Just before Christmas, a COVID-19 outbreak was declared at Au Château Home for the Aged, forcing the long-term care facility to tighten up health restrictions at the very time when families are wanting to get together and as some people are lobbying for the removal of vaccine-centered measures at the home.
Unvaccinated family members say they are being treated unfairly
Family members assigned as caregivers to residents can usually come into the home freely to help with basic care. Jamie Lee Desroches says she used to go in almost daily to be with her sister, but since the home has instituted measures barring unvaccinated people from entering, she can no longer provide this care and comfort. Now, as with all unvaccinated family members, she can only visit with her sister in a designated area called Coin des amis, which needs to be reserved and can only be accessed from outside the home.
“All I want to do is be able to enter the home, walk the hall and sit with my sister, apply lotion and ease her pain while she is comfortable and safe – exactly like I did almost daily before this policy was put into place,” she deplores. Desroches says she is worried about her sister’s well-being, which prompted her to file a complaint with the Ministry of Health and Long-Term Care. “My sister’s dwindling health is driving me to resolve this issue with urgency,” she states, adding that there have been numerous COVID-19 cases in the home despite the restrictions, which she sees as proof that the measures are ineffective.
The ministry informed Desroches that LTC homes have the authority to adopt such health measures. “The end result was always that I should seek legal advice as the Ministry has no authority to request the Home make a change to their policy,” she sums up. Still, she points out, there is no obligation for the home to apply the restrictions, which some other homes in Ontario have already lifted.
Lise Rheault says she also feels discriminated against as an unvaccinated person, adding that the restrictions are keeping her from seeing her mother, who suffers from late stage Alzheimers. Rheault says seeing her mother in the Coin des amis is not always possible, as the 84-year old has to go through a connecting link to reach the space and the draft makes her turn around. “She won’t come out, it’s too cold. She doesn’t understand why I won’t go in, she gets upset. It’s very hard on her,” she says. “Every week I drive out there [from Sudbury] and I try.”
The situation was better in the summer when her mother would come out more easily, but she adds that in her seven trips out before Christmas, “she came out once for 15 minutes.” It’s demoralizing for both mother and daughter. “Then I drive all the way back home and I cry.”
Rheault says she worries all the time about her mother’s health and well-being. “I buy clothes and drop them off, I have no idea if it fits,” she gives as one example. “I can’t check her and there are things she won’t show anyone else.” She refers to a yeast infection that went undiagnosed because her mother would not let anyone look under her breasts. “Now I pay a lady to go there every day to let me know if Mom needs anything,” Rheault explains, but it doesn’t stop the worry. “I don’t sleep half the time,” she says, adding that her mother’s state is deteriorating and “she needs me now. I’m told when she’s in hospice, you can come in. I won’t be able to go in until she’s dying! Where’s the humanity?” she asks.
A short time before Christmas, the family managed to bring their mother out to the Coin des amis by playing music to attract her, and they had a family gathering with about 20 people, Rheault recounts. On Christmas day, she drove in only to have “a one-minute visit in the entrance. Mom would not go to Coin des amis (…) We were between doors so it was too cold to visit. Got my hug, gave her her gift and returned to Sudbury. Sad, she was upset because I wouldn’t go in. Breaks my heart every time.”
Rheault says she used to take her mother out of the home and bring her to Sudbury for visits, but the drive is too hard on her now. “Last time, she was sick for two days.” She has also considered a transfer to another home, but says “moving her could be catastrophic because it’s a big change, she wouldn’t recognize anyone.”
What Rheault, Desroches and some other unvaccinated family members would like is a change in policy so that they can enter Au Château like their vaccinated counterparts. They are even willing to undergo testing, they say. They argue that being unvaccinated is not a greater risk to residents as even vaccinated people can catch and spread the virus.
