An “atrocious” end of life for a resident in a senior center

Bertrand Genest, former editor-in-chief of Daily, will only have occupied his room for five weeks at the Chicoutimi Seniors’ House. Suffering from a degenerative illness, the man passed away, surrounded by his family, on May 14. Even if his departure was predictable and was the subject of a well-planned end-of-life protocol, Mr. Genest’s last hours nevertheless experienced their share of upheavals.

Prolonged waiting, obvious pain ignored, non-compliance with doctor’s instructions… His daughter, Guylaine Genest, wishes today to publicly raise the issues encountered during the two nights preceding the death of her father, and which greatly traumatized her family.

“Given that my father spent his life in the journalistic world, I knew that something like that he would have wanted to report. What we went through, I wouldn’t wish it on anyone. I found it atrocious, atrocious, atrocious. For him, and for us,” explains Guylaine Genest, adding that she still does not know if she would file an official complaint for the recent events.

Painful last hours

It was on Friday, May 10, that Mr. Genest’s loved ones made the decision to stop therapeutic care and move on to comfort care. His attending physician then ensures that the necessary medication will be included in the file, in order to offer Bertrand Genest peaceful last days. During the night, however, he shows obvious suffering, very far from the semi-comatose state projected by the doctor.

“He started moaning, wailing on his bed, calling for my brother. He was fidgeting so much that if there hadn’t been bars on his bed, he would have fallen. It was unbearable,” laments Guylaine Genest.

However, the staff in place refuses to contact the doctor on duty, judging that the situation does not require it. The family must insist heavily until a first contact is made with the doctor on duty, who at that time adjusts Mr. Genest’s medication.

A few hours later, seeing that the treatments did not produce the expected effect, the patient’s relatives made a new request to contact the doctor. Again, the request is initially refused. However, the family managed to communicate with the doctor after long arguments with the staff, and the staff came to meet the family on Saturday morning.

“She told us that what happened during the night should never have happened, that she should have been called sooner. And it’s true that my father should never have had pain. She reassured us for the following night, telling us that if my father came out of his sedation again, there were already doses twice as high in the file,” summarizes Bertrand Genest’s daughter, about her conversation with doctor.


Bertrand Genest, former editor-in-chief of Le Quotidien, died on May 14 (Courtesy)

The night from Saturday to Sunday, however, was no easier than the previous one. Once again, Guylaine Genest’s father is agitated, tense, tense, and out of his sedation. The family contacted the team, who then replied that Mr. Genest would not be able to receive any more treatment, since it was Sunday. Relatives should once again insist that staff contact the doctor. After this call, Ms. Genest suddenly noticed a complete change in attitude from the medical team, who would henceforth display kindness and benevolence until the death of Bertrand Genest.

The day after the events, a senior employee went to the family to apologize on behalf of the CIUSSS du Saguenay-Lac-Saint-Jean. According to her, the doctor’s instructions were not clear in the file, which led to confusion.

“They are left to their own devices”

Despite the CIUSSS’s apologies, Guylaine Genest wonders: could it not be the lack of personnel that contributed to the chaos surrounding her father’s last moments? Not wishing to place all the blame on the team in place, she said she was surprised that so few workers were present on the unit. According to Ms. Genest, during these two nights, a single attendant was assigned to two households, while the nurse told her to be responsible for four units of 12 patients each. At times, around thirty minutes could pass before the family was answered by staff.

“It seemed like he lacked a mentor to support them. The night nurse was alone, left to her own devices, with 48 patients. I have the impression that she didn’t have time to read the file carefully. When we realized that my father had been alone like that, at night, for five weeks, we couldn’t believe it. The residents are also left to their own devices for the night,” estimates Guylaine Genest.

“In Seniors’ Homes, it’s definitely difficult. Employees who work 16 hours, or places which are not able to have the ratio due to lack of staff, it is common. This is what we see on the ground,” confirms, for his part, the regional president of category 2 workers at the CSN, Olivier Cote.


Beneficiary attendants receive a bonus of $180 for each block of 750 hours worked in a CHSLD. (Archives The Sun)

With the summer holidays approaching, the latter is rather pessimistic about the coming months that await the health network teams. While the CIUSSS is struggling to recruit enough employees, it is also under a lot of pressure to fill the MDAs, given the growing waiting lists to access them. “With the current withdrawal of the independent workforce, this is nothing to help,” adds Mr. Côté.

The Genest family’s questions regarding the ratio in the Seniors’ Center are not the first to surface since the opening of the establishments. Earlier this year, employees complained about having an unrealistically large work surface to cover during their shift. The regional president also deplores that the training provided to employees in the field is not adequate. According to the union, the lessons would not be carried out in an optimal situation, which could make them incomplete. The high turnover of staff would also complicate the task.

“It’s been said for a long time that people should be freed from their jobs to explain everything properly when someone new comes along. But these people have to do their job, at the same time as showing it to new employees. And we won’t make any hiding places, there’ll be a lot of them. But sometimes it also comes out, it’s a fairly constant turnover,” mentions Olivier Côté.

Find balance

At the CIUSSS du Saguenay-Lac-Saint-Jean, we ensure that the teams of nurses and beneficiary attendants in place ensure that they provide the care as recommended by the doctor. Different scenarios would also be studied in order to compensate for the lack of manpower in the network.

“We make sure to always respect the minimum thresholds recommended by the MSSS for each shift. Like every year, the summer period brings its share of challenges to our network which requires planning. We must find the balance between access to quality care for users, while granting all staff members necessary vacation time,” indicates the CIUSSS information officer, Simone Lalancette.

Regarding the supervision of end-of-life users, the organization states that it has methods to inform employees. However, it does not specify the details of these.

“Mechanisms are in place to inform staff. We are keen to do things well to ensure that this step is done with kindness, gentleness and respect,” insists Simone Lalancette.



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