Montrealer Jean Bossé, who suffers from Alzheimer’s disease, has been placed on the waiting list for a place in Quebec’s public accommodation network in 2021. It wasn’t until more than 600 days later that the 68-year-old was finally assigned a room in a CHSLD.
Posted at 5:00 am.
“The system is crazy. “A serious change needs to be made on the part of the health and social authorities,” said Mr. Bossé’s partner, Monique Hébert.
PHOTO OLIVIER JEAN, THE PRESS
Monique Hébert and Anne-Élisabeth Bossé, wife and daughter of Jean Bossé
Mr Bossé’s daughter, the actress Anne-Élisabeth Bossé, regrets the fact that throughout the process it was impossible to obtain information about her father’s rank on the waiting list. “We don’t know anything. It’s very opaque,” she says.
Minister responsible for seniors Sonia Bélanger is “very aware” of the need to find solutions to increase the supply of accommodation for seniors in the context of an aging population, but believes that “we do not agree with Quebec’s CHSLD can bring paper”. “We want to change the model of aging in Quebec in terms of accommodation,” she said.
Mr. Bossé’s case is not an isolated one, as the stories collected by La Presse show (see the “Caregiver “caught”” tab). For example, Marguerite (fictitious first name*), a former businesswoman from west Montreal, has been waiting for a place in a CHSLD for more than a year. “We don’t know where we’re waiting. We are just told to be patient and that a year is not that long,” says her daughter, who fears her mother will die before she gets a place in a CHSLD.
And his fears are not entirely unfounded: La Presse, examining the 700 coroner’s reports from 2021 and 2022 following the deaths of elderly people in private retirement homes, found that 25 of them died… on the waiting list for a place in public accommodation.
INFOGRAPHICS THE PRESS
So, on November 1, 2021, a 76-year-old man, LB, died while waiting three months for a spot in a CHSLD in west Montreal. The interim resource (often the phase before placement in a CHSLD) in which he lived nevertheless emphasized to the health network authorities that LB’s case had become “too severe for the capacities of the environment”, according to the report submitted by the coroner after his death.
As of May 20, 2023, the CIUSSS de l’Ouest-de-l’Île-de-Montréal had 286 people on the waiting list for a place in a CHSLD. The average waiting time was 232 days. Spokeswoman Hélène Bergeron-Gamache emphasized that urgent cases would be dealt with “immediately”. For others, a “private service” including close monitoring, hygiene care and feeding support may be offered “24 hours a day, 7 days a week until the user transitions to a CHSLD,” she says.
In the other court documents seen by La Presse, there is a 79-year-old person, MB, who died on January 21, 2021 as a result of a fall down a staircase in the retirement home where he lived in Marieville. This lady suffering from Alzheimer’s had been waiting for a place in a CHSLD for 17 months.
PHOTO OLIVIER JEAN, LA PRESSE ARCHIVE
As of May 20, 2023, the CIUSSS de l’Ouest-de-l’Île-de-Montréal had 286 people on the waiting list for a place in a CHSLD.
The spokesperson for the CISSS de la Montérégie-Centre, Martine Lesage, reiterates that places in CHSLDs are allocated according to the level of precarity of the users. In urgent cases, a place can be allocated within a few weeks. The longest period is usually one year. However, Ms Lesage admits that places in wards for clients with cognitive disorders such as Alzheimer’s are rarer and that it takes longer to get one of these places.
The president of the Coalition for the Dignity of Seniors, Pierre Lynch, emphasizes that the problem has existed in Quebec for years. But as the population ages, access is becoming increasingly difficult. Mr Lynch notes that older people whose profile would still require CHSLD care are sometimes not quickly admitted to these facilities “due to the lack of places”.
Big changes were expected in senior housing in Quebec following the pandemic. Unfortunately there were none.
Nathalie Déziel, director of the Regroupement des caregiveres et naturals de Montréal
An obstacle course
PHOTO OLIVIER JEAN, LA PRESSE ARCHIVE
Some people wait several years before getting a place in a CHSLD.
In a special report on access to public accommodation for seniors in Quebec published in October 2021, the Quebec Ombudsman found “unacceptable” the fact that some people wait several years for a place in a CHSLD. He spoke of a “complex administrative structure” that left “little room for human consideration.” Then, in a new report released on September 21, the Quebec Ombudsman points out that access to shelter in CHSLDs in Quebec is still “an obstacle course.” While they wait to get a place, some people are “placed in environments that do not meet their specific needs, posing a real risk to their safety.”
