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PUBLICATION: The Hamilton Spectator
DATE: 2005.11.04
EDITION: Final
SECTION: Local
PAGE: A2
COLUMN: Andrew Dreschel
Dr. David Eden, regional coroner, is probing whether the transfers contributed to patients'
deaths.
Hospital leaders say trans− fers of vulnerable patients from Chedoke are carefully planned,
executed and monitored every step of the way.
That's a key point because the coroner's probe into the deaths of four former residents of the
Chedoke complex care hospital tragically highlights the dangers −− and death rates −− associated
with transferring long−term care patients from one surrounding to another.
And though the risk is well−known in the Canadian medical community, it hasn't received anything
like the recognition it has in the United States, where it's referred to as relocation stress
syndrome or transfer trauma.
"It's certainly a phenomenon we're well aware of," says Murray Martin, CEO of Hamilton Health
Sciences (HHS), which funds the Mountain Brow Chedoke hospital.
The four patients died after being transferred to other long−term care facilities as a result of the
controversial mothballing of the Brow building, the aging home for some of the most severely
disabled adults in the city.
Earlier this week, regional coroner Dr. David Eden told The Spectator that the issue being probed
is whether the transfers to a facility with different resources than Chedoke contributed in any way
to the deaths, all of which came to the attention of his office in the past month.
Regardless of the results of Eden's investigation, research clearly suggests that patients who are
relocated from a facility they've been in for a long time do run a greater risk of death and serious
physical and psychological injury, particularly among elderly and long− term care residents.
In fact, in a review of mostly American literature, health researcher Victoria Robinson found death
rates are two to almost four times greater than among those who are not moved. She notes
studies suggest transfer death rates for the frail elderly may even be higher.
Robinson, a PhD candidate at the University of Toronto's Institute of Medical Science, says it's a
complicated subject that cries out for more research in Canada.
"In complex continuing care, you have certain mortality rates per year and to say that certain
patients died asa direct result of transfer is very difficult to do," she cautions.
What triggers the risk? Researchers believe moving from familiar surroundings causes
separation anxiety and stress. Others note that because levels of care vary from facility to facility,
death and sickness may be linked to the way patients adjust to the changes.
Some facilities are better at providing a continuum of care than others, and successful transfers
require planning, consultation and monitoring.
St. Peter's CEO Donna Cripps says that's exactly what went into the transfers to St. Peter's.
Relocating the 56 Brow residents became necessary when the McGuinty government froze
funding for a promised new facility and ordered HHS, St. Joseph's Healthcare, and St. Peter's to
review complex continuing care needs in the community.
In May, the hospitals concluded there were already enough beds to accommodate the residents,
who ranged in age from 19 to 92.
So far, 12 Brow patients who need intensive daily medical care have been transferred to St.
Peter's site on Maplewood Avenue; nine, who require daily living assistance, have been moved
to St. Peter's new long− term care facility on the Chedoke grounds.
Another 13 Brow patients are awaiting discharge. Others have been placed in different facilities.
Cripps says none of the deaths being probed by the coroner occurred at St. Peter's, but one
transferred palliative−care patient did pass away there.
Though Martin at HHS is reluctant to talk about the investigation, he suggests people shouldn't
jump to conclusions. He said coroners are obligated to look into citizens' concerns.
The trouble is, the fate of the Brow residents has been such a long saga, so full of
disappointments and betrayals, it's hard not to view this latest twist as a kind of tragic epilogue.
Andrew Dreschel's commentary appears Monday, Wednesday and Friday. adreschel@thespec.
com or
905−526−3495.
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