Nursing home hidden camera investigation: Understaffed and overworked

 Announcer: -[ David ] This is your Marketplace. Families on a mission... This needs to change, it is totally unacceptable. -[ David ] ..to uncover the truth. Nobody was there to help her. -[ David ] And, we get hired to see what it's really like inside. Are staff set up to fail? I would not want to be the one in the bed in the state that long-term care is in right now. Minister Elliottt, I'm David with CBC. How do you address the concerns that these front-line workers have? We take their concerns very seriously. -[ David ] A special edition of your Marketplace. How to fight for better care. [ ♪♪ ] [ Moaning ] -[ David ] Listen carefully. [ Moaning ] -[ David ] The call for help is faint, but desperate. [ Moaning ] -[ David ] In the darkness at this long-term care home an 84-year-old grandmother struggles to breathe. [ Faint Moaning ] -[ David ] At home, her daughter Marie had been told staff were checking her mom throughout the night.

[ Faint Moaning ] -[ David ] The breathing gets weaker, and then stops. She's gone. Nobody there to help her. She died alone, struggling. Nobody was there. And you're left wondering if they could have saved her. I think they could have. [ Crying Out ] -[ David ] For years we've heard your concerns. What happens to our parents and grandparents when we are not there? Are there enough staff to keep them safe? To find out, we are going deep inside long-term care. -[ David ] Sending a Marketplace producer to volunteer, spending more than 60 hours undercover at Markhaven. The same home where Marie's mother died. Okay. -[ David ] We are taking care to respect residents' privacy, focusing on common areas. It does not take long to see staff who try-- [ Polka Music Playing ] -[ David ] --but are simply outnumbered. -[ David ] Elderly residents waiting for help to use the toilet. -[ David ] Staff just trying to keep up, racing from person to person. -[ David ] This is one home, but we are hearing similar stories nationwide. Our undercover producer is-- you see her roaming the hallways, trying to find someone who is just available to help with this. -That is normal, absolutely.

-[ David ] Miranda Ferrier represents more than 30,000 personal support workers, or PSWs in Ontario. How do you use the word normal to describe someone waiting for more than an hour to go to the washroom and there not being someone to help them? It's been accepted as the norm. Should it be? Absolutely not, it should not be accepted as the norm. -[ David ] Unanswered call bells... [ Rhythmic Beeping ] -[ David ] Barely time for the basics. -[ David ] By one estimate, Ontario staff only get six minutes to get each increasingly frail resident out of bed, dressed, and down for breakfast.

I'm going to wheel you up, Gary. -[ David ] Staff who want to do better, but there just is not time. A lot of the times in long-term care, nine times out of ten, you are skipping steps. Whereas-- that might be, that day you don't wash under their armpits and you don't wash their nether regions, or, you know, you don't change their incontinence product real quick because it's not that wet yet, because you don't have the time. -So you just let them sit in it? -So let-- You let them sit in it until it's full. Because you don't have the time. -[ David ] It's not just a problem at one home. A year ago at another Ontario home we caught this conversation on hidden camera. -[ David ] These PSWs are talking to a government inspector. She is powerless because there is no minimum staffing ratio for nursing homes. -[ David ] And when there aren't enough staff, the worst becomes possible. You are a daughter and you are listening to what sounds like her final breaths. -Breaths, yep. Not easy to take. -Sorry. -No, no. I wasn't there to help her.

Nobody was there to help her. I think that's the biggest part of it. -[ David ] Giovanna's death happened right after the home's funding was cut by the province, forcing it to lay off a night nurse. Marie's mother died alone, in a home where staff seemed always stretched and at night, numbers dropped. Sometimes, just one PSW for a wing of 27 residents. She loved to be with her grandkids. She laughed a lot.

She told a lot of funny stories. Fake stories to my kids. She'd get them going. She was really funny, she had a good sense of humour. A really good sense of humour. -[ David ] Worried for months about her mother's care, Marie decides to install a hidden camera in her room. I wasn't going to be able to see her a lot. In the month of May, I had eye surgery. -[ David ] Giovanna needed a tracheostomy to breathe, a tube bringing air to her throat. In case of a problem, the home's own care plan demanded a call bell within reach. Whenever she wasn't well she always held onto that call bell to get help. -[ David ] On the night she died, though, Marie wonders, were staff too busy to check? Too overloaded to notice the gasp for help? Mom was gone. And I believe, in all hearts, that the cause of her death was due to lack of experience. Staffing not knowing what they are doing. Training. Not enough staff. What do you want the ministry to change? There should be legislation that has to have more people to take care of our loved ones, more nursing staff, more PSWs on the floor.

