Dorothy Dunnington wonders if anyone will ever be held accountable for a massive bone-deep pressure ulcer that became infected and led to her sister's death at the age of 40.
Last week, Halifax Regional Police announced that investigators found there was no criminal wrongdoing and they were closing their investigation into whether there was negligence at Shannex's Parkstone Enhanced Care home in Halifax, where Chrissy Dunnington had lived for 14 months prior to her death in March 2018.
Chrissy was born with spina bifida and hydrocephalus, a condition that caused a buildup of fluids in her brain. She had cognitive and physical disabilities and used a wheelchair. Her ability to communicate was very limited.
Eight weeks prior to her death, she was rushed to hospital at her family's urging and treated for a bone infection as well as septic shock, pneumonia, a urinary tract infection and severe dehydration.
Dorothy Dunnington believes that had paramedics been called to her own home, she would have been held responsible for her sister's condition.
"We have stricter rules about how we care for pets. If we don't care, we don't feed somebody properly, we don't clean their wounds out, we don't look after them, they're charged," she said.
"And yet somebody completely dependent on other people, it seems to be OK and I don't I just don't understand it."
Medical examiner Matthew Bowes, who reviewed Chrissy's health records, wrote in a letter to police that he found no evidence that her death was the result of circumstances that included negligence on the part of a physician or staff.
However, in his letter that was also sent to the Dunningtons, he also said it wasn't his role to assign blame and that he wasn't determining whether she received adequate care.
Next week, Dorothy Dunnington plans to meet with Bowes. She said she's still puzzled about how he could refrain from drawing conclusions about her sister's treatment, yet still rule out negligence.
Since Chrissy's death, the province has started tracking bedsores in hospitals and said it is working to improve treatment protocols.
But Dorothy Dunnington frequently hears from families who have concerns about their own loved ones. She worries that as time passes, other people in care remain at risk.
"I don't know what we need to do to fix it, but I know what's happening right now is not good enough," she said.
Chrissy lived with her foster parents until they were in their 80s and started to struggle with the physical demands of her care.
Initially, the family thought the spot at Parkstone meant they "had won the lottery, that it was a beautiful place," where they could all visit her frequently and she'd have plenty of other social interactions, said Dorothy Dunnington.
During Chrissy's time at Parkstone, a mechanical lift moved her from her bed to wheelchair. Her family said they visited often and frequently raised concerns about the amount of time she spent slouched in one position.
They were worried about her developing bed sores.
In the months prior to Chrissy's hospitalization, they learned she had a pressure sore, but Dorothy Dunnington said the family was assured it was an abrasion that appeared to be healing.
She said she and her siblings weren't alerted to the extent of it until a staff member phoned to tell them that Chrissy's health was failing.
Within days, they found her in bed struggling to breath. It was only at the hospital did Chrissy's siblings see what was under the bandages on her backside — an oozing five-centimetre-wide gaping wound that exposed her tailbone.
"The condition that she showed up in the hospital that day, had we not got her there that day, we were told by the emergency room doctor she would have died in her bed," said Dorothy Dunnington.
"She was not cared for properly. She was not fed properly. She was not cleaned properly. They did not seek out appropriate care for a very large pressure wound. There are things that could have been done before it got too big."
In a statement, Shannex said it has been an "extremely difficult situation for the family and everyone involved."
"Residents who live in long-term care homes often have complex health conditions. Our teams work every day to assess, monitor and provide care for our resident's individual needs," said Matt Proctor, vice-president of marketing and communications for Shannex.
"Unfortunately, while the police investigation was open, we were not able to reach out to the Dunnington family. Now that the police investigation is closed, we plan to reach out and determine if there is any information about Ms. Dunnington's health status that we may be able to share which they may not have previously held."
Dorothy Dunnington said her family has very little legal recourse now that her sister's case won't be dealt with through the criminal courts. They considered civil action, but decided against it as any potential damages would only be measured based on Chrissy's lost wages, which were non-existent.
"We were told by lawyers that it would be a slap in the face as to how much we would be offered or awarded and Chrissy's life was worth more than that," her older sister said.
"Her life didn't look like yours or mine, but she had a right to live her life and to put a value on somebody's life based on their income, that basically means everybody that has special needs has no value. Their life has no value and that's OK? Well it's not. I think there needs to be other avenues, other ways."
Her family also struggles with guilt that they placed Chrissy in care because they were unable to care for her themselves. Dorothy Dunnington said they trusted staff to look out for her, and now regret it.
"I would like to see it come out that they could have done better, that they could have saved her life, that the system that was in place at the time is the reason why she is not alive today and that there were steps that could have been made. I would just like them to have some kind of responsibility for what happened," she said.
The Dunnington family is still waiting for the final results of a Department of Health and Wellness investigation into a complaint they filed when she was in hospital. The department said in a statement to CBC that it was resuming following the conclusion of the police investigation.
A preliminary report found there were problems with wound care at the home and no evidence to support staff's assertion that Chrissy was repositioned every two hours. The Dunningtons also had issues with the report, saying it contained basic factual errors including about Chrissy's medical history.
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