Au Château says unvaccinated have been accommodated, but resident safety is priority
Jacques Dupuis, director of Au Château, says he empathizes with families affected by the restrictions and he would like nothing more than to lift them and return to normal, “but we are not there just yet.” He says the Au Château board reviews COVID protocols at the beginning of every season and makes its determination based on data at that time. The last time the policies were reviewed was in October, just as a Fall wave of COVID, influenza and strep was presenting a triple threat. The board opted to keep the restrictions in place to help protect residents at that time.
“After winter, we will reevaluate the policy, but now is not the time” to loosen measures, he says. “The policy is reasonable in the current circumstances. (…) A lot of people are sick and hospitals are overrun. Yes, things are evolving, but we’re not there yet.”
Dupuis insists that the measures are not punitive toward unvaccinated people, and in fact the home has gone above and beyond to make special accommodations for them, such as creating the Coin des amis. “I respect their choice, I have nothing against them,” he says of those not vaccinated. “I sympathize with them, that’s why the home found a way to accommodate their needs.”
But while the home has made special arrangements to facilitate visits for unvaccinated family members, Dupuis says they cannot base their overall health policies on this group. “All organizations, whether public or private, make policy for the benefit of the general population, for the good of the whole community and not for a minority group,” he notes, adding that Au Château’s “absolute priority is protecting its residents.” He adds that of the 160 residents of Au Château, only 4 or 5 are affected by the policy and he assures that all receive the same level of care.
Dupuis believes that the majority of families are in agreement with the current policies and says that while a few homes in the province have relaxed restrictions, around three quarters still have them in place. He adds that the Ministry of Health has reviewed the policy and “if it were not reasonable, the ministry would order us to change it.”
The director also points out that Au Château staff must be protected, as every time an employee gets COVID, they are off for ten days minimum, leaving the home short staffed. “We can’t afford to have more people get sick,” says Dupuis.
The director refutes the claim that families are being kept apart. “They can come to the Coin des amis every day if they want [excluding periods of outbreak],” he points out. “They can also pick up their loved one for the weekend.”
As for end-of-life situations, Dupuis says that palliative care measures kick in and override everything else, so that no one is ever deprived of their family at that time. “Our protocols then go out the window, the only exception is that people wear a gown and mask. We do not disallow anyone from seeing their relative in that case,” he assures.
COVID outbreak means tighter restrictions still
Just as frustration is brewing over COVID measures, Au Château has had to put its accommodations on hold and close the entire home to all visitors due to an outbreak declared on December 22. That day, four residents and three employees tested positive, requiring everyone to be tested. Dupuis was expecting the worst, as 20 staff were off sick. “I expect things will get worse after Christmas,” the director said that day.
He was right, unfortunately. On Tuesday, January 3, the home was facing a “double outbreak” of COVID-19 and Coronavirus-HKU1, another respiratory virus, with 19 residents and over 30 staff infected. Among the residents, 12 had COVID-19 and nine had Coronavirus-HKU1, with two infected with both viruses.
The situation had the home short-staffed, with several employees working double shifts and most working 7 days per week instead of five. “It puts enormous pressure on our staff,” recognizes Dupuis.
Still, the news is not all bad. “No one is sick to the point that it is critical. They are doing fairly well,” notes Dupuis. He adds that propagation has slowed and the first people infected are beginning to come out of isolation, which is a positive sign. “It is controlled now. That is the goal of outbreak management; we isolate, control and minimize the duration. It is looking good.”
Dupuis points out that the district Health Unit is responsible for declaring the end of the outbreak, and only at that time will Au Château be able to lift the outbreak measures, reopening the home to vaccinated visitors and offering the Coin des amis once more to unvaccinated visitors.
As for when the restrictions might be lifted entirely, Dupuis says that will be up to the board, but the October decision was meant to cover the winter months with another review planned in the Spring. That may change with the new make-up of the board, which meets next on January 18, but the director sees the current outbreak as another reason to err on the side of caution, at least until the winter wave is done. “I would be surprised if the board takes that risk at this time,” he predicts.