A doctor found the conditions and staff shortages so dire at the Herron long-term care home during the pandemic's first wave that she asked her husband and teenage children to help care for the residents, a coroner's inquest heard Wednesday.
Nadine Larente, a doctor of geriatric medicine and director of professional care at the West Island health agency, testified on the second day of hearings about Herron, part of coroner Géhane Kamel's public inquiry into the wave of deaths in long-term care homes between March 12 and May 1, 2020.
Larente was at a meeting on March 29, 2020 when she received a text message from a colleague about alarming staff shortages at Herron.
She testified she didn't remember exactly what the text message said, other than "SOS."
Larente went to Herron later that day at around 4 p.m., hoping to brief staff on infection control measures. But she was surprised to find only four staff members on duty, trying to care for 133 residents.
She said the owner of the Herron, Samantha Chowieri, was also there and explained that several staff members had called the 811 Info-Santé hotline asking if it was safe to report to work — given that there were COVID-positive patients in the residence. The staff members followed the advice of Info-Santé operators, who told them to isolate for 14 days.
Larente, who is also a geriatrician, said she questioned the wisdom of that directive given the long-standing staff shortages throughout the long-term care network.
"Between the risk of transmitting COVID and deserting a centre with no care given altogether, there's a difficulty,'' she said. She said she was worried enough about it that she contacted Dr. Lucie Opatrny, an associate deputy health minister, to express her concerns.
"I was worried because, with all the centres in outbreaks across the province, that directive didn't make sense, to abandon people before there are replacements,'' she told the inquiry.
Soiled patients, untouched food, shortage of basic supplies
Larente's testimony, and that of Martine Daigneault, another health agency manager who was at Herron March 29th, painted a picture of what it was like inside.
Larente said she found food trays left on carts outside patients' rooms. Most of the food was cold and untouched.
Larente worked mostly on the ground floor. She said patients there were more independent, and most were dressed, hydrated and had received their medication and food that day.
Daigneault, who arrived later that night and worked primarily on the second and third floors, said she found several patients soiled, some with soaked mattresses. She testified there was a "nauseating" smell of urine and feces as she exited the elevator, and that the floor was sticky.
Larente said she was surprised to find the facility appeared to be short of basic material, such as adult diapers and wipes.
Daigneault said many patients had to be cleaned with brown paper towel instead of washcloths.
She said she "was in shock" to observe that some patients were very thirsty and clearly dehydrated, with dry skin, mouths and lips.
WATCH | Inquest gets underway into Quebec nursing home:
Doctor's family came to help
When Larente realized how few staff there were and how much work there was to do, she didn't hesitate to call her husband and three teenage children for help.
She said there wasn't enough personal protective equipment to allow for changing between patients, so they did the best they could with what they had.
They tried to isolate patients who showed symptoms. They fed patients, changed patients who were soiled, and tried to determine which patients had received medication and which were still in need.
By 9:30 pm, the situation was stable enough that Larente's husband took her two youngest children home.
Larente and her oldest daughter stayed until 11:30 p.m., when most patients were asleep and things had calmed down.
Kamel, the coroner, told Larente she was "deeply moved" by her and her family's efforts to help patients that day, and she thanked her for her efforts.
'I get the impression we left these people to die'
Larente was asked about another report tabled at the inquiry dated April 11, 2020.
The report said that some residents with wounds hadn't had bandages changed for several weeks.
It said one patient had a wound with a bandage that hadn't been changed since March 15th. There were also gaps in blood pressure readings for some patients, and it appears one patient missed at least one dialysis appointment.
At one point, Kamel interjected to ask whether doctors should have been called to do a proper examination of each patient.
"When I read this — and I get a chill up my spine to say this — I get the impression we left these people to die,'' the coroner said.
Daigneault also testified that she saw patients whose bandages clearly hadn't been changed for weeks. She said she was surprised by the owners' lack of involvement. "They were very detached," Daigneault said.
Kamel's mandate is to investigate dozens of deaths at six long-term care homes — known as CHSLDs — in the province, and one seniors residence. The portion of the hearings involving Herron began Tuesday after being suspended while prosecutors decided whether to pursue charges against the owners of the now-closed facility. Ultimately they decided no criminal charges would be laid.
The portion of the inquest involving Herron is expected to last until at least Sept. 19 and include testimony from dozens of witnesses. The coroner's investigation is not intended to assign blame but to make recommendations to avoid similar occurrences.