COVID-19, strained health system to blame for senior's multiple hospital transfers after fall: family

Debra Trowell says her 92-year-old-mother's experience after breaking a hip — involving moving her several times to hospitals in several communities — shows a fractured and disjointed health-care system that was struggling before COVID-19 hit, and is worse now.

"COVID is responsible, but our health-care system has been in bad shape for a long time," Trowell said. 

"My heart goes out to those who work in health care, because they can't do their jobs properly. They don't have the support they need."

Her mother, Florence Kines, suffers from dementia. She slipped while getting ready for a shower at the supportive housing lodge where she lives in The Pas, Man., on Dec. 7.

She was taken by ambulance to St. Anthony's Hospital in The Pas for emergency treatment, but she couldn't be admitted there because the acute care in-patient unit was closed due to COVID-19.

"When she broke her hip, I hugged her and felt like I was saying goodbye. That was the last time I saw her face-to-face, because we weren't being allowed in hospitals because of code red," said Trowell, who also lives in The Pas.

"All I could do was phone and check on her."

From there, she was taken by ambulance to Flin Flon — more than 100 kilometres north of The Pas — while waiting for a flight to Winnipeg.

Trowell said a nurse told her there was a backlog of patients, all waiting to be airlifted.

Flown to Winnipeg

Two days later, Kines was flown and admitted to Concordia Hospital in Winnipeg — more than 520 kilometres from her home in The Pas. She waited another 24 hours in urgent care there for the results of a rapid COVID-19 test that came back negative. 

Three days after her initial fall, she received surgery for her hip.

"I was just sick about it, because I knew she would be super confused and stressed, not knowing why she was where she was. I couldn't do anything about it. It was just terrible. Gut wrenching," said Trowell. 

Getting information from staff on how her mom was doing was hit and miss at best, she said. Less than a week after the surgery, Trowell called to check on her mom and was told she had another fall.

"They told me she had to get an X-ray. They found her on the floor Saturday night but they never called me to tell me about it. Then I couldn't get the X-ray results," Trowell said.

Plans were being made to send her back to the hospital in The Pas, but the outbreak prevented that. Instead, the decision was made to transfer her to Swan River, about 150 kilometres south of The Pas, at the family's request.

Another fall

That was Dec. 22, and a blizzard was forecast. The emergency team only made it as far as the hospital in Ste. Rose du Lac — roughly halfway between Winnipeg and Swan River. 

When Trowell found out where her mother was, she learned she had suffered another fall while unattended, this time hitting her head. 

"I thought I was going to have a heart attack," said Trowell. "She's on blood thinners from surgery. She will bleed more."

The next morning, a doctor from Ste. Rose called Trowell, informing her Kines was in grave danger and should get her affairs in order. Kines was transported to Dauphin hospital for a CT scan, which found she had suffered a fractured skull and a brain bleed.

She was returned to Swan River, where she could be close to a family member in case she died, but Kines pulled through. The fallout from the head injury was significant — she had trouble swallowing, wasn't able to stand and suffered depression.

'Challenging realities': authorities

The Northern Health Region, the Winnipeg Regional Health Authority and Manitoba Shared Health issued a joint statement in response to questions from CBC News.

"The emergence of COVID-19 in the past year, combined with periodic winter storms, reflect some of the challenging realities of providing health care to a population spread over a large geography," it says.

The statement confirms the acute care inpatient unit in The Pas was closed to new admissions or inpatients for much of December because of COVID-19, and acute care patients were rerouted elsewhere. It denies any issues with patient capacity, delays in air transport or staff shortages.

In spite of COVID-related hospitalizations, "sufficient staffing has remained in place throughout the pandemic to care for acute patients dealing with non-COVID-related illness and/or injury," the statement says.

Citing privacy legislation, the health agencies said they could not say if any of Kines's falls are being investigated or are deemed critical incidents.

Kines remains in Swan River Hospital, and Trowell is pleased with the care she's getting there.

But she says her mother is less healthy now than when she first went into the system in December, and her quality of life has deteriorated.

She thinks if it weren't for COVID-19 restrictions, the outcome for her mother would have been different.

"I understand them, but there was no one to advocate for seniors like my mom on a daily basis. Right now with COVID, these people need an advocate on every floor, because their family can't be with them."