-[ David ] We showed the video to Miranda and together we notice something alarming. She was seemingly partially out of the bed trying to reach here. Oh, my God, where the call bell was. They left the call bell on the chair. They left the call bell on the chair. Ah, sorry. -[ David ] That call bell, the one required to be in the bed with Giovanna. Even as she struggled, she couldn't reach it. No one should have to suffer like that. And I mean, the problem is that they are all suffering like this. -[ David ] Suffering that Marie did not know about until months later when she watched the video. Staff were supposed to check on Giovanna throughout the night but no one did until morning. If she was able to get help, the morning that she passed, she would have probably been alive. -[ David ] Workers discover her body half out of bed.

Marie believes she was trying to reach that call bell, the one that might have saved her. This is them moving her body. If her feet were down dangling, she was trying to get help. She was trying to get up. And get to her bell. -To get help. -To get help. -[ David ] For two years we have been investigating long-term care homes in Ontario. Now, we are deep undercover in one home, spending days inside, hearing the consequences of short staffing. -[ David ] We have heard the same story from across Canada, including here in Hare Bay, Newfoundland...

..where Sharon Goulding-Collins has a plan to fight for elderly residents like her mother, who has dementia and lives in a nursing home 45 minutes away. Hi, Mom. Hi, Mom. What are you doing? Mom, Mom. Are you going to have a nap? Are you going to have a nap? -Hi, Sharon. -Hi. [ Mother Chattering ] -[ David ] Sharon is now a stranger to the woman who spends her days calling for her own parents. Yeah. [ ♪♪ ] It is amazing, she is just so strong. And then for this to happen? -[ David ] There have never been more dementia residents, like Lillian, in long-term care. A growing number with very high needs and unpredictability. Sometimes other dementia patients become aggressive, and there have been altercations that have left Lillian bruised, no staff there to help. There are so many other things that have happened that nobody's seen. Like the bruises on her from here to here. Like the scratches and cuts on her face.

Like being punched in the mouth. But there was nobody there when it happened? There was nobody there. -Nobody there to stop it. -Nobody. -[ David ] Sharon is usually at home when she hears about a new injury. An attack from a fellow dementia resident. This can't go on. This is an 82-year-old woman who is getting beaten up. Um... And the response was-- and it was not the first time, "I'm sorry but we can't be everywhere all the time." Why do you think that is? Why can't they be there when their residents are being attacked by others? Because there's not enough staff. There's only so much that they can do. -[ David ] Even though the regional health authority says they are fully staffed, they acknowledge dementia patients can be combative.

So there are safety plans in place. 300 kilometres away in St. John's, Heather Reardon faces that on every shift. -Hi, Heather? -Hi. Yeah, I'm David. On the night shift when staff numbers drop she's the only registered nurse in charge of 140 patients. I wish I could split myself in half because I could be needed upstairs because someone has had a fall, or I could have somebody in respiratory distress down on another unit, and both are unstable, and both need a registered nurse, but there's only one of me.

The quality of care is not there. Simple day-to-day things are not getting done. They might only have time-- they may have to leave them in bed. They may be left in bed the full shift rather then being up for several hours because we do not physically have the manpower. Fast-forward your own life 50 or 60 years, would you want to be in a long-term care facility, the kind that you work in right now? In the state it is now? Absolutely not. I would not want to be the one in a bed in the state that long-term care is in now. -[ David ] If nurses say they are stretched, imagine personal support workers, the front line staff. Those who wash, care, feed, lift, and keep safe the elderly. Undercover, we are seeing it and hearing PSWs so burnt out, they are quitting. -[ David ] It is not just the stress that is wearing on staff across the country. They are often on the receiving end of violence. It's hard to make out but you can see down the hallway that a resident is kicking one of the staff members.

-[ Miranda ] Mmm-hmm. -[ David ] How often do you hear about violent incidents against staff? -[ Miranda ] Every single day. So much so, that it's actually become the norm. -[ David ] The violence against staff is the norm. Yeah. Why would you want to work there? My point exactly. That's why we're short-staffed, that's why the PSW profession is not necessarily one that people are lining up to get into. It's because, you know-- the really sad thing, David, is when you sit with PSWs or in a room full of them, and I am many times with my members, and they will say, well, who got scratched today? And it's a joke. Or who got bit today, you know? -[ David ] For its part, Markhaven did not want to do an interview but tells us they provide a "safe and comfortable working environment." They agree that more staff are needed and say they provide the best care possible with the money they get from the government.

