Privacy lacking for palliative care patients at Parkwood

Click here to read ‘Privacy lacking for palliative care patients at Parkwood‘ by Jonathan Sher – London Free Press, October 28, 2015

London’s Parkwood Hospital places some palliative-care patients in crowded wards where they spend their final days watching roommates die, a situation a leading advocate for seniors calls “institutionalized elder abuse.”

“I can’t believe this,” said Susan Eng of the Canadian Association for Retired Persons. “It’s appalling . . . It’s this kind of thing that frightens the hell out of people.”

A lack of privacy for dying patients and their families was one of a number of problems flagged by experts hired by the hospital to produce a report three years ago that wasn’t made public. The Free Press recently obtained it from another source.

Dr. Jose Pereira and Dr. Robin Fainsinger, who led palliative care in Ottawa and Edmonton, questioned why Parkwood places eight palliative patients in rooms with four beds each, calling the practice a “significant source of distress for patients, families, staff and referral sources.”

“It is very difficult, and one could argue inappropriate, to have four terminally-ill patients in the same room with limited privacy and limited space for family members to visit,” they wrote. “Patients who are at the end of life are also subjected to witnessing the deaths of their roommates; sometimes multiple deaths are witnessed.”

Asked by The Free Press about the report, those who oversee Parkwood at St. Joseph’s Health Care defended their record in a statement placed on the home page of its website that revealed plans to replace wards with private rooms in the spring.

“It is people who provide care, not facilities,” St. Joseph’s chief executive Gillian Kernaghan wrote. “Whatever the need, our staff, physicians and volunteers act with the greatest skill, sensitivity and compassion. This is health care at its finest. This is what St. Joseph’s is all about.”

The Free Press asked why it will take hospital officials four years to replace eight ward beds with private rooms. St. Joseph’s spokesperson Kathy Burrill replied Parkwood is part of a wider network that needed reform, so changes at Parkwood had to wait until the entire network was ready.

“We needed to consider how to move forward as a whole,” she said.

In the meantime, Parkwood staff try to find privacy, an official wrote:

Whenever possible, a dying patient is moved to a private room.

Families and patients can use a private lounge and meeting rooms.

Asked if the delay has been too long, Burrill said that was a “reasonable question” but one better directed to those who oversee regional health-care spending, the Southwest Local Health Integration Network.

But the network’s senior director said local hospitals were driving changes in their facilities. “I can’t speak to the timeline hospitals used,” Kelly Gillis said.

Dying with Dignity Canada chief executive Wendy Morris said patients and their families deserve better: “The report nailed it . . . That just doesn’t meet the definition of quality care.”

The lack of privacy robs families of the chance to reconcile with dying loved ones, creating troubles that may endure after death, she said.

Eng rejects the justification hospitals use for the delay. Hospital officials should have changed an “inhumane” practice even before experts pointed it out. “It’s institutionalized elder abuse . . . You’ve made their last few hours really awful,” she said.

Asked about such concerns, Burrill wrote, “We do not speak to other organizations through the media.”

In her message to the community, Kernaghan writes ward beds will be replaced but defends the status quo, including a quote from the wife of a patient who preferred it when he was moved from a private room to a ward bed, and citing a survey that found 92.8 per cent of patients and family rated overall care as very good or excellent.

The hospital foundation will launch a fundraising drive in November that includes a target of $500,000 to replace eight ward beds with private rooms; the hospital will also give $250,000.

“We’re really excited about it,” Burrill said.