordinator, to Birnbaum about his father.

“I am also very sorry that you feel that we did not provide the care you expected at Maimonides,” Clarke added, suggesting that Birnbaum’s

During my father’s whole life, he’s been this wonderful, lovely, sweet, kind man … but the disease has really taken a toll on him.

family could file a complaint with the ombudsman’s office.

Birnbaum hopes that his father, who had worked as an engineer, can find placement at the Jewish Eldercare Centre on Victoria Ave., also overseen by the same CIUSSS.

“During my father’s whole life, he’s been this wonderful, lovely, sweet, kind man who would never do or say a bad thing to anybody, but the disease has really taken a toll on him,” Birnbaum said.

“The one thing left is his religion, and I’m hoping he can go to Eldercare for the last few years of his life.”

Thériault, of the CIUSSS, did not respond to a question about whether Birnbaum’s father could be transferre­d to that institutio­n. aderfel@postmedia.com Twitter.com/Aaron_Derfel

 ?? JOHN MAHONEY ?? A man’s family is blaming budget cuts for the fact he was kicked out of Maimonides. They say his Alzheimer’s made him aggressive at times, which can be difficult to manage.
JOHN MAHONEY A man’s family is blaming budget cuts for the fact he was kicked out of Maimonides. They say his Alzheimer’s made him aggressive at times, which can be difficult to manage.

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