Canada's largest veterans’ facility under fire
Dorothy Burnell, 86, talks to her husband George Burnell, 92, at Sunnybrook's Veterans Centre in Toronto where he lives on Sunday, Oct. 28, 2012. (Colin Perkel / THE CANADIAN PRESS)
Colin Perkel, The Canadian Press
Published Thursday, November 8, 2012 12:44PM EST
Last Updated Thursday, November 8, 2012 10:29PM EST
TORONTO -- Canada's largest veterans facility is under fire from several families with complaints their frail relatives have been neglected or forced to endure unsanitary conditions.
They also say raising concerns at Sunnybrook Health Sciences Centre -- among them delayed bathing and feeding, soiled sheets, dead mice in rooms, a lack of toilet paper, and constant room and caregiver changes -- were mostly met with indifference or hostility.
"It's appalling what's going on in the veterans' wing of Sunnybrook," says Rodney Burnell, whose 92-year-old father George lives on the spartan 3rd floor of K-Wing.
"They fought for us and it's our turn to fight for them."
For its part, Sunnybrook suggests the complaints are coming from a handful of malcontents. The facility points to surveys showing sector-leading levels of patient and family satisfaction.
Complaints, it says, are taken seriously, investigated and acted on as required.
"We want every veteran to get the best care possible," says medical director, Dr. Jocelyn Charles.
In a section of its sprawling campus, Sunnybrook is home to 500 veterans of the Second World War and Korean War. For many, it's much like a pleasant old-age home.
Others need care for even basic functioning and live in a hospital-like setting. It is among this group the complaints seem loudest.
Some families -- those whose relatives need the most care -- say there's a bleak reality beyond the pomp of Remembrance Day, the welcoming gardens, and Warriors Hall with its well-worn furniture: Moaning patients ignored; others left to stare at ceilings for hours; dentures hanging from mouths.
The Burnells cite a litany of issues with George's care, including his being moved eight times without notice to the family.
"My husband was in a real panic. He didn't know where he was," Dorothy Burnell says.
"The family felt like he was just shoved around like a dirty rag," her son adds.
The facility says patients are placed according to their care needs, meaning they are moved from time to time. Sometimes, patients are moved because their bed or room is required for someone else.
It would be "very rare" for someone to be moved without relatives knowing, Charles says.
"We have a whole system of notifying people."
Residents, many of whom are unable to feed themselves, go hungry or get cold food, relatives say, because there aren't enough caregivers to feed them.
"We try to feed every veteran in a timely manner," Charles counters. "When we're aware of any delays, we look at what were the systems issues and is there an improvement we can make."
Some relatives have resorted to hiring their own caregivers to keep watch over their loved ones.
Jackie Storrison, whose 91-year-old father has been at Sunnybrook for three years, says the care has "seriously dropped" but efforts at redress were stonewalled.
"They wrote the book on excuses," says Storrison, who keeps a journal of incidents. "My interaction with anyone there has been very negative and non-productive. So I've given up."
Storrison, who puts her father to bed most every night, says she frequently discovers feces on his sheets, but has been chastised for changing them.
At one point, she says her dad went without toilet paper for three days. She says his primary-care nurse said there was nothing she could do because it was a housekeeping matter.
Often, she says, his medications aren't administered.
Storrison says one of the people she complained to should be called the "don't-bother-the-nurses" manager.
"My heart goes out to the number of men there who don't get visitors."
Burnell recounts how her complaints about mice and droppings were dismissed as something that happens in nursing homes because residents eat in their rooms.
Staff finally laid traps next to his bed then, she says, they promptly forgot about them.
"My son looked underneath the window-ledge area and saw all these (dead) mice," Burnell, 86, says.
Recently, she says she found her husband severely bruised on the bridge of his nose but nobody could say what happened and no one made any note of the injury.
Sunnybrook did not immediately respond to a request for comment on the claim.
Nancy Smokler, manager of patient relations, expressed surprise at most of the grievances, saying no one had come to her despite her "open door."
"If people are not finding their complaints are being addressed on the unit ... they can be told to come and see me."
