BY KEITH LACEY
A government protocol allowing developmentally delayed adults to move into long-term care facilities is a recipe for disaster, says a government critic and professor who predicts more tragedies like the one that claimed the life of Keith Croteau last week will happen again.
“What it comes down to is this government’s priorities are wrong...we shouldn’t be placing developmentally delayed adults as young as 18 into long-term care facilities..they should remain in community care where they belong,” said Patricia Spindel, a social work professor at the University of Guelph.
“What happened to Keith Croteau is just devastating...it was a preventable death.”
Spindel contacted Northern Life after reading about the death of Croteau, 59. He died after allegedly getting into a fight with another developmentally delayed man last week at Extendicare York.
Bryan Belliveau, 55, has been charged with second-degree murder. He remains in custody at the Sudbury District Jail awaiting a bail hearing.
Spindel was a policy adviser for the Ontario Association for Community Living (OACL) throughout the 1980s.
She’s spent 20 years volunteering to assist families and organizations concerned about the plight of developmentally delayed people.
Another tragedy like Croteau’s will happen again if the government continues to cut back funding to organizations like OACL, said Spindel.
There is a huge shortage of staff at many long-term care facilities and the majority aren’t properly trained to cope with the physical, psychological and emotional needs of most developmentally delayed adults, said Spindel.
“I think the staff for the most part do their very best, but the recognized ratio of staff to clients in these facilities is somewhere between 15:1 or 18:1,” she said. “It’s no more than three to one in community living settings…and staff there have specific training to deal with these clients.”
Older adults who need and deserve beds in long-term facilities are often frail and many suffer from other issues like dementia and Alzheimer’s disease, she said.
Their needs are often ignored due to lack of staffing or compounded by staff having to dedicate time to developmentally delayed clients, she said.
Ministry of Health and Long-Term Care spokesperson A.G. Klei defended the government’s protocol.
There is an extensive review process for all developmentally delayed adults or primary caretakers who apply to live in a long-term facility, said Klei.
A demonstrated need for 24-hour care for basic personal needs must be proven before any developmentally delayed adult is accepted, he said.
A detailed consent process is also involved, which involves developmentally delayed adults having access to integrated, community-based services while living in a long-term facility, he said.
The care and safety of all persons inside these facilities is a top priority with the ministry, and staff have been in contact with Extendicare York to investigate the incident last week, he said.
Since 2004, the ministry has increased staffing levels in long-term facilities by more than 4,900, including hiring almost 1,200 nurses, he said.
The government has also introduced a new Long-Term Care Homes Act, which has passed second reading at Queen’s Park, he said.
Highlights of the act include a zero tolerance policy on neglect and abuse of any client, whistle blowing protection for staff and residents who report neglect or abuse and ensuring a registered nurse is on staff 24 hours a day at every long-term facility, said Klei.
Organizations such as Family Alliance Ontario have been pressuring Madeleine Meilleur, Minister of Community and Social Services (MCSS), to change protocol allowing admissions of people with developmental disabilities into long-term facilities, said Spindel.
“These people should be placed into appropriate community placements...so far the government has refused,” she said.
The government is not being up front about its intentions with families who have developmentally delayed adults, says Spindel.
“People are being duped,” she said. “When you place people with a whole variety of disabilities into the same setting with older adults who are frail or have dementia, it’s called warehousing,” she said. “No one gets their needs looked after.”
Spindel said she plans on writing to Meilleur and George Smitherman, Minister of Health and Long-Term Care, to express her outrage over what happened to Croteau.
“And I do believe it will happen again if things don’t change,” she said. “This was a repeat of incidents that were happening 25 and 30 years ago on a regular basis before the introduction of community living. We’re heading back into the dark ages. That’s not acceptable.”
Paul Doig, a spokesperson for MCSS, said his ministry won’t comment on the Croteau case.
Doig said the application process to move a developmentally delayed adult into an long-term facility is thorough enough to ensure all their needs will be met.
His ministry supports the protocol in large part because it addresses a government mandate to promote equal rights for all citizens, he said.
The government’s Long-Term Care Home Access Protocol for Adults With a Developmental Disability was released in July 2006.
In 2004, MCSS announced the government was starting a process to transform the developmental services (DS) system Ontario to make it more accessible, fair and sustainable.
The government also announced it was closing its final three DS facilities in Ontario for adults with a developmental disability by March 2009.
“The phasing out of the remaining government operated DS facilities completes Ontario’s revolution from a facility-based to community-based system that promotes greater inclusion, independence and choice,” states the government document.
Last July, Spindel blasted government policy in a paper she wrote called Doublespeak: The Ontario Government’s Betrayal of People with Developmental Disabilities. She upgraded her paper just two weeks ago.
Spindel doesn’t pull any punches in her critique.
“This document, and the machinations behind it, may well go down in Ontario government history as an attempt at one of the most masterful betrayals of an entire movement and service system in Ontario history, all accomplished through the use of this movement’s own language-terms like inclusion and equal rights.
“Through this protocol, the Liberal government has attempted to justify the institutionalization or re-institutionalization of people with developmental disabilities as a de-institutionalization initiative.”