INFOGRAPHICS THE PRESS
Lucie Longchamp, vice president of the Federation of Health and Social Services (FSSS-CSN), which represents 3,000 workers in private retirement homes (RPAs), notes that clientele in RPAs has increased significantly in recent years.
PHOTO EDOUARD PLANTE-FRÉCHETTE, LA PRESSE ARCHIVE
Lucie Longchamp, Vice President of the Federation of Health and Social Services (FSSS-CSN)
The image of the older person at the swimming pool or billiards no longer corresponds to reality.
Lucie Longchamp, Vice President of the Federation of Health and Social Services
For Ms. Longchamp, private retirement homes “are obviously not all equipped to care for this growing clientele.”
Hans Brouillette, public affairs director of the Regroupement québécois des Résidences Privés pour Agieux (RQRA), affirms that this increase is putting enormous pressure on RPAs. When a resident loses autonomy, an assessment is requested by CLSC so that home care can be provided. “But often it can take months. Who is responsible for the shortfall during this period? RPA,” he says. And when a request is made to travel to a CHSLD, there can again be long delays, notes Mr. Brouillette.
“What do those who have no one do? »
Jean Bossé was barely two years into retirement after his career as a police investigator with the Sûreté du Québec when he was diagnosed with Alzheimer’s disease in April 2019. He was 64 years old. “It’s a very, very early form,” says Anne-Élisabeth Bossé, spokeswoman for the Quebec Federation of Alzheimer Societies.
As his loss of autonomy progressed, Mr. Bossé received home care from his CLSC. His partner, Monique Hébert, hired private workers, used daycare centers and help from relatives. In October 2021, Mr. Bossé qualified for a position as a middle clerk.
“I wasn’t there yet and found a place for him. But I was told that I shouldn’t wait too long to put him on the waiting list because there are delays and the disease progresses quickly,” says Ms. Hébert, who therefore accepted.
In November 2022, Mr. Bossé will move into a private senior residence.
As the weeks passed, Mr. Bossé’s health deteriorated. To the point that the private residence he lives in issues an “excessive care notice.” “That made us think about the CHSLD,” notes Ms. Hébert. But when she asks, she finds out that her partner is still on the waiting list as a priority 4, i.e. non-urgent case. The problem: The RPA where Mr. Bossé lives and the CHSLDs where he waits are all in Montreal, but in two different areas.
After publishing an article in La Presse in August about the problems of access to CHSLDs between health areas, the Minister of Health and Senior Citizens, Sonia Bélanger, recalled that she had modified the protocol for access to the accommodation in the spring so that it “more” contained “flexible”.
Ms. Hébert asked several questions and requested meetings with decision-makers. Her partner finally moved to a CHSLD in Montreal on September 20th, where he is receiving excellent care.
Ms. Hébert and Anne-Élisabeth Bossé ask themselves what happens to people who have no one to fight for them and find their way in the system. “I’m relatively young. I am educated. I know how to take care of myself. I’m not afraid to speak […] What do those who have no one do? » asks Ms. Hébert.
Multiple solutions
In an interview, Minister Bélanger assures that she wants to increase the accommodation options for people with severe loss of autonomy in Quebec, in particular by opening 46 retirement homes (3,500 places). A “needs assessment” is also underway to add CHSLD beds in certain regions through the renovation of existing buildings. Among others, the Laurentians, Lanaudière, Montérégie and Outaouais are targeted. But Ms. Bélanger doesn’t just want to focus on CHSLDs. “Our goal is to overhaul the entire lodging ecosystem,” she says.
PHOTO MARCO CAMPANOZZI, LA PRESSE ARCHIVE
Sonia Bélanger, Minister for Seniors
The minister wants to “continue to support” RPAs and also “continue the development of home care”. When it is pointed out to her that the clientele of home care does not match that of CHSLDs, the minister responds: “The more we invest in home care, the fewer people need to go to CHSLDs.”
Philippe Voyer, professor at the Faculty of Nursing at Laval University, represents this vision of diversifying care models for seniors. But in his opinion, the pressure of aging will be “so immense that we will need many more places to live for people with cognitive disorders.”
The Minister recognizes that the challenge remains significant. Among other things, because the staff shortage is significant. “But we have to move. We have no choice,” she said.
* The family wished to remain anonymous to avoid damaging their case.
Learn more
4560 Number of people waiting for a place in the CHSLD in Quebec in August 2023
Source: Department of Health and Human Services
3039 Number of people waiting for a place in the CHSLD in Quebec in March 2020
Source: Department of Health and Human Services