Community Transition Unit (4B) at the VG: elderly dementia patients have no privacy, are plagued with rats and Legionnaires’ Disease, and can’t drink the water

Conditions on the Community Transition Unit (4B) of the crumbling and leaky Centennial Building at the VG hospital in Halifax are so bad that they’ve provoked the family of an 85-year-old woman with dementia to speak out.

The family’s hope is the Nova Scotia Health Authority (which operates hospitals) and the Department of Health (which operates nursing homes) will move more quickly to find alternative arrangements for about a dozen women and men.

These elderly citizens are housed in wards with three or four beds each, which affords little privacy. They often have no access to toilet facilities because the washrooms are too small to permit walkers and wheelchairs. Residents of 4B with dementia are at risk of Legionnaires’ Disease because they can forget they shouldn’t drink the tap water, which contains legionella bacteria. Most people on the transition unit at the Centennial have dementia, so family members of the woman were surprised to see no sign above the sink in the ward to — at the very least — try to remind residents the water isn’t fit to drink.

And, oh yes, mice and rats have been detected on 4B in the Centennial Building. The VG’s pest control contractor makes weekly visits and is on-call.

The presence of rodents and legionella in the tap water would be sufficient cause for provincial inspectors to shut down a restaurant. But a hospital with medically and/or mentally compromised elderly residents …well, that seems to be another story in Nova Scotia.

All these concerns were dutifully noted by the family of the 85-year-old woman who wrote to the Nova Scotia Health Authority (NSHA) late last May. The family also clearly stated how much they appreciated the top-notch care provided by staff on 4B, where the problems of the medical complex where it’s located are well-known, and were described as “Third World” by one prominent surgeon half a dozen years ago.

On July 30, two months after their written complaint, the family received a boilerplate response from a senior executive with the NS Health Authority acknowledging their concerns and touting plans to build new facilities to replace the Centennial. The letter noted that “change doesn’t always happen as quickly as we would all like, but significant action is being taken.” The letter suggested the family contact NSHA’s Patient Relations Service (1-844-884-4177) or email healthcarepexerience@nshealth.ca.

But by then, the family of the 85-year-old Dartmouth woman had moved her to a privately-owned and -operated Shannex nursing home. In fact, the family said they were so horrified by the conditions of the 4B unit that they moved their mother within three weeks of her arrival. To add insult to injury, her personal savings were being used to pay for her stay in the four-bed ward in the Centennial at the same rate as if she had a semi-private room in a long-term care facility with meals served in a dining room.

“Making someone pay for accommodation that is inappropriate and unhealthy is not only unfair but borders on ageism,” Bill VanGorder, the N.S. spokesperson for the Canadian Association of Retired Persons ( CARP), tells the Examiner. “What is really sad is that nothing has changed at the VG unit since I made the same comment four years ago.”

Because she was being charged $107.75 per day (more than $3,000/month), her son and daughter-in-law decided Mom might as well spend her money at a private nursing home until a subsidized place at another long-term care facility becomes available.

Because of the length of waiting lists in HRM, that’s likely to take another three to four months, by which time her savings will be gone. That said, the family feels good about their decision, and say Mom has recovered some of her previous personality since leaving the hospital and moving to a more home-like setting.

The Halifax Examiner has chosen not to publish the name of the family because it would identify the 85-year-old woman and it might (although it should not, if the process works properly) affect how long she will wait in the line for a subsidized long-term care placement.

Prior to hospitalization last February for pneumonia and a bowel infection, the woman’s family had looked after her in their home for five years. Besides the diagnosis of dementia, Mom has Stage 4 cancer. “Clearly we don’t have enough nursing homes because the wait list is still long,” says Mom’s son.

About 1,100 people across the province are currently waiting, down significantly from about 2,000 in 2013, before a major funding increase and expansion of Home Care. People admitted to hospitals can stay in Community Transition Units — also known as Alternate Level of Care Units in some hospitals — as long as six months before moving home or to a nursing home. There are 21 such beds in the Central zone, 56 such beds in the Eastern zone covering Cape Breton and Guysborough County, 32 beds in the Northern zone, and 52 beds in the Western zone covering the South Shore and Valley.

Four years ago, the province collected $4.8 million from elderly residents living in Transition Units in hospitals. (The dollar amount for last year is still being tallied; we will publish  it when we receive it). Most hospitals do provide private or semi-private rooms to those waiting for long-term care but on 4B at the VG site, the unit’s four private rooms are reserved for individuals with aggressive or challenging behaviours. The other 13 people on the unit share wards partitioned by curtains.

“We understand the solution the province is working toward will eventually mean new facilities to replace the VG, but these patients don’t have years to wait,” says the son of the 85-year-old woman. “Our concern is for the 13 people with dementia who are still on that 4B ward and expect to be there for months waiting for a long-term care bed.”

“4B is not a good place to be for elderly people with dementia,” says Mom’s daughter-in-law. “She couldn’t get up and move around because there were too many things in her way — the table with the food tray, the commode chair and her walker. It was actually kind of dangerous, so staff put an alarm on her. And then she didn’t want to move because she was afraid she would set off the alarm!”

“In our minds, it’s inhumane for people with dementia to have to lose their dignity in this way,” says Mom’s son. “Not everyone is as fortunate as my mother to have some savings to help get out of there. And the Province seems to have no plan to deal with the growing number of people who will soon have dementia.”