Tim Gottschall’s experience in seeking care for his late mother, Hilda Gottschall, is all too familiar. Like so many other broken-hearted families, the Gottschall’s learned that Nova Scotia health care can be deaf to patient needs and family desires.
Mrs. Gottschall was diabetic. Diabetes presents its own set of problems, which are well-known to medical professionals. Yet hers seems to have been treated rather cavalierly. During a phone consultation her doctor determined she was having a medical emergency. Her doctor told Tim to bring his mother to the Halifax Infirmary, where he (her doctor) would have a team assembled to handle her case. But the ambulance refused to take her to the Infirmary and delivered her to Dartmouth General. This forced Tim Gottschall put his mother in his car and drive her across the bridge where a medical team was waiting to do an amputation!
After a month in hospital his mother was sent home. That’s when Tim discovered a gangrenous toe! Naturally, Tim didn’t understand why she was discharged from hospital.
This time she went to Dartmouth General. Tim did all he could to make staff aware of her previous medical history, which included two cardiac events and a bedsore that had been successfully treated. Because of COVID restrictions he felt his mother wasn’t getting the care she needed. “Physiotherapy – they didn’t return my calls,” he told The Herald. He finally got a meeting with the hospital administration where he laid out all their failures, like not bathing her, not giving her physiotherapy or engaging with her, and a newly developed bedsore.
“Bedsore” is too benign a word to describe the gaping fist-sized hole she had. I know of another recent case (2020) where a patient in another facility also had “a bedsore”. But that sore measured 6 inches by 2 inches and was open to the bone!! If hospitals don’t treat bedsores as a significant issue, those who are patient families and friends damn well should scream the place down. We have had too many cases in this province – and too many unfulfilled promises by the NSHA – to resolve the bedsore problem.
Gottschall’s are critical complaints because when you talk to those who work in long-term care they say the majority of residents they receive are far more ill than a generation ago. I question the harm being done to patients while in hospital. They go to hospital with one set of medical issues, which are addressed, after which a type of neglect seems to kick in for those people waiting to move into long-term care.
In 1990 an elderly relative of ours was taken by ambulance to the Victoria General in Halifax. By the time her daughter, who followed the ambulance in her own car, found a parking space and entered the VG security was ready to charge the daughter with elder abuse.
The VG admission team found the patient had a broken collar bone, broken hip and was malnourished. The problem for the VG, and the then Capital District Health Authority, was this woman was a transfer patient from the Hants Community Hospital in Windsor, where she had spent the previous three months. During that time two hips were broken, as well as her collar bone.
Through investigations we learned these broken bones were the result of falls that happened because her call bell wasn’t answered she attempted to get out of bed to go to the washroom by herself. The malnourishment occurred because while food was brought to her, it was usually placed out of reach. Bedside tables get shoved aside during doctor visits, personal care sessions or room cleaning. Staff forget to move the table back to where it had been and food services staff were told not to move a table. So the food was there, but the patient was physically unable to reach it. Staff would remove the tray without asking if she ate or why she didn’t eat.
In 2012 there were national headlines about the “lack of nutritional value” of the food served to Canadian hospital patients. The nutritional value was so poor that anyone exposed to it for 30 days would most certainly become malnourished. How does anyone recover from any illness when they are in such a state?
It’s because of the lousy hospital food in terms of nutrition, not taste, that we even have a body called the Canadian Malnutrition Task Force (CMTF). In 2016 the head of the CMTF, Heather Keller, made media rounds promoting a proper diet as key to good health.
At the time Keller was making the rounds, chef Joshna Maharaj was working with the Scarborough Hospital for Sick Children to create more flavourful meals for patients. News reports at the time said, “Out went bland prepackaged meals. In their place, meals using fresh basic ingredients, seasonal fruits and vegetables, and meats from local producers.” Maharaj’s “changes got lots of media attention, support from foundations and seemed like a good idea. BUT, once she moved on, hospitals returned to their old habits and tasteless – and harmful – menus.”
So where are hospital menus in Nova Scotia now? A healthy diet is critical when you consider that between 50-60% of patients in this province are hospitalized for eight or more months waiting for a long-term care placement.
Poor nutrition, lack of physical activity (at most patients might be sat in a chair or walk around the nurses’ station), and mental stimulation (think months laying in bed looking at a TV screen) seem to compound the declining health of people waiting placement.
The Gottschall’s experience is featured in The Chronicle Herald of Friday, Nov. 3, 2021:
The fact that his mother endured a bedsore which he described as “a hole” shows another area where headlines have done nothing to improve care.
Fist-sized bedsores which caused death were the headlines in 2018. Even then the proliferation of bedsores, which are a clear indicator of a failure of care, were a decade-old story in Nova Scotia.
The failures in Nova Scotia health care are not new. They are well documented. The NSHA has promised action on them and then relied on the short memories of the public and politicians to do what it always does. Study the problem, but not act.
These kinds of prolonged failures should constitute a criminal offense.