The acute care psychiatric ward at The Ottawa Hospital is no place for an elderly dementia patient, says an Ottawa woman whose husband’s condition worsened during the two months he spent on the ward this summer because there was nowhere else for him to go.
Zofia Wald-Mroz says her husband, Krzysztof Mroz, regressed and became incontinent after he was admitted to the secure ward at the Civic Campus on July 24 from his assisted living facility in Orléans. Krzysztof (pronounced Kristoff) is a 78-year-old retired anesthetist with advanced dementia who was sent to the Civic for his sometimes violent behaviour at the home.
He has since been transferred to The Royal, where his condition has improved, but Zofia fears he will soon be sent back to the Civic because of a shortage of long-term care placements and so-called alternate level of care (ALC) hospital beds where elderly patients can wait for a spot in long-term care to open.
For a time, Krzysztof was in the room next door to Jean-Marc Lang, a 26-year-old man with autism who has been confined on the ward since February and whose story was told by this newspaper earlier this month.
The Ottawa Hospital currently has 219 ALC beds and the pandemic has made the average length of stay in them higher than normal.
“The COVID-19 pandemic has created a significant challenge for our regional health-care system. Safety measures and COVID-19 outbreaks in long-term care homes have led to reduced capacity and made it difficult to transfer patients into the care they need in the community,” the hospital said in an emailed statement.
“The Ottawa Hospital, along with other hospitals in the region, is implementing a number of measures to increase capacity both in the hospital and throughout the community, to ensure that patients have access to the most appropriate care for their needs. This includes the temporary 40-bed unit currently being constructed at the Civic Campus, expanded long-term care capacity in the community, and the transitional care unit at Greystone Village retirement home (overseen by Bruyère).”
It took weeks of lobbying by Zofia for Krzysztof to be moved to The Royal, where she said his treatment has been “amazing.” He was admitted to its geriatric psychiatry ward on Sept. 18 and immediately began to improve. But The Royal wants to return him to The Ottawa Hospital and Zofia fears he’ll end up back on the secure psychiatric ward and will again slide downhill.
The average stay on The Royal’s geriatric ward is 60 to 90 days and the hospital says its policy is to return patients to where they came from, be it their residence, an LTC home or another hospital, in order to make room for incoming patients.
Krzysztof has been on a waiting list for long-term care for two years, Zofia said. She can’t look after him at home — he requires around-the-clock care and she said she was told she could only have a personal support worker come to the house twice a week to help Krzysztof shower. Nor can she afford a retirement home, with their “outrageous” $5,000 to $7,000 monthly fee, she said.
But an acute care bed at The Ottawa Hospital costs about $1,000 a day plus the cost of the security guard, if one is needed again should his aggression return.
“What a waste of health care funds,” Zofia said. “If you want to spend that money, give it to me and I’ll put him in some retirement home.
“Ultimately, long-term care is not a choice, it is a necessity. And I really don’t think that people who are at end of life, even if it is prolonged end of life, should have to cover that cost. For me, it’s part of the health care system.”
“The thing that I find tragic is that this has been going on since July and Kris is taking up an acute care bed from some other deserving patient,” Zofia said. “Maybe he needed the two weeks it took to stabilize him at The Royal, but the rest of the time he could have been in a more appropriate place.”
Krzysztof’s time at the Civic was “appalling,” she said. The secure psychiatric ward isn’t equipped to care for geriatric patients and he would often be left alone in his room for hours at a time, often in a wet diaper and urine-soaked clothes because he was unable to get himself to the bathroom.
“This is a clinical teaching hospital in the capital of the country,” she said. “His clothes would be soaked. His t-shirt would be soaked. He was reeking of urine. He shouldn’t be left in diapers for eight hours. These are things that I would never, ever imagine would happen in a hospital.”
The COVID-19 pandemic has made the situation even worse, she said. The Civic’s few private rooms were used to isolate patients, meaning her husband was moved to five different rooms in the two months he was there, something highly disruptive for a person with dementia. He grew more aggressive and the hospital was forced to post a security guard outside his door.
Unlike most of the patients on the ward, Krzysztof was completely dependent on the nurses and orderlies for his care.
“People who have psychiatric problems can find a magazine to read or look at a television. They can self direct. My husband requires more. He was left in the room with nothing to do. I’m not faulting the staff. That’s the type of floor it is. But he should not have been on that floor.”