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BC’s Deadliest Care Home Outbreak Took Yuet Sheung Wan. Her Family Wants Change

‘She was so much more than just a COVID statistic,’ says granddaughter.

Christopher Cheung 18 Mar 2021TheTyee.ca

Christopher Cheung reports on urban issues for The Tyee. Follow him on Twitter at @bychrischeung.

Yuet Sheung Wan’s love language was touch — a tough language to lose with the arrival of the pandemic.

Wan always gave tight hugs to her grandchildren. A seamstress from Hong Kong, she kept her hands busy after immigrating to Vancouver in the 1990s to help raise two granddaughters in the Little Mountain area. She packed their lunches, patiently simmered Chinese soups and sewed ballet costumes. Later in life, she participated in a health study that paired seniors with robotic pets. The tactile Wan warmly bonded with her cat Mao Mao, which knew to roll over for belly rubs.

“I wonder whether that’s why her hands always felt so strong even as she became frail,” said Bernadette Cheung of her grandma. “She had a mean grip when holding on to us.”

Wan was there to help cook for Cheung into adulthood. “It was her food that got me through my university days,” she said.

But a few years ago, the family noticed that Wan had begun buying the wrong ingredients for her recipes.

In 2019, she fell off her bed. During a hospital stay, a doctor diagnosed her with dementia. Wan, who had been living on her own until then, would require round-the-clock support.

Later that year, the family checked Wan into a care home.

When the pandemic arrived, hugs and touch were out of the question. There were Zoom calls and window visits, but the barrier of distance, along with Wan’s deteriorating hearing, made it hard to communicate beyond nods, smiles and waves.

“My mom got calls