The “systemic ageism” and the obsolescence of the facilities created “a perfect storm” in the CHSLDs, according to an expert who came to testify Monday at the hearings of the coroner Géhane Kamel on the deaths of elderly or vulnerable people that occurred in social settings. accommodation during the first wave of COVID-19.
“The CHSLDs have been in the blind spot of this crisis,” lamented the former Minister of Health under the government of Pauline Marois, Dr Réjean Hébert.
The specialist in gerontology, now professor in health policy evaluation at the University of Montreal, recalled that “almost 10% of patients in CHSLDs died of COVID-19” during the first wave, a rate five times greater than that of Canada.
He explained this “massacre” by the fact that care for the elderly is “the poor relation” of the health system, despite an increasingly aging population.
Even before the pandemic, “there was a shift towards other priorities”, creating “an insufficient ratio of nurses” and “an exodus of doctors”, according to him. Result: the CHSLDs were not able to provide acute care, so patients in distress were transferred to hospital, a move often “extremely difficult” for those with cognitive disorders.
He also cited “multiple bedded rooms”, “shared bathrooms,” “inadequate ventilation” and “poor air conditioning” as killers during the pandemic.
Blind spot
But what scandalized him the most was the indifference he perceived on the part of the population. “We’ve heard all kinds of things, we’ve heard people suggest that the elderly self-confine themselves, as they were the ones who were at risk, so why should the rest of the population suffer? We have not seen an “Old Age Matters” movement, we have not seen the dismissal of school directors. “
According to him, this apathy was also present among decision-makers, while “the minister’s crisis committee did not even have a representative from the elderly sector” and all resources were diverted to hospitals, in particular masks and screening tests.
The transfer of many patients from hospitals to CHSLDs already overloaded in order to empty hospitals, in addition to “the prohibition of visits by family caregivers”, who nevertheless performed “important” tasks, were according to him the last. nails in residents’ coffin.
The context of the investigation
The coroner’s inquest is looking into the deaths of elderly or vulnerable people in residential settings during the COVID-19 pandemic, which account for half of the victims of the first wave.
During this period, from February 25 to July 11, 2020, Quebecers aged 70 and over accounted for 92% of deaths due to COVID-19, according to data from the INSPQ.
Its objective is not to identify a culprit, but to formulate recommendations to avoid future tragedies.
Six CHSLDs and a retirement home were designated as a sample. One death was examined for each establishment. Since Monday, the coroner has been looking into the provincial management of the crisis.