COVID-19 was repeatedly cited as a cause of death at the Herron nursing home to obscure the fact that dozens of elderly residents died from thirst, malnourishment and neglect, a Quebec coroner’s inquest heard Tuesday.
In an emotional testimony, an auxiliary nurse recalled how the facility in Montreal’s West Island was already poorly run before the crisis, how most of its staff abandoned their posts when the coronavirus struck, and how the local health authority then took over in a high-handed and inefficient manner.
She described discussions over whether to triage residents in such a way that those who were dying wouldn’t be fed. And she recalled harrowing scenes: a woman’s body left unattended in a room shared with her husband, and nurses quarrelling in front of grieving family members.
The auxiliary nurse testified at coroner Géhane Kamel’s public hearings into 47 deaths at Herron, a part of an inquest into the high death toll in Quebec nursing homes during the first wave of the pandemic. Quebec is the only province holding public hearings on COVID-19 fatalities in long-term care, opening a rare window into a crisis that resulted in the deaths of more than 4,000 of the province’s care-home residents in the spring of 2020.
A recurring theme in the auxiliary nurse’s testimony was the lack of humanity afforded to dying residents and their relatives. One appeared to have died of thirst after being forgotten in his room. Another family received misleading information even as an elderly resident was dying.
The auxiliary nurse’s name cannot be revealed because of a publication ban.
Starting March 13, 2020, a government directive banned visitors, including family caregivers, from entering nursing homes in Quebec. Many elderly residents with Alzheimer’s disease declined quickly when left by themselves. “I saw firsthand that they were dehydrated, in spite of my best efforts to keep them hydrated. I saw that they were malnourished,” the auxiliary nurse said.
In her testimony, and in a 55-page report that she submitted to the inquest, she said that many fatalities at Herron were misleadingly marked as suspected COVID-19 cases, when the deaths were a result of the chaotic handling of the crisis.
“I had the impression that they were blaming the virus because it would be easier to blame the virus than to acknowledge the hard truth that these people suffered from malnourishment and dehydration. I felt that it was a way to escape culpability,” she told the inquest.
The inquest has heard that Herron was short-staffed, and that it had turned to a placement agency two months before the pandemic. The director of nursing care hadn’t been replaced after she left her job in early 2020.
Athanasios Pappas, the first resident to test positive for the virus, died on March 27, 2020. The next day, the auxiliary nurse said, one of the home’s employees came to her floor “in a panic” and said the virus was in the building. “I felt that everybody working had the right to know that it was in the building. So I called everybody in the nursing station and I let them know, and this group of agency [orderlies] basically left en masse,” the auxiliary nurse said.
She tried, unsuccessfully, to talk them out of leaving, she said. That afternoon, she gave a ride home to an orderly who told her, “I don’t think I am coming back tomorrow.”
When she came to work on March 29, most of the personnel were missing. The registered nurses left early. One said he had a fever. Another had been told by managers to go and get tested because she had cared for a patient who was found to have been infected.
The auxiliary nurse said she and two orderlies were left to care for a floor with 60 residents. While dispensing medications, she also had to help the orderlies. “I helped out feeding, I helped serve trays, I helped wash people. I was running around like a fool.”
She found one of the first fatalities at Herron, Léon Barrette, whose body was already cold when she visited his room the morning of March 29. There were no physicians or registered nurses present, so a Herron administrator told her she had to handle the paperwork, which she had never done before.
The cause of death was indicated as possibly the new disease. “Everybody was ‘COVID-19 suspected,’ regardless of what symptoms they had,” she testified.
Mr. Barrette had been admitted March 27 and needed oxygen because of breathing problems. But there were no notes on his chart from between his admission and when the auxiliary found him dead. She testified that she saw no oxygen bottle in his room. His family members believe Herron’s staff had forgotten about him.
The day shift ended at 3:30 p.m. and the orderlies left, “knowing full well that there was no one to replace them,” the auxiliary nurse said. She felt she had to stay, since no one except another orderly showed up to work on her floor.
The remaining kitchen staff delivered food but, fearing the virus, would not help serve the trays.
That evening, one resident had diarrhea twice. “We couldn’t get to him fast enough, he slipped in it and he fell twice. So here we have a 102-year-old man who lived a life of pride, a life of dignity. And he’s lying in his own feces,” she said, tearing up. She left at 8 a.m., having worked 18 hours.
That evening, the local health authority, known by the abbreviation CIUSSS ODIM, found out about the crisis and said it would take over the facility from owner Samantha Chowieri.
The auxiliary nurse said things didn’t improve under the CIUSSS. The staffing was uneven and it wasn’t clear who was in charge.
She and her mother were close to two residents who died on April 6, Albert Arpin and Ruth Wayland.
The auxiliary nurse’s mother had spoken to Ms. Wayland’s daughter, who said that an administrator, Tina Pettinicchi, had assured her that Ms. Wayland was fine and feeding herself with Boost, a nutritional drink. In fact, the inquest heard, Ms. Wayland died in an agitated state, screaming and trying to pull out her intravenous needle.
Mr. Arpin also got worse that weekend. The auxiliary nurse called his daughters so they could say their goodbyes to him. When they showed up, the auxiliary nurse said, someone from the CIUSSS yelled at one of the daughters and told her that she was not allowed in the facility and that she was contaminating the space.
Another CIUSSS staffer then argued with her colleague that the daughters should be able to go in. “In the elevator … Suzanne looked at me, shook her head and remarked that it was a zoo,” the auxiliary nurse said, referring to the daughter who had been yelled at.
Oxygen tanks were in short supply, and the auxiliary nurse said she had to fight “tooth and nail” to get Ms. Wayland and Mr. Arpin oxygen and morphine to ease their last moments.
She said she often “butted heads” with a CIUSSS nursing supervisor when she tried to tidy and clean the bodies of deceased residents. In one case, she said, the supervisor snapped at her for reporting that a dead resident had been left in vomit. “It takes five minutes to clean someone and show respect,” the auxiliary nurse said.
In another case, in a room shared by a married couple, the wife died and was left in her bed for a day. The husband had Alzheimer’s. Every few hours, he checked on his spouse and rediscovered that she had died. “It was extremely callous,” the auxiliary nurse said.
She said there were so few staff members left that she and Ms. Chowieri, the owner, at one point discussed whether to feed only healthier residents while keeping the rest hydrated. “With such a skeleton crew … some of them were not getting fed. So at this point it was my fear that if we didn’t triage the building we would lose the whole building.”
Ms. Chowieri said she would talk to the kitchen staff, but ultimately didn’t pursue the idea, the auxiliary nurse testified.