Winnipeg woman's death after 5 weeks without palliative home care highlights serious system delays: report
Katherine Ellis was incorrectly placed on patient priority list, independent review says
A Winnipeg woman who died earlier this year after more than a month without the palliative home care she was promised highlights significant system delays, according to a recently released independent review.
Although the report itself does not name the woman who died, 62-year-old Katherine Ellis's common-law partner Eric De Schepper shared her story with the media — including CBC — shortly before her death last February.
Ellis chose to receive at-home palliative care in January, following a Stage 4 pancreatic cancer diagnosis a couple months before. She went more than five weeks without home care until a nurse showed up three days after her death, unaware that Ellis had died.
De Schepper cared for Ellis alone during the time she spent at home, but her hygiene suffered as her bedsheets couldn't be changed for weeks. De Schepper filed a complaint with the Manitoba Ombudsman against the Winnipeg Regional Health Authority, leading to the review.
The lightly redacted report completed last June discovered gaps and breakdowns in communication and procedure in Winnipeg's home care system, offering 21 recommendations that largely include workflow improvements and defined responsibilities.
At the top of the list is a recommendation to ensure palliative patients are given the highest priority, as Ellis had been incorrectly listed as a Priority 3 patient when she should have been Priority 1.
"By implementing these mitigation measures, the risks associated with supply deliveries and pickups can be addressed," the report states.
Report is 'Kathy's legacy': De Schepper
Luba Bereza, the director of WRHA's centralized home care operations says she welcomes the report's recommendations.
"Home care is a pretty busy place. On any given day, we're scheduling almost 15,000 visits, and so sometimes things get missed," she said.
"As home care staff, we … want to do the right thing every day for our clients and their family members, and sometimes it's hard to see when we make errors like this that significantly impact people's lives."
Bereza says WRHA is already working to make some of the changes in the report, including a "very specific palliative care code" under the electronic scheduling system, engagement sessions with front-line staff and a new mobile app to help alleviate some administrative work.
While the entire experience has taken a toll on him, De Schepper told CBC News that he's glad Ellis's experience wasn't in vain, since speaking out looks to be leading to some change.
"This is Kathy's legacy, if she hadn't passed away and I hadn't taken action, nothing would have changed."
The greatest challenge facing Winnipeg's home care system is staffing shortages, as the vacancy rate for Manitoba home care aides is over 20 per cent, according to the report.
A thorough retention strategy including competitive benefits and compensation packages for workers is recommended by the report, as "a revolving door of caregivers" can negatively affect the quality of home care and the well-being of those who receive it.
The report also targets Bereza's portfolio, saying it involves a workload that "may be considered too large for a single person to effectively manage," as well as a lack of technological integrations in the home care system that can lead to inefficiencies and increased workloads.
A dedicated palliative team also needs to be established, it says, but it acknowledges the budget for home care is tight and the staffing shortages are overwhelming workers — something their union has said for years.
Debbie Boissonneault, president of Canadian Union of Public Employees Local 204, says the report "is a start."
Home care workers need better pay, as the cost of gas is driving many to leave the field, as it "takes a lot of their salaries and some of them just can't afford to stay in the job," she said.
Home care is a demanding job and can be emotionally draining when patients are not receiving adequate care, said Boissonneault.
'We want people to age at home'
However, Boissonneault is hopeful a new provincial government will lead to improvements for home care workers, as she said the previous government did not do enough to recruit and retain them.
During the recent provincial election campaign, now-Premier Wab Kinew promised to hire 100 additional workers to the field. He also promised higher mileage rates and $2 million annually to go toward a suite of financial incentives to recruit and retain home care workers.
The entirety of Winnipeg's home care system needs to be examined to ensure progress, said Boissonneault.
"We want people to age at home. We need to make sure that our government is there for the people that are taking care of the people in their homes."
With files from Emily Brass and Caitlyn Gowriluk