Testimonial | Our healthcare system is abandoning the dying old people

“Don’t worry about me, sweetie,” my mother often told me when I visited her during one of her frequent hospital stays. This is also what she told me this time, but her voice was much lower, more mushy than the times before. A few days later, on October 25, 2021, in a large hospital in the metropolis, my mother, Paule Pratte, 99 years old, died.



André Pratte

André Pratte
Director at the firm Navigator and “senior fellow” at the Graduate School of Public and International Affairs of the University of Ottawa

During her last days, I took care of her as best I could, very imperfectly. The health system took care of her in the same way that we deal too often with dying old people, or with the most perfect indifference.

Our Prime Minister, François Legault, often says that we must take care of the elderly who, he rightly emphasizes, “built Quebec”. Do we really take care of it when death approaches? The experience of my mother-in-law, who also died in hospital this year, and that of my mother allow me to doubt it. Of course, there is medical assistance in dying, which allows you to “die with dignity”. Of course, there are palliative care homes.

But what about the many old men and women who, for one reason or another, do not have access to this kind of care?

It happens that they suffer martyrdom, like my mother-in-law, because doctors and nurses, following an ultra-rigid protocol, do not manage to relieve the pain. Or it happens that their last days are spent in a double room, the other bed occupied by a man suffering from diarrhea, on a floor where some of the professionals spend much more time in front of their computer than providing “comfort care”. To a 99 year old.

“Comfortable care”, insisted the doctors, avoiding the words “palliative care” at all costs. They knew what death awaited my mother.

According to the World Health Organization, “the objective of palliative care is to obtain, for users and their families, the best possible quality of life”. This is not what my mother-in-law, my mother and their relatives went through.

My mother died alone, between the visit of a son in the morning and that of the other son, scheduled for the afternoon. I would have liked so much to be there to hold his hand during his last efforts to breathe …

A bit of humanity

During his stay of more than two weeks in the hospital, several doctors, nurses and orderlies appeared absent and cold. It is true that they are overwhelmed and monopolized by the most serious or the most vociferous cases. On the last Sunday there was only one nurse for the whole floor. But all the same, a little humanity?

My mother would spend hours moaning in bed, ripping off the jacket, probes and needles. In order for someone to deign or be able to stick their nose in the door, you had to press the help button. Help arrived 10 to 15 minutes later in the form of an attendant who could do nothing but inform the nurse, who would arrive another 15 minutes later. Thirty minutes of moaning in pain, discomfort or fear is a long time. Especially when those minutes are among the last of your life.

Indifference

We have designed a health system in which large areas remain frozen in the face of the physical and psychological suffering of the dying old people. “What destroys the world is indifference,” sang Bécaud, which my mother introduced me to at the Palais Montcalm, 50 years ago.

Indifference. Take a trip to the emergency room of any hospital. You will undoubtedly find a few old men there, emaciated at the bottom of their stretcher, stationed along a wall.

Old people completely lost in these establishments as complex in their architecture as in their bureaucracy. Old men that no one comes to visit.

Indifference. How else to explain that the management of the COVID-19 pandemic in Quebec was declared “successful” when thousands of old people died, abandoned, in CHSLDs and residences? This is not to blame Mr. Legault or his health ministers. It is about admitting that all of us collectively should be ashamed of having failed so miserably. Above all, we must admit that this failure is not an isolated case, but is symptomatic of the way we treat the old dying today.

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