By Pauline Kerr
The final report from the inquiry into the murders of longterm care patients by nurse Elizabeth Wettlaufer was released last week. We can only hope the recommendations about increased staffing and better control over medication will save other families from the heartache of having a loved one murdered in a long-term care facility. In the days leading up to the report’s release, questions were asked about Wettlaufer, as they have from the moment she was arrested. The focus wasn’t on why she did it, but how she got away with it for so long. Now we know. She got away with it and would have continued killing had she not confessed. There was literally nothing in place to stop her. Keep in mind, Wettlaufer was no Florence Nightingale. Her personnel file was filled with numerous medication errors and problems with other staff and patients. The reason she kept her job? She was a registered nurse willing to work nights in a desperately understaffed long-term care facility. It’s no secret nursing homes are chronically short-staffed and inadequately funded. We’ve seen it right here in Bruce County, at Brucelea Haven. The problem didn’t happen overnight. Everyone has known for years the bulge in the hose known as the post war baby boom would inevitably affect long-term care, just as it had education and housing decades ago. The response of successive governments was not to put plans in place to deal with the situation but to go on with business as usual, cutting budgets where they could and pouring cash into whatever would get them votes. That wasn’t long-term care facilities. The fact is, health care is expensive, and the most expensive type of health care is in-patient facilities. A couple of decades ago, there was a shift to close beds and hospitals. To put it simply, drop-in clinics were cheaper than emergency departments. A mix of good medication and social workers was cheaper than mental hospitals. And a system of visiting nurses and homemakers was cheaper than chronic care wards. It worked reasonably well in cities, considerably less so in rural areas, but it never worked anywhere the way it was supposed to, for a lot of reasons. Doctors like practicing in hospitals, where they have a full range of support staff and equipment, as well as colleagues to consult. Hospital nurses and other staff get better pay and working conditions than those who work in the community. Some patients really do need treatment in a hospital. And looking after the elderly has never been a highly respected or well paid job in our culture. What happens when someone needs hospitalization in a system that demands he or she be cared for in the community? We have mental patients deemed a risk to the public walking away on day passes. In one recent case, a man who murdered his roommate boarded a plane and left the country. What happens when a person with complex medical needs is sent home from hospital without adequate preparations or homecare? They get re-admitted, sicker than ever and placed in longterm care. And what happens when a whole lot of people are reaching a point where they simply can’t remain in their own homes and need to be in nursing homes? The homes get crowded. There are waiting lists. Desperate families may place their loved one in a facility a long way from home because it’s the only bed available. Staff find themselves caring for more, and sicker patients and they either burn out or get a better paying hospital job. Or they get sloppy, maybe dangerously so. Managers sometimes look the other way rather than take on a power ful union or try to replace someone when they know full well they can’t. Add to this the fact that deaths at nursing homes are the norm, not the exception, and they aren’t investigated the same as other deaths. And everyone hopes nothing will happen, that someone like Elizabeth Wettlaufer isn’t looking for a job at their local nursing home. So-called angels of death – healthcare workers who kill their patients – are rare but not unknown. We owe it to everyone in this community to lobby the province for adequate funding for long-term care, to make sure there’s proper oversight of all healthcare facilities including nursing homes, to visit loved ones often and report anything that seems off, and to remember that each of us is only one stroke, one car crash or one horrifying diagnosis away from being where Wettlaufer’s patients were.