Homes 'way behind'
Affordability will be a key consideration when recommendations are made as a result of the Muskoka Heights inquest, Dr. Barbara Clive, medical director of specialized geriatric services at Credit Valley Hospital in Mississauga, said.
"We have to have recommendations that are affordable because they (the owners) are going to download the cost to the vulnerable seniors," said Clive, speaking directly to the five jurors Friday at the inquest exploring the deaths of four seniors due to a fire at Muskoka Heights Retirement Residence in 2009.
Recommendations coming out of the inquest can become law in the province to help prevent future deaths by fire in seniors' facilities.
"Sure, we'd all like sprinklers every 10 feet, extra staff and staff training, but it costs money," said Clive.
Alzheimer's Society lawyer Graham Webb took issue with that comment. He has been working to make automatic sprinklers in all seniors' care facilities a law for 16 years.
"You have to have a minimum safety standard in homes," he told The Packet outside the Simcoe County council chambers where the inquest is being held.
"The poor seniors are the most vulnerable. They are the ones thrown under the bus," he said.
Automatic sprinklers are a legal requirement in nursing homes and new seniors' homes, but for private homes built before 1998, such as Muskoka Heights, they are not legally required.
It's these older facilities that pose the greatest fire risk, said Webb.
The inquest is expected to recommend sprinklers become required by law, because they have been proven to extinguish or control a fire.
Controlling the fire gives staff more time to evacuate residents and the fire department more time to extinguish the fire.
Affordability determines where frail seniors go to live, said Clive.
Care facilities range in price from as low as $900 a month to as much as $11,000 a month.
Webb asked Clive if she thought a "substandard" $900- facility would be a place people would "choose" to go to?
"Probably not," she answered.
Webb pointed out funding support for retrofitting sprinklers has been provided by the Advocacy Centre for the Elderly (ACE). Webb also represents ACE at the inquest.
"Fire safety in seniors' care facilities is a huge challenge," said Clive.
That's because the situation over the past 10 to 20 years has changed dramatically as patients are shifted from hospitals to nursing homes to retirement homes, assistive living and independent living situations.
"The level of care of people in these facilities is going up and up and up," she said. "Nursing homes are now very complex medical settings where 90% of people are dependent," she said.
Webb pointed out to Clive that some people in Muskoka Heights were qualified for nursing homes.
She replied that that is "typical" across the province.
"There are no empty long-term care beds in the province. There are thousands of people on the waiting list.
"We are all frustrated, but we don't have the long-term care beds," she said.
Fire safety is a greater challenge in care facilities than ever before because there are more and more people with greater physical and cognitive challenges living there, she said.
"We need training of the staff to understand. To just yell 'fire' is not enough. They might not hear, or they might not understand. Or, maybe, they can't even push the door open. They might forget their walker and fall down," Clive explained.
Clive wasn't surprised when she heard that a Muskoka Heights man with a cognitive impairment re-entered the burning building after being evacuated by the lone personal support worker on duty at 6 a.m., when the fire started.
"The place could be burning down around them and they could resist going out because they are totally overwhelmed and they don't understand what's going on," she said.
The legislation needs to "catch up" with reality in care facilities, said Clive.
"We are way behind."
The inquest will not carry on this week; it will resume May 14.