Brampton families given 2 months to find alternate care for loved ones with complex needs

On Jan. 8, 2013, Harjinder Sharma came home from work feeling tired. He ate a bowl of lentil soup and went to bed.

That was the last meal Sharma, then 43, fed himself. Several hours later he woke up gasping for air. He’d gone into cardiac arrest. He suffered serious brain damage due to a lack of oxygen. Doctors told the family he’d require round the clock care for the rest of his life. 

“His condition is he’s aware — he recognizes me and my son. When we tell him something, he reacts accordingly. But he can’t speak,” said Sangita Sharma, his wife.

From October 2013 until he was moved to another facility last December, Sharma’s husband was a resident in the complex continuing care (CCC) ward at Brampton Civic hospital.  He has no mobility, a tracheostomy to breathe and a gastrostomy feeding tube. His wife — who lives five kilometres from the hospital — was able to visit him daily to provide the additional day-to-day care he needed.

But last October, the hospital informed her it was “transitioning” its CCC beds to Etobicoke General Hospital, where they’ll be converted into a unit that wouldn’t provide the same kind of care.

Documents reviewed by CBC show that William Osler Health System — which runs the Brampton hospital — told families this was a plan in the works for some time. However, it had to be accelerated because of COVID-19 and the need to optimize its acute-care capacity.

Harjinder Sharma was just 43 when he suffered a cardiac arrest, which damaged his brain. He now requires around-the-clock care and breathes through a tube. (Sangita Sharma)

William Osler gave her family two months to find another place for her husband. The problem is — there doesn’t appear to be any other complex continuing care beds in the city of Brampton.

“I was so shocked and I said …’How? How are you just closing suddenly?’ Because for these people, it’s … a home for them,” said Sharma, whose husband is now being cared for 35 kilometres away in Toronto.

Sharma is one of seven families with a loved one who was forced out of Brampton Civic hospital’s complex continuing care and into a ward at a Toronto facility. Their loved ones require regular visits from family for basic care tasks, such as changing, feeding and cleaning — something that is now a challenge because they are in a different city.

Some patient advocates say there was a shortage of CCC beds before COVID-19 hit and now worry the patients who are moved out during the pandemic will not be moved back closer to their families.

Brampton to Etobicoke to Toronto

Sharma says the hospital gave her three options: take her husband home, put him in a long-term care home, or move him to another CCC hospital in another city.

She said she cannot physically care for him at her home, her husband’s needs are too complex for staff at a long-term care home and she can’t drive long distances because she suffers from severe anxiety.

“It’s really, really hard for all the families [who are] involved in the care …  if they won’t be able to see them,” said Sharma, who added that her husband recognizes her and  smiles when he hears her voice or when she sings to him.

“Anyone who is brain injured … family presence is the first thing — [it brings] stimulation,” said Sharma.

Harjinder Sharma, left, pictured with his wife Sangita Sharma as she sings to him in his hospital bed. Sangita says her husband responds to her through blinking or squeezing her hand. (Sangita Sharma)

In December, William Osler unilaterally moved her husband to another hospital in its system — Etobicoke General Hospital in Toronto.

Three months later, William Osler informed her Etobicoke General could no longer meet her husband’s needs.

On April 9, the province issued an emergency order that allowed for the transfer of patients to other hospitals without consent to bolster capacity to care for COVID-19 patients. Six days later, the hospital moved Sharma’s husband farther from Brampton to Runnymede Healthcare Centre. 

“It’s like a slap in the face,” said Sharma.

It’s a similar story for Lola Gayle’s 88-year-old mother Salome. Gayle’s mother was a patient in Brampton Civic’s CCC unit before she was moved to Etobicoke General in December and then to Runnymede Healthcare Centre following the emergency order.

Salome Gayle, 88, suffered a stroke that left part of her brain damaged. She was formerly a CCC patient at Brampton Civic Hospital. (Lola Gayle)

In 2016, her mother suffered a severe stroke that damaged a quarter of her brain. She can no longer speak or lie flat and also has a tracheostomy and a feeding tube.

Gayle — who lives in Brampton — said she and her siblings used to take turns to regularly visit her mother to wash her, cut her nails and provide other care. She said she now struggles to travel to Toronto daily while juggling her job as an acting principal in Peel and taking care of her two young children.

“It was like an assault on us,” said Gayle.

 “We were in distress, we’re confused. We were not consulted. We were not given any choice.”

In a response to complaints by families of Brampton Civic Hospital’s CCC patients, Ontario’s patient ombudsman was critical of William Osler’s handling of the move.

“As you know, Brampton has high numbers of newcomers, people of colour and lower income individuals who face an increased level of systemic barriers related to access to health and transportation equity,” the letter from the ombusdman to William Osler reads.

“The transfer of these patients to hospitals in Toronto, challenges families’ ability to continue to participate in the care of their loved ones …  given William Osler did not provide the documents we requested, we do not know if the hospital weighed these adverse impacts in its decision or did anything to mitigate them.”

William Osler defended its communication with families in a statement to CBC News, saying: “A robust communications process was undertaken to engage patients and families in a dialogue around this change.”

Care close to home

Alex Van Kralingen, the lawyer representing Gayle, Sharma and five other substitute decision makers of former CCC patients at Brampton Civic Hospital, said he learned in December that Brampton Civic Hospital had its designation as a CCC hospital removed. CBC news has reviewed documents in which officials from William Osler confirm its board approved the change in designation.

The Ministry of Health did not respond to questions from CBC News about why Brampton Civic Hospital’s designation as a CCC hospital was removed — a move that appears to leave one of the largest municipalities in the country without any CCC beds. The ministry announced more CCC beds are coming to Peel Memorial, but construction isn’t set to begin until 2023.

“We provide health care locally because it’s an obligation under the Canada Health Act, but separately, it’s the right thing to do,” said Van Kralingen.

“And these family members were incredibly frustrated with the idea of being removed from the care setting that was appropriate for their loved ones, but also closest to them.”

Alex Van Kralingen is a lawyer representing seven substitute decision makers for patients in the William Osler system. (Farrah Merali/CBC)

According to some advocates, the elimination of Complex Continuing Care beds was an issue pre-COVID-19.

“Something we’ve seen over the last number of years is this erosion of chronic care beds in hospitals,” said Jane Meadus, staff lawyer and institutional advocate at the Advocacy Centre for the Elderly in Toronto. 

Meadus said while it’s not clear what motive hospitals would have to push complex continuing care patients out, it’s happening more quickly now because of the COVID-19 emergency order.

“I think that this is simply using [the order] in some ways as an excuse to get people out.”

Response from William Osler

In a statement to CBC News about its closure of the CCC beds at Brampton Civic, William Osler Health said: “[Its] goal is to achieve the greatest quality of life for all of our patients, while ensuring care is received in the setting best suited for their individual need.” 

“Patients had the option to transfer to other centres better designed to support their specialized health care needs.”

The hospital network said it hopes CCC patients will choose to stay in the facility they’ve now been moved to as it is a “more appropriate health care setting for their needs,” but added patients will have the opportunity to return to William Osler once the emergency order expires.

Meanwhile, the Sharmas want to see their loved one moved back to Etobicoke — it’s closer to home, meaning they can make more visits.

Harpreet Sharma holds up a family photo of him as a child with his parents before the cardiac arrest that damaged his father’s brain. (Farrah Merali/CBC)

“I understand that everybody is suffering due to COVID. I understand that some people’s lives may be worse than ours,” said Harpreet Sharma, Sangita’s son.

“But I think that this is kind of like the dark side that people don’t expect.”

View original article here Source