`HE DIED FROM NEGLECT': A FAMILY'S FIGHT FOR ACCESS AMID COVID RESTRICTIONS
“When COVID happened, it was our worst nightmare ever,” said Krystell Peralta.
Long before the pandemic, her family and others had complained about the quality of care residents were getting at George Pearson Centre, a long-term care home owned and operated by Vancouver Coastal Health for people with complex care needs.
Krystell's brother lived there and, on Aug. 23, he died in hospital of dehydration and multiple infections. Kevin Peralta was only 28.
Five years earlier, an inoperable brain tumour had rendered him immobile and unable to speak. He was able to communicate by blinking in response to questions. The Peraltas knew Kevin's death was inevitable. But they're heartbroken and outraged about his suffering during the final months and days.
“My brother didn't die from his ( brain) tumour,” said Krystell. “He died from neglect, lack of care and definitely loneliness.”
Before his diagnosis in 2015, Kevin was studying biochemistry at SFU and preparing to write the Medical College Admission Test.
The slow-growing tumour was too close to his brain stem to be completely removed, but re-sectioning surgery had been expected to give him another two decades of life.
But it didn't. Instead, the tumour came back aggressively. By August 2016, when the once-vibrant, competitive hip-hop dancer moved into GPC, he was immobile and unable to speak. Kevin had a feeding tube and a tracheotomy.
He had diabetes and, with the tumour sitting on his pituitary gland, he urinated frequently putting him at risk of dehydration or, conversely, a urinary tract infection if his urine bag wasn't drained frequently.
Until pandemic restrictions locked down B.C. care homes in March, Kevin's parents, Cres and Florencio, visited every week day after work from 3 p.m. to 9:30 p.m. Every weekend, they were there from 1 p.m. to 9 p.m. Krystell, a cardiac care nurse, visited when she wasn't working.
“If it wasn't for my nagging and advocating for my brother to the care staff, if my parents weren't there daily to see their son's condition,” she said, “Kevin would've died sooner.”
In an emailed statement, Vancouver Coastal said patient privacy and confidentiality prevented any direct response to the Peralta family's concerns.
VCH offered condolences and went on to say that it takes seriously all concerns raised by patients.
But Krystell said whenever she tried to advocate for Kevin, GPC staff tried to silence her.
She was told that she was “too intense” and that as a nurse she should be quiet, knowing how hard the job is.
The siblings were closer than most. When we spoke by phone, she was visiting his gravesite at Fraser Mountain View Cemetery.
Krystell was 10 and Kevin only five in 1998 when the family immigrated to Vancouver from the Philippines. When he was diagnosed with a brain tumour, Kevin designated her as his temporary substitute decision-maker.
When the lockdown happened, the Peraltas' initial request to be deemed as essential visitors due to Kevin's terminal diagnosis was denied.
But in mid-June, after submitting letters from Kevin's neurosurgeon and having emailed pleas to Dr. Bonnie Henry and Health Minister Adrian Dix, GPC's administrator Romilda Ang allowed Kevin's parents to visit three days a week for an hour.
Krystell, however, was not allowed in. She was told that it was because she worked in a hospital. But at the end of July, Krystell was finally allowed in as a “social” visitor twice a week for an hour.
On one of her first visits, she pointed out to staff that her brother's ear was swollen and red, and there was a crusted discharge. Nothing was done about it.
On Aug. 14, Kevin vomited while she was there. Later that day, when his parents arrived, their son was covered in vomit that was clogging his tracheotomy tube.
He was taken to emergency and after two days and some antibiotics for aspiration pneumonia, Kevin was sent back to GPC.
Three days later, his ear was worse. His vital signs were poor and dropping. Kevin was sent unescorted by ambulance back to emergency. A day later, the family agreed that Kevin should be moved to comfort care.
At least there, they reasoned, they would be able to stay with him, hold his hand and ensure that his pain was managed. He died peacefully three days later.
Only after Kevin died did the Peraltas find out that they hadn't been alone. Other families had also raised the alarm about GPC's quality of care and, out of fear for their loved ones' health and safety, had also been begging to be deemed essential visitors. Most never complained. Some like Krystell and Agnes Cayer who did say they were bullied and believe that their loved ones may have suffered as a result.
After the lockdown, Cayer's brother, Eric Wegiel, went to hospital three times in 30 days with three different kinds of infections.
After that, GPC allowed a camera to be mounted in his room so the family could monitor his care during the lockdown. But often it didn't work because staff kept covering it with towels.
After Kevin's funeral, Krystell sent a lengthy email to Vancouver Coastal Health's Patient Care Quality Office.
Tristin Wayte responded that he was sorry to hear about Kevin's death. But he went on to write: “The language you use below (in the email) is very harsh and judgmental and I'm concerned that you might be looking for some kind of retribution.
“I know you've received this kind of feedback before about your communication style from my office and from the sounds of it below, from GPC as well.”
Coincidentally, the day after I spoke to Krystell, ombudsperson Jay Chalke released his 42-page report, Guiding Principles for an Effective Complaint Resolution System.
Fear of retaliation, being labelled a troublemaker, being unable to speak for oneself because of language barriers or disability are all key reasons why Chalke said only a small percentage of British Columbians complain about any public institution, let alone long-term care homes.
Because of those barriers “a single complaint should not be dismissed as an anomaly or as unrepresentative,” Chalke wrote.
Instead, he said a single complaint ought to “be understood as potentially representing the unvoiced concerns of a larger number of silent, but dissatisfied, service users.”
When Krystell read what Chalke had written, she cried.
“Every time they (GPC administrators and staff) called me a bully for complaining, I tried to explain to them that my complaints were on behalf of my brother and should be taken as constructive criticism to improve the care for my brother and for everyone,” she said.
“What I ultimately want and what Kevin would want is improvement of care for all residents but especially the ones who don't have a voice.
“It's so easy to just forget about them.”