Quebec seniors’ home fire underscores vulnerability of elderly

If you're an aging baby boomer (like me) or have an elderly parent living in a care home (me, again), the deadly fire at a Quebec seniors' residence probably sent a chill through you.

We all dream of living independently into graceful old age in our own homes, helped by loving family and the occasional bit of professional support. But like it or not, many of us will spend our last days being cared for by strangers in a place like La Résidence du Havre, which went up in flames this week.

The final death toll remains unknown but with 24 residents unaccounted for, it could reach more than three dozen. It's a devastating loss in any community but for a village like L'Isle-Verte – population less than 1,500 – it's staggering.

Many villagers rushed to the scene and watched helplessly as their friends and loved ones were consumed. One man described using a ladder to try to rescue his mother trapped on a balcony before flames forced him back and he watched her die.

The prospect of spending your last years in a seniors' facility suddenly seems even less appealing.

The business of housing the old can only grow as the Baby Boomer generation ages. But the industry, much of it privately run, has been subject to adverse scrutiny on a number of fronts: understaffing, abusive or neglectful caregivers, flu and noroviruses that sweep regularly through care homes, fire. The great Bette Davis did say "Old age ain't no place for sissies."

It's not fair to generalize about a whole industry based on a few incidents. But I predict that as the percentage of potentially vulnerable seniors in the population grows, scrutiny will grow with it.

The fire threat has loomed for years and many provinces have required new facilities housing seniors with limited mobility to have sprinklers.

[ Related: L'Isle-Verte seniors' home fire raises ire over sprinkler regulation ]

That includes Quebec. A newer section of La Résidence du Havre had sprinklers that protected it but there was no requirement to retrofit an older section built in 1997, which burned to the ground, CBC News noted.

The situation is reflected elsewhere in Canada, where new buildings have protective sprinklers but older ones don't. Ontario, spurred by a spate of fires in the last few years, last year became the first province to require buildings housing seniors and the disabled to be retrofitted.

Another fear we have is that our loved ones will be neglected or abused by their caregivers.

Canadians were shocked last year by the story of an 85-year-old woman whose son secretly recorded video of her Peterborough, Ont., nursing home staff taunting and mistreating his mother, who suffers from dementia.

However, after a police investigation, no charges were laid despite images showing "caregivers" hitting her, waving a feces-smeared cloth in her face, blowing their nose on her sheets and making out in her room, CBC News reported. Four employees were fired and the home was cited for several violations.

[ Related: Few elder-abuse cases lead to criminal charges, federal study indicates ]

One of the most serious cases surfaced more than a decade ago at a Montreal facility. A class-action suit included hundreds of cases of staff abusing residents, some of which were also caught on audio recordings done by family members, CTV News reported last year.

After 13 years, the suit wasn't settled until last year for $7 million. It's thought to be the largest such award in Canadian history, though many of the residents who were mistreated have since died, CTV News said.

Lawyer Jean-Pierre Menard, who handled the class-action investigation, said such abuse is rarely isolated and, before escalating, often starts with small infringements on patients' rights.

He advised patients and families to speak out at the earliest sign of misbehaviour by staff.

“The zero tolerance policy means all management and employees have to take the side of the patient,” Menard told CTV News.

Coincidentally, public hearings into the living conditions in public-sector nursing homes are underway this week in Quebec.

The Montreal Gazette reported the inquiry commission is to look at 36 issues, but a patient advocacy group complains it's redundant because of previous investigations by other agencies, including the provincial auditor general and Quebec Ombudsman.

“We’re long past reflection," Paul Brunet, president of the Conseil pour la protection des malades, told the Gazette.

“It’s time for action and implementations on hundreds of measures needed to make it more human to live in long-term care."

Quebec's long-term care homes are supposed to provide aging seniors, many with cognitive and physical illnesses, with a warm, homelike atmosphere, known in French as “un milieu de vie," the Gazette said.

But in many cases, they are nothing more than “long corridors with rooms on either side,” Brunet said.

[ Related: Norovirus linked to 9 deaths in B.C. care home ]

And this time of year, the potential for influenza outbreaks increases, though there's little we can do about that except hope that residents, staff and visitors are vaccinated.

A 2009 scientific paper in in the Cleveland Clinic Journal of Medicine said vaccination is the most important preventative measure, buttressed by easily accessible hand-cleanser dispensers and masking up in the presence of infected patients.

Nursing homes now routinely lockdown their facilities, urging non-essential visitors to stay away during flu and norovirus outbreaks.

But sometimes there's little that can be done, as in a norovirus outbreak that was linked to the deaths of nine residents of a Victoria care home last year.

About half the facility's 100 patients became ill and the elderly are particularly susceptible to the weakening effects of dehydration, diarrhea and vomiting the illness brings on.