It’s been four years since Tony Barnett’s father Alfred James “Jim” Barnett passed away at the Parkstone Enhanced Care home in Clayton Park. The 80-year-old had been admitted to the unit for residents with dementia in December 2013, unable to talk but capable of walking with assistance, arm-in-arm with Tony or his sisters.
The family was paying $3,000 a month for his
care. He was admitted after his dementia had progressed to a point where after several years his daughter, Brenda Poirier, and her mother could no longer care for him. Within two months at Parkstone, his father was confined to a wheelchair, says son Tony.
Brenda says a nurse at the Shannex-owned home called about her dad having two separate falls but she was assured “he was all right.” Tony and his other sister, Barbara Benedict, visited every few days and noticed he had little appetite and seemed to be sleeping a lot.
“He was on medication and seemed to be going downhill fast,” recalls Barb. “I wish now I had asked more questions.”
On March 10, 2014, Parkstone summoned the family but Jim
died before they arrived.
Tony was shocked by his father’s rapid decline and death. He received an even bigger shock when the Office of the Medical Examiner called his sister Brenda a few days later to ask about their father’s broken hip. The funeral home had noticed it on the death certificate. Barbara was there when her sister took the call from the medical examiner’s office and remembers her sister saying the office wanted to know if the family wanted further inquiry.
“I said, what?” recalls Barbara. “We were all shocked his hip was broke.”
Tony says he wanted to find out why Parkstone had never told the family about the injury but his grieving mother vetoed any further action, saying their father was out of pain and “at peace.”
That peace was shattered last week when Tony read about the circumstances surrounding Chrissy Dunnington’s death this March. Dunnington was a 40-year-old disabled resident at the same Parkstone Enhanced Care home. She was admitted to emergency with pneumonia and septic shock from a badly infected bedsore. The province is investigating a complaint filed by her foster family alleging Chrissy’s care was negligent during her 18 months at the Shannex facility. Tony says Chrissy’s story triggered memories of what his family experienced during his father’s short stay on the dementia unit with 27 other residents.
“There were a lot of people in there who smelled of feces and many times we couldn’t even find anyone to come and clean my dad,” recalls Tony. “It was an empty unit, like a ghost town. We had to go outside the locked unit and request at the front desk if someone could come and help.”
It also bothered Tony’s sisters to see their father wearing somebody else’s clothes. Tony claims that during his father’s short stay on the dementia unit not only his clothes but his glasses and dentures disappeared and were never found. A bigger mystery is how or why the family didn’t know Jim Barnett had a broken hip.
Tony and his two sisters say Parkstone never informed the family he’d had a fracture. They say they never had a conversation with a doctor. Both Tony and his sister Barbara question why their father let out “ungodly screams” as he was being dressed one morning shortly before his death. Tony says the continuing care assistant replied “all dementia patients do that.”
Weeks after Parkstone notified the family aboutthe falls, Tony and Barbara noticed their father kept pointing at his side. Tony says he asked a nurse to request that the doctor
check him out on his weekly Thursday visit. He says the nurse reported Jim had been seen and the doctor indicated he had “a sore side.”
Shannex, which owns Parkstone and more than 30 other for-profit nursing homes in the Maritimes, says it cannot comment on individual cases because it is bound by provisions in the provincial Privacy Act.
The family’s specific concerns about their father’s care were listed in an email to Shannex last week. The company responded by email.
Katherine VanBuskirk, a Shannex spokesperson and director of community relations, told The Chronicle Herald that Parkstone would check its medical records and have someone call the Barnett family.
“We have been speaking with the family and will certainly continue to work with them to answer any questions they have,” Van-Buskirk said in an email Wednesday.
She did not address any of the specific complaints raised by the family.
On Monday, Brenda Poirier received a call from Joanne Martel- MacKay, the current administrator at Parkstone. She wasn’t working there when Jim Barnett was a resident but confirmed it’s her job to ensure families’ questions are answered.
Brenda, who had power of attorney over her father when he was alive, says she asked the administrator about her father’s broken hip. Martel-MacKay said medical information couldn’t be shared with anyone except the administrator of the estate. That’s a problem in this case because Jim Barnett died without leaving a will so no one was appointed administrator. Martel-MacKay left her name and phone number and invited the family to contact her for further discussion.
Last week, Tony decided to call the Office of the Medical Examiner and ask how they found out about his father’s broken hip four years ago. Here’s part of the response he received: “Upon review of the death certificate, it was noted in section 14 that there had been a hip fracture. A fracture is always a ‘red flag’ and we gather information related to the fracture. For example, how did the fracture occur and did the individual return to the level of mobility they had prior to the injury. The purpose is to try to determine if the fracture contributed to the death.
“The medical examiner reviewed your father’s medical records. Your father was up and mobilizing after he fell. The medical examiner felt the falls did not contribute to his death.
“The death was considered a No Case and the cremation was approved.”
It is not clear how the word “mobilizing” is defined.
Tony, Barbara and Brenda all say that after the falls, their father never regained his former mobility.
“He was strapped in the wheelchair,” Tony recalls.
“We never saw him up walking again,” says Barbara.
Tony plans to follow up with the medical examiner to try and find out what the medical records from Parkstone say about his father’s condition, and what information led the medical examiner to conclude Jim was “up and mobilizing.” That information can’t be accessed by the media but only by next-of-kin. As for obtaining their father’s medical information from the nursing home itself, that’s a mushy area under the province’s Personal Health Information Act.
The thrust of the act is to protect records and permit disclosure only as “exceptions,” explains Janet Burt Gerrans with the Office of Freedom of Information and Protection of Privacy (FOIPOP). For example, Brenda could make an application through probate court to be named the administrator of her father’s estate and ask Parkstone for the entire medical file. It’s still up to the home whether to release it.
The act uses the word “may” not “must” when talking about disclosing medical information. Another avenue the Barnett siblings could try is under a section of the act which states the nursing home may release to family members certain information (not the whole file) about care recently received by the deceased resident.
If the home denies the request, the FOIPOP office can help with an appeal although that would be a first. There’s so much secrecy the process is likely to require more effort than most grieving families can muster.
In Ontario, an arms-length government agency known as Health Quality Ontario provides online public reporting about health indicators in nursing homes. Data on falls, bedsores, restraint use and staffing can be accessed by facility and provincewide.
In Ontario, the data is put in every three months using a software program called RAI (Resident Assessment Instrument). Nova Scotia is considering whether to fund the tool and hire extra staff to do the paperwork. In New Brunswick, the same system cost less than $3 million to implement. Many provinces now use it.
Meanwhile, Tony remains troubled by the care his father received. He says he’s not planning to fight or sue or make a formal complaint. His father’s gone and what Tony learned, he says, may serve as a cautionary tale for others.