Home care and nursing homes share similar problems in understaffing, Wettlaufer inquiry hears


Home care and nursing homes share many of the same problems in attracting and retaining nurses, the Ontario inquiry into Elizabeth Wettlaufer’s crimes heard Wednesday.

During the inquiry into the safety and security of residents in long-term care, chronic understaffing in the nursing homes where Wettlaufer worked has come up again and again.

Provincial law dictates that nursing homes must have one registered nurse on duty 24/7, and Wettlaufer would sometimes be the only one available, particularly during night shifts at Caressant Care in Woodstock. 

It has been suggested that the lack of available nursing staff could have played a role in how Wettlaufer was able to continue practising for so long. ​In September 2016, she confessed to a psychiatrist that she had injected people with insulin between 2007 and 2016, killing eight and harming six. Wettlaufer, now 51, was sentenced in June 2017 to eight concurrent life terms in prison. 

Qualified home care staff leaving for hospitals

After leaving her final nursing home job at Telfer Place in Paris, Wettlaufer worked briefly with St. Elizabeth Home Health Care and continued to try to harm patients like Beverly Bertram, who survived an insulin overdose administered by Wettlaufer. 

In testimony from Donna Ladouceur, co-executive director for the South West Local Health Integration Network (SW LHIN), the inquiry heard that the home care industry has experienced problems with qualified staff leaving to seek work in hospitals.

That could be because home care has become more difficult in recent years, Ladouceur said. Many patients return home from hospital earlier than in the past, meaning their care needs would be higher.

“Seven years ago, after having a hip replacement, a knee replacement, [patients] might’ve been in hospital seven, eight days. They were in hospital for much longer periods of time,” said Ladouceur, who said Ontario’s aging population has also played a role in increasing care needs. 

“When patients make the choice to stay in their home, their acuity level is going to change and go up.”

Compounding the issue is that nurses who work in home care often have longer commutes, less pay and less support than those who work in hospital, Ladouceur said.

Still, Ladouceur said that overall, St. Elizabeth home care has good practices and is attuned to risk levels.

On Thursday, Steven Carswell, director of quality for the SW LHIN, will continue testifying about risk levels in home care. 

The inquiry will continue through Friday and break until September. 

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