Workers at Quebec's worst-hit long-term care home struggled to feed, hydrate residents, inquest hears

It took a matter of days at the end of March 2020 for what was happening inside CHSLD Sainte-Dorothée, Quebec's worst-hit long-term care home, to degenerate into chaos, witnesses told a coroner Monday.

On a fourth day of testimony about the home at the coroner's inquest examining deaths in seniors' homes in the province, an occupational therapist who had volunteered to help sobbed as she recounted heart-wrenching decisions she said still give her nightmares.

The woman, whose identity is protected by a publication ban, said she was performing the duties of a patient attendant, washing and moving patients in their beds, despite having no proper training.

She described her anguish at having to tie a COVID-positive patient with dementia to an armchair to prevent him from wandering the halls, looking for a phone to call his wife every day.

She said she tried everything to keep him in his room, but the telecom companies at the time could not come and install a phone and his family could not afford a cellphone for him. 

"In all these situations, I still ask myself if I did the right thing. I did the best I could to the best of my ability, but it still haunts me," she said through tears.

She described having to do more work than other volunteers, such as psychologists and school nurses, because she knew how to move patients. 

"Some patients needed food and water, and I just didn't have time. It was awful."

Not allowed to wear PPE, ordered to work on different floors

She said staff and volunteers alike were ordered to work in different units and floors nearly every day. 

As a result, they knew so little about the patients, the woman said, that "we didn't know if they were dead or not before we opened the door to their room."

The therapist was one of six people testifying Tuesday to have worked with patients at Sainte-Dorothée amid the worst of the crisis, in late March and April last year. All of their names are protected by a publication ban. 

The ongoing coroner's inquest is revisiting what happened in the care homes in the spring of 2020. Its goal is not to determine guilt, but to come up with recommendations to prevent future tragedies, said the coroner leading the proceedings, Géhane Kamel.

Six publicly regulated care homes — known as CHSLDs for Centres d'hébergement de soins de longue durée— and one private seniors' residence have been selected to be examined by Kamel. One death is examined for each establishment.

Currently, Kamel is probing the death of 94-year-old Anna José Maquet on April 3, 2020 at CHSLD Sainte-Dorothée, in Laval. 

The workers discussed being forbidden from wearing masks and other personal protective equipment unless they had to be in direct contact with a patient.

They were repeatedly forced to work days of up to 16 hours, often had to care for more than 15 patients and saw people die every day. 

The occupational therapist recalled being thankful for the handmade visor she bought from a colleague when a COVID-positive patient with dementia-induced behavioural issues spat in her face.

Kamel told one patient attendant who said she and her colleague were left alone to deal with 32 patients, that the story was giving her goose bumps. 

One patient attendant who worked the night shift says she was left out of the first mass testing for employees at the home (an attempt to quell the raging first-wave outbreak), seemingly because management forgot to call and tell her about it. 

In all, 102 patients died at CHSLD Sainte-Dorothée; 211 residents and 173 employees were infected with COVID-19. 

The occupational therapist began working at the home three days after Maquet's death and said almost all the home's staff was already away sick or quarantining. 

A nursing assistant who testified later in the day was among them. That woman said she's worked at Sainte-Dorothée for more than 15 years. She said for weeks in March, after the Quebec government declared a public health emergency, most of the staff weren't wearing masks. 

She began to experience fatigue and leg pains in early April but was told she couldn't leave because the home was so short-staffed. Hours later, a manager found a replacement for her and she was allowed to leave.

Workers haunted by patients' suffering

The nursing assistant said she became very sick the next day and wasn't able to return to work until one month later, May 2. 

"I was crying from the pain. It was so physically painful, and I just couldn't imagine how the patients had gone through that alone in their rooms, with no one to hold them," she told the inquest. 

The occupational therapist, who was the first to testify for the day, said at the end of her testimony that despite the horror of her experience at the CHSLD, "I would do it again." 

"If we weren't there, what would have happened? … Who would have done it?"

She said conditions worsened throughout April, before she was ordered by her doctor to stop working because of a back injury developed while moving a patient.

The inquest into what happened at Sainte-Dorothée continues Tuesday and Wednesday.