[ ♪♪ ] -[ David ] Back in Hare Bay, Sharon is fighting for change. Angered by her mother's injuries, and no one being around to stop them. This needs to change, it's totally unacceptable. So, that's when I created the group. The Facebook group. -[ David ] Her online community now has about 5,000 members from across Canada calling for legislative action, a campaign Sharon names after her mother. What is it that Lillian's Law, what you are proposing, is calling for? The initial thing is the ratio. As there is a law for daycare, where you have a ratio of caregivers to children, we want the same for long-term care residents. For people who can't care for themselves. [ ♪♪ ] -[ David ] Every day she hears stories of residents left for hours without help. And then the extremes. A woman left in bed with a broken hip, the doctor not called until morning. What do they say? What sits with you? It's the same thing.

What has happened to my mother, there so many more extremes, so many more things that have happened that should never have happened, and are worse. -[ David ] Across the country, staff shortages in long-term care are making headlines. In Québec, the ombudsman says nursing homes are a disgrace. The conditions the staff work in are not acceptable. -[ David ] Staff can barely keep up. [ Cheering ] -[ David ] And in Ontario... -[ Rallier ] Will you stand with us and keep fighting until seniors get the dignity they deserve?! [ Cheering ] -[ David ] A call for more staff in long-term care. [ ♪♪ ] The seniors helped us build cities, build our province, and build our country... -[ David ] Supported by the provincial Conservatives... [ Applause ] -[ David ] Then, Doug Ford won power. Today we are announcing 15,000 new long-term care beds in the next five years. -[ David ] Now he is promising more room for seniors in long-term care. 30,000 new beds in ten years. -[ David ] But with a staffing crisis right now, who is going to take care of the people in those beds? -[ David ] After two years of investigating long-term care homes, we are seeing the impacts of short staffing.

So, what is the solution, then? The solution is more staff. We need more staff, we need more funding. -You need more funding. -Yeah. -[ David ] We are showing our hidden camera video to Candace Chartier, CEO of the Ontario Long-Term Care Association which represents most homes in the province. We are asking the government for $100 million a year for the next four years. Do you think you will get it? I think they are listening to us. I think that if they-- Because in this province there's a government intent on cutting costs. It is, but it's a government that's investing 15,000 beds, new long-term care beds. If we can't staff our current beds and you want to put 15,000 more beds in the system, more staff has to happen.

Please hear me when I say change is coming, help is on the way. -[ David ] Ontario's new premier Doug Ford campaigned on helping seniors. [ Applause ] -[ David ] We want to speak to him but his government has declined our interview requests for almost eight weeks. We're talking to the people on the front lines, be it doctors, nurses, other frontline healthcare workers. -[ David ] So we are catching up with Doug Ford and his Health Minister unannounced. Minister Elliott, I'm David with CBC. Can I just ask you a really quick question about long-term care? Sure. The issue is specifically around frontline workers. They are saying in long-term care that there simply aren't enough of them for the beds that exist right now. Your government is announcing even more beds. How do you address the concerns that frontline workers have around increasing resident on resident violence, about the fact that they, in some cases, have just six minutes to get even people with dementia, who are incapacitated, to get them up and dressed and to the washroom, to get them washed and get them to breakfast-- how do you address the concerns these frontline workers have? We take their concerns very seriously and what we are doing in the ministry right now is a human resource review of what healthcare professionals we need in various healthcare settings.

Are you committed to listening to those frontline workers, people like personal support workers, who form the real frontline? Absolutely, that is who we want to hear from. We want to hear from frontline workers because we want to make sure that they feel safe in the work that they are doing and that they are able to do it in the best way, the way that they were trained to do it, and to make sure that all patients receive high-quality care. [ ♪♪ ] -[ David ] It is too late to help Marie's mom. She died after months of Marie sounding the alarm. You'd been warning of problems. I had been warning them of problems. Both the home and the ministry.

And the ministry. -And when did-- -And they failed me. When did the ministry finally respond to your concerns? My report came in October. By October, your mother is gone. Yes. -[ David ] And remember, it was only after reviewing this video that Marie uncovered how her mom died. Her long-term care home, Markhaven, tells us they have now asked the Ontario Ministry Of Health to review Giovanna's death. Meanwhile, in Newfoundland, Sharon is relentless in pushing for better care with mandatory staffing ratios. Maybe if someone is passionate enough about this, that we can inspire others to do the same. To come together and be a strong voice for those that do not have a voice. Who put that certainty and strength into you as a person? I think it was my mother. To do what you can, and if there is something that needs to be addressed and it is wrong, then it is wrong. She's fighting for herself through you. Yes, I guess so. [ ♪♪ ] -[ David ] Do you have loved ones in long- term care? Share your story. E-mail us at marketplace@cbc.ca.

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