Home-care nurses told her not to worry about her bedsore. She was hospitalized the next day

Two years ago, on a late November morning, Sylvie Hudon woke up shaking like a leaf.

The 66-year-old, who is paralyzed from the waist down, was trembling from what she says were the early signs of sepsis.

She hadn't seen it coming.

Just the day before, nurses visiting her Quebec City home had told her she had "no need to worry" about a bedsore located at the very bottom of her back — even after she flagged a bad smell.

She would later find out her wound contained four different types of bacteria, while one had entered her bloodstream. The hole on her back ended up being the size of an orange — stretching all the way down to the bone.

"It was something major," said Hudon, who called an ambulance for herself. "[They] brought me up to the operating block right away."

Hudon says it never should have come to that point.

Since 2020, she'd received home visits from CLSC nurses three times a week to monitor, change the bandages and clean the pressure sore — a frequent occurrence for people with limited mobility or a spinal cord injury.

"Over those two years, maybe 20 nurses came to my house … when you have a rotation like that, they can't compare from one time to the next if it's redder or pinker or bigger or smaller," said Hudon.

"It's not one single person who missed it."

Months of hospitalizations and a surgery later, she's sharing her story in the hopes that her situation doesn't repeat itself.

While she's not pointing the finger at home-care nurses, saying they were doing what they could, she says people with pressure wounds deserve better care.

"I can't be satisfied with basic care. We need more," said Hudon. "We need someone who's going to be able to do a real assessment."

Alongside advocates and patients in Quebec City, she's calling for the development of additional specialized resources for people with spinal cord injuries dealing with bedsores in the Quebec City region.

At the end of January, Moelle épinière et motricité Québec (MÉMO-Qc), an advocacy group for people with disabilities, filed a petition with over 1,500 signatures in the National Assembly, asking for the expansion of services and the creation of a clinic responsible for prevention, research, training and management of wound care, particularly in eastern Quebec.

'How many years have I lost?'

For about two months in the hospital, Hudon says she had to lay on her side, and when she returned home, she could only sit up for three hours a day.

"It was limiting my outings, limiting all family relationships," said Hudon.

The same happened for Simon Plamondon when he developed his first bedsore in 2018.

After he was admitted to hospital for pneumonia, the Quebec City resident returned back home with a pressure wound. Although he had a CLSC home-care plan, he says within a week, the bedsore doubled in size.

Nearly two weeks later, he went to the ER for what would be the start of several hospitalizations.

At the age of 38, he estimates he's been hospitalized for more than a year in total.

"How many years have I lost?" said Plamondon. "I'm starting to find myself again… I've spent too many years with depression, not being able to see anyone. I shut myself off."

He says one of the reasons he keeps speaking out about his experience is because of Normand Meunier — a Quebec man who chose to pursue assisted dying after developing a severe bedsore under similar circumstances.

"I've always chosen resilience," said Plamondon.

"We have the right to be healed. We have the right to be cared for without delay."

16 similar testimonies

Between March and June 2024, MÉMO-Qc gathered 16 testimonies from people like Plamondon and Hudon in the Quebec City area who suffer from pressure wounds.

Ariane Gauthier-Tremblay, a community organizer with MÉMO-Qc specializing in rights advocacy, says they approached Quebec's ombudsman with their findings.

Although Quebec City has a rehabilitation centre for people with spinal cord injuries, Gauthier-Tremblay says once discharged, patients rely on home care from nurses who "don't see many people with spinal cord injury."

"It's a little community," says Gauthier-Tremblay.

"So they would treat the wounds as a diabetic wound or like a post operational wound which is not appropriate."

In October 2024, Quebec's ombudsman released a report which found that according to the information received, Quebec City's regional services available to prevent bedsores or their deterioration is not sufficient and not adapted to "the reality of people with a spinal cord injury."

The ombudsman issued six recommendations — notably ensuring nursing staff providing home-care services perform a complete clinical examination and have access to the services of other professionals to optimize the treatment of the injury.

By the end of 2025, the local health authority was also asked to confirm the deployment of pressure injury prevention tools and training in all of its emergency departments, as well as the creation of a directory of spinal cord injury patients who have developed a bedsore.

In an emailed statement, a spokesperson for the regional health authority said upon receipt of the ombudsman's report, they "promptly" implemented all six of the recommendations. They said they have carried out the requested follow-ups with the ombudsman.

"One is still in progress, namely the deployment of pressure injury prevention tools in all CIUSSS de la Capitale-Nationale emergency departments, and the implementation of training related to these tools, which will be completed within the next few weeks," read the statement.

In an emailed statement, a spokesperson for Santé Québec says people who are suffering from any kind of disability are entitled to care.

"It is important to point out that significant and concrete action has been taken by CIUSSS de la Capitale Nationale, following the submission of recommendations," read the statement.

Chronic wounds a "massive" problem in Canada

Dr. Sheila Wang emphasizes the importance of addressing the bedsore at its earliest stage.

Subjectivity and a lack of standardization can be a problem, she says, when it comes to measuring and tracking wounds.

A dermatologist at the wound care centre at Women's College Hospital in Toronto, Wang helped launch Swift Skin in 2015 — an app to ensure consistent measurements are made by health professionals.

"It wasn't until I entered medical school and was seeing wounds that I realized … how massive a problem chronic wounds are," said Wang.

"In Canada alone, like 30 to 50 per cent of all health care involves wound care."

Categorized into four stages, she says sores are much more severe once they've entered stage three and four.

"You can create an infection that even starts to enter the bloodstream," she said.

Considering the care needed to recover and prevent a severe bedsore — which include special mattresses and adjustments ideally every two hours for bedridden patients — she says it can be difficult for a person to do it alone or with limited resources.

"It's obviously not enough," said Wang. "We can do better."