Forest Heights crisis highlights gap between hospitals and long-term care, expert says

Forest Heights Revera Long-Term Care Home has quickly become the home hardest-hit by COVID-19 in Waterloo region, with 23 deaths, 118 resident cases and 45 staff cases, according to numbers released by regional public health Friday.

The situation shows why long-term care homes should have been treated more like hospitals during the pandemic, a local gerontologist says, with early, aggressive measures in place to halt the spread of infection.

"When a pandemic comes, we should be able to anticipate that if the virus gets in, [people in long-term care] are not going to do well," said Dr. George Heckman, an associate professor in the school of public health and health systems at the University of Waterloo.

"As a system, we got caught and we did not focus on long-term care early enough and aggressively enough, as we did in the acute care hospitals."

Heckman said one clear action should have been to prioritize personal protective equipment early on. While mask fittings are a routine practice in hospital, that is not the case in long-term care homes, he said. 

The union representing personal support workers, registered practical nurses and other staff at Forest Heights told CBC K-W, that as with many Ontario long-term care homes, staff at Forest Heights didn't have early access to the level of personal protective equipment available in hospitals.

"In the beginning there was a shortage, so the only time they were using PPE in the very beginning was if they were going into a room with a resident that was COVID positive," said Dayle Steadman is vice-president of Unifor Local 1106. 

"Since then they've been provided with the PPE that's required."

More testing, earlier on, would have also helped, said Heckman.

Forest Heights moving residents

Forest Heights has recently hired 20 new staffers and been assigned 12 personal support workers by Ontario Health, in response to the number of cases and deaths, according to a statement from the long-term care home's chief medical officer.

Revera, which operates the home, said Tuesday it plans to move 40 residents to hospital, to allow more distance between residents. More than half of the home's residents had previously been in four-person rooms.

Irene Bitschy, 105, is among those who've been moved. She tested positive for COVID-19 at the home last weekend and was moved to Cambridge Memorial Hospital on Tuesday, according to her granddaughter, Heidi Sproul.

Sproul said she's glad her grandmother will be surrounded by doctors and nurses, but said the solution is imperfect.

"Being moved from the only place that she's known for the last 10 years, where she was surrounded by pictures of family and the staff that she knows, now she's in a hospital with no contact with any family, so we're concerned about her mental health as well," said Sproul.

'They weren't prepared,' says family member

Although staffers at the home are hardworking and loving, Sproul said she noticed they seemed overworked and short-handed, even before the pandemic hit.

Sproul said she thinks the home could have done more to isolate residents from one another, earlier on. 

"We think that they weren't prepared for an outbreak like this," said Sproul. 

The union agrees, especially since many residents were sharing rooms. 

"They didn't take the initial precautions that other homes have taken," said Steadman.

Health care as a system: Heckman

Moving residents into hospital seems the right move for Revera, said Heckman. But moving forward, he said "we really need to think hard as a health system" about how to improve long-term care.

That means paying workers better, so that they aren't pushed to work in more than one home, and having access to the level of protective equipment that is available in hospitals, he said.

In the days and weeks to come, Sproul said she and her family will be waiting by the phone to hear updates about her grandmother. But she agrees the pandemic should be a moment to reflect and push for change.

"If we don't speak up about the concerns that we have then we're not going to see changes happening," she said.