Smokler did acknowledge the mice issue, but said the hospital has dealt with it.
As a veterans' centre, Sunnybrook is unique in Canada in that it gets funding from both the province and Ottawa.
The facility complies voluntarily with Ontario standards and submits voluntarily to quality audits -- the last one was several years ago, according to operations director Dorothy Ferguson. But it is ultimately accountable to Veterans Affairs Canada.
Following a "benchmarking" exercise, the facility laid off 12 full-time and eight part-time registered nurses in April. However, Ferguson insists most are still working.
"They haven't actually left -- we did decrease the numbers in the budget but we're still working through the process," Ferguson says.
Still, families complain about constant staff turnover -- especially stressful for residents with Alzheimer's or dementia. Newer staff lack experience or familiarity with patients, they say.
Sunnybrook's patient-to-nurse ratios are as good or better than similar facilities, Ferguson says, and the "skills-mix adjustment" has had no impact on care.
Only 16 registered nurses and registered practical nurses out of about 500 across the program left this year, she says.
Stephen Little, area director with Veterans Affairs Canada, says the facility has budget "constraints" but there are no issues with the care it provides.
Sunnybrook, he points out, is not as generously endowed as more expensive private nursing homes, but it meets or exceeds standards, he says.
On occasion, a resident may be dressed or bathed later than normal because staff may be tied up, he says.
"As with any large institution, there are priorities (but) at no time is the safety and the well-being of the residents being jeopardized in any way," Little says.
Families say they chose Sunnybrook -- which bills itself as one of Canada's foremost veterans' centres -- because of its first-class reputation.
The reality was a shock, some families say.
The social worker who showed her around "should be working in marketing because she paints a wonderful picture," Storrison says.
"If that's considered one of the best long-term care facilities, I don't ever want to set foot in another one. I can't imagine how they would be."
Debra Stuart, whose 90-year-old father has been in Sunnybrook since April last year with advanced dementia, says she tried in vain for months to get anyone to listen to her concerns.
While some staff are caring and knowledgeable, she says she's also seen patients verbally abused or handled roughly, basic care neglected, and a dire shortage of nurses in off hours.
No one paid attention to her pleas recently when her dad was unusually unresponsive for several days, she says. He was finally diagnosed with pneumonia.
"For the families, this is like our war," Stuart says.
"He is a war vet," Stuart says. "There's money to take care of people like him and he should be taken care of."
On the other hand, Stuart's sister Randi says she's "extremely happy" with her father's care, while Sunnybrook says Stuart has been abusive toward staff, something she denies.
Dave Gordon, executive director of the Royal Canadian Legion, Ontario provincial command, says he's had no complaints about Sunnybrook in several years -- except from Stuart.
"We take complaints of this nature very seriously and we do a follow up with them," Gordon says.
One woman, who asked her name not be used, calls the five years of care her father received before he passed away recently "fantastic."
Even so, she says his care was compromised because of staffing cuts among registered nurses. Her complaints, when she had them, were dealt with "after I yelled."
"The bottom line is that these patients in there are not going to be treated the way their families treat them," the woman says.
Sunnybrook is adamant its level of care is as good as, or better, than comparable facilities.
As he munches down on his frequent between-meal hamburger purchased at the cafeteria, an ambulatory vet responds when asked about his care: "It's perfect. I wouldn't leave here for all the world."
Yet, he, too, immediately describes unhappiness over constant caregiver changes, noting staff are pretty much his "only family."
Charles says it's a familiar plaint
"Some of them really want one or two nurses to look after them all the time, but that's really not feasible," Charles says.
Dean Peroff, a lawyer acting for Stuart, counters suggestions relatives are overly emotional or expect too much, saying there's a clear pattern to their stories.
Staff appear to have a "fortress mentality" and leave relatives with a "general sense of insensitivity," he says.
Many relatives are afraid to complain and some families spoke only on condition they not be identified.
"There's a tremendous fear of coming forward," Peroff says.
"That's not atypical in any health-care facility," Ferguson, the operations director, says.