As a Crown prosecutor for three decades, Victoria’s Samantha Hulme has a thick skin. But seeing her father, who has Alzheimer’s, in hospital with too few people to care for him or clean his room broke her.
“I love my parents so much, and I know everyone does, and the health-care aides and nurses and doctors and food services and cleaners are trying so hard, but there’s not enough of them,” said Hulme. “It’s not a money issue, it’s where are the people?”
After finding her father alone after a medical incident in Saanich Peninsula Hospital that the family wants to keep private, the Hulme family hired a care aide for $850 a month to sit with the 82-year-old for a couple of hours two days a week — when Samantha or her brother, who lives on the Lower Mainland, can’t be there.
The care aide encourages him to eat and drink, ensures he takes his medication, and helps him get to the washroom and changed if needed.
When a friend originally suggested the idea to Hulme, 57, she imagined it wouldn’t be permitted. She has since learned that it’s not an uncommon practice.
Island Health says it has policies for when families wish to bring in additional support for their loved ones in acute or long-term care, be that a nurse, care aide or companion service.
In general, the health authority says the care must be recommended and approved by the care team, service providers must be regulated by a professional college, and the family and workers coming in must sign appropriate waivers.
There are different guidelines and waivers for companion services.
Hulme’s father arrived at Saanich Peninsula Hospital from Galiano Island via water taxi five weeks ago.
He was admitted with a serious bladder infection that left him unable to walk or even stand. He spent three weeks in acute care and is now on a ward awaiting placement in long-term care.
Samantha’s brother had been commuting from the Lower Mainland to care for their dad in his home — where he lived with his 79-year-old wife — on Galiano Island.
He was doing so under a provincial stay-at-home program called Choice in Support for Independent Living that allows clients to hire a caregiver to continue to live independently. About three-quarters of people 85 and older live in their own residences, according to B.C.’s senior advocate.
Samantha took early retirement in part to look after her parents.
In February, when their mother, who has cancer, was diagnosed with a heart condition, however, the family realized their dad would finally have to go into long-term care. But the family, waiting for a preferred spot since April 2022, didn’t anticipate how long it would take.
“Instead we end up in an emergency situation where my dad falls in hospital — we’ve never had him fall at home — and my dad gets COVID in hospital for the first time after we managed to keep both my parents safe from COVID for three years,” said Hulme.
At the end of August, 18 patients mostly in acute care at the facility, which has 48 acute-care beds and 143 long-term care beds, tested positive for COVID. In addition, Hulme’s mother “who was there to care for [her husband] because the care is so poor” contracted COVID at the hospital and got “really sick.”
“You think he’s in hospital, he’s going to be safe there and sadly, despite the best efforts — I want to emphasize this — of the cleaners and care aides and nurses and doctors, the ship is going down.” Hulme said.
Hulme praises the staff and team-based approach at the hospital, which serves a growing population on the Saanich Peninsula and Gulf Islands, but calls it “shockingly understaffed — especially nurses, cleaners and care aides.”
“Honest to God, the nursing ratios are seven or eight patients to one [nurse] some days and there was one day when there was no care aide working at all,” she said. That means a nurse is left to try to feed vulnerable patients and help them take their prescribed medication.
“The garbage isn’t being taken away, the floors aren’t being cleaned, and a patient isn’t being changed,” said Hulme. “My dad fell one night and they know he’s a fall risk but there’s only so many people.”
Hulme recently wrote to the health minister, her MLA, and the hospital’s patient care and quality office to bring to light the severity of the understaffing from a patient perspective.
“These nurses and care aides are just going down for the count and they are friggin’ exhausted,” said Hulme. “The same for the doctors.”
In July, overnight closings of the hospital’s emergency department began due to lack of physicians to fill shifts. That was supposed to end this month, but the physician shortage has continued, resulting in the closings being extended to Oct. 27.
Emergency physician Dr. Jeff Unger said over just three years, 13 emergency physicians and about 30 nurses have left the emergency department, while patient volumes have increased 40 per cent over the same period.
Unger said while the shortage of emergency physicians was the “final straw” in the health authority being unable to reopen the emergency department overnight, all Saanich Peninsula Hospital emergency-department and ward-care staffing is insufficient, “resulting not only in poor, fragmented, undignified and delayed care, but at times grossly unsafe care.”
He said the hospital is overcapacity every day, averaging 117 per cent capacity, with 10 of 16 emergency department beds, and sometime all 16, occupied by admitted patients who have to wait an average of about 26 hours, often in hallways or alcoves, before a ward bed becomes available.
Unger maintains that hospitals need practical, realistic and evidence-based solutions that account for the aging population and understaffed workforce.
“If not, where will Saanich Peninsula Hospital be in the future, given that those aged 75-plus have the highest local 10-year population growth rate at 67 per cent, and already account for 25 per cent of our emergency-department visits and 60 per cent of hospital admissions?”
Unger said without the overnight ER closures at the hospital, “there would likely have been a total collapse of both emergency department and in-patient care at Saanich Peninsula Hospital.”
If there’s a silver lining in the temporary closings, he said, it’s that it has focused ER staff on the times of greatest patient need, when 85 per cent of patients were cared for pre-closure.
Unger said the public will need to accept a “paradigm shift” in health-care expectations, accepting what is fundamentally safe, adequate and reasonable, rather than “ideal, comprehensive and convenient.”
Hulme said people have been “labouring under the misapprehension” that hospitals are clean, safe, well-staffed places and family can go home and “visit them like we did in the ‘80s and ‘90s — but that’s not what’s going on.”
“You are going to have to step up, go in and do some personal care for your loved one, help clean up, and get them to eat and drink.”
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