Death while under Protection

Saturday evening a resident in a long-term care facility was found unconscious on the floor of the washroom in their room. It’s unclear if the individual had a heart attack or fell and hit their head. They were unconscious, but breathing on their own.

Their care-giver found them, called the RN on duty, who assessed the person and situation and called 9-1-1. Someone stayed with the resident the whole time. Paramedics arrived within 10 minutes. Just at their point of arrival did the resident stop breathing. There is some question about whether CPR could have helped. None was administered. The caregiver maintains the person had only just stopped breathing, the paramedics decided it was too late to do anything.

Having declared the resident deceased, the paramedics helped move the person from the floor to their bed. The question becomes what next?

This resident was under the direction of Adult Protection Services of the Department of Health and Wellness, with final instructions sealed and held by the Public Trustee.

Staff at the care facility had no instructions about who to contact to inform about the death. Are there family to inform? Is the deceased to be buried, cremated or are they an organ donor? Where organ donation is a factor speed is of the essence. Those details were under seal with the Public Trustee.

This is an example where the health care system is designed for the convenience of the executives rather than the patients and front line workers. The Public Trustee’s office is open Monday to Friday. It’s either from 8:30 am to 4:30 pm or 9 am to 5 pm. Specific hours aren’t listed on the Department of Health’s website. And the 211 Service says “the site” hours are 8:30 am to 4:30 pm. I’m unsure if that’s their (the 211-service’s) site or Dept. of Health’s site:

http://ns.211.ca/service/10060203_6030784/adult_protection_services

Nonetheless, the information available is fairly ambiguous. It seems to be a wait-until-the-office-opens situation. Meanwhile, a person’s remains are in limbo. Does Halifax expect long-term care facilities to keep deceased residents around, in this case for 37 hours, until someone comes in to an office? And if that person had agreed to organ donation, would all of those transplantable parts no longer be suitable for surgery?

This is one of the many gaps created in a health care system which relies on top-down ideas. No one seems to have considered the details and procedures for death outside office hours.

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