Violent patients at care homes face 'unacceptable' wait for treatment

The daughter of an elderly man killed in a Winnipeg care home is happy a judge is recommending more special behavioural units be created in Manitoba to deal with patients with violent or aggressive tendencies.

• Man, 87, dies after Winnipeg care home assault

"It would be amazing to have a locked ward in every nursing home," said Frank Alexander's daughter Joanne Rislund. "I know that is costly. It helps the staff, it helps the residents to feel safe."

The recommendations came from the inquest into the death of 87-year-old Alexander, who died after being pushed by Joe McLeod, in 2011. The two men lived at the Parkview Place personal care home on Edmonton Street in Winnipeg.

A national dementia strategy is something we have wanted for a while.- Sharon Blady

"My dad had been forced to the floor, I'll never forget those words," said Rislund, adding the incident with her father happened just three months after the family admitted him to Parkview.

"I am impressed that the judge felt ... this was necessary. [The Winnipeg Regional Health Authority] and Manitoba needs to step up to the plate and take a serious look at what happened here, and they have but they need to go further."

Family did what they could

The inquest report from judge Michel Chartier, released Friday, said McLeod's family had done all it could to find a specialized placement for the 70-year-old man, who suffered from Alzheimer's disease. He died last month.

• Joe McLeod, senior accused in care home assault, dies in hospital

It is alleged that McLeod knocked Alexander down, causing him to fall backwards and hit his head on the floor. McLeod was charged with manslaughter, but was found unfit to stand trial after a psychiatric assessment.​

​"No family should have to go through what Mr. Alexander and Mr. McLeod's [families] have gone through," said Gina Trinidad, the CEO of long-term care for the WRHA.

"The WRHA is committed to providing safe comprehensive care for all of our clients, patients and families and we are committed to the recommendations put forward by Judge Chartier and we will work very hard to implement these recommendations with government and our partners."

National Alzheimer's strategy needed

The report said the number of Alzheimer's patients is increasing each year and there needs to be resources and facilities to care for them — and protect other patients from those with violent tendencies.​

Blady said the federal government has been slow to help the provinces develop more effective special care strategies.

"The idea of a national strategy, a national dementia strategy is something we have wanted for a while and unfortunately we haven't had full cooperation and desire to move forward from federal partners on that," Blady said.

Right now, the wait to get into existing behavioural units is a year.

Chartier said unacceptable and has directed the WRHA to increase the number of beds so the waiting period doesn't exceed 60 days.

As well, all personal care homes need to develop such units in their facilities, he said.

Chartier also recommended the WRHA increase staff training and introduce new safety protocols at personal care homes to ensure that violent patients are fully monitored and prevented from harming others.

Changes already underway

Manitoba Health Minister Sharon Blady said many of the report recommendations are already underway.

We just have to ensure that these recommendations don't fall through the cracks.- Faye Jashyn

"A lot of changes have already happened or [are] already in the works," said Blady, adding the province currently has about 300 such units under development. 

"I'm looking at the idea of what is already in place and get those pre-existing spaces, beds to live up to the standards that we want and the recommendations indicate."

Fell through the cracks

McLeod's daughter, Faye Jashyn, said she is pleased with the recommendations to change a system she said let her father fall through the cracks.

"It feels like someone actually did understand we weren't doing this to bump my dad up the system. We were trying to get him help," said Jashyn. "We just have to ensure that these recommendations don't fall through the cracks, like other recommendations in other inquests and inquiries.

"There has to be some measurement in place to see 'are we actually making a dent in helping these families?" she added.

"Get a recommendation committee together that will actually report on the progress and have this be on the radar, and not have it fall through the cracks like my dad did."

Blady said she's reviewing successful out-of-province models hoping to improve ongoing special care unit construction projects here in Manitoba.

She said in a statement the government will implement the report's recommendations. She also apologized to the families of both McLeod and Alexander.

Statement from Health Minister Sharon Blady

Manitoba families have every right to expect their loved ones in a personal care home are safe and provided with professional care. Today, Judge Michel Chartier released his report into the tragic death of Mr. Frank Alexander.  This was an important, independent judicial process to help get answers as to what happened and how we can work together to prevent such tragedies from happening again.

No family should have to go through what these families did. I apologize to Mr. Alexander's family and to the family of Mr. Joe McLeod. I am committed to implementing the recommendations that are in Judge Chartier's report.

I have asked Karen Heard, deputy minister of health, healthy living and seniors, and Donna Miller, deputy minister of justice, to work together to develop an implementation plan for these recommendations and deliver that plan by Sept. 30. This implementation plan will be made public and updated as progress toward each recommendation is made.

Our government has worked very hard to make our home care program among the best in the country and to improve our long-term care facilities.  Since we came into office, we have hired hundreds more personal care home staff to ensure each resident gets more direct time with staff, and we have added more than 1,000 personal care home and supportive housing beds.  There are more than 300 personal care home beds in development right now to help our parents and grandparents receive the long-term care support they need, when they need it, closer to home.  This includes new personal care homes in Winnipeg, Morden and Lac du Bonnet.

As a part of new personal care home construction projects, we are adding more specialized spaces for individuals with complex behavioural needs and we are investigating whether more existing personal care home beds could be enhanced to help residents with complex needs.

I thank Judge Chartier for the work that has been done in preparing this report, as well as all of those who testified throughout the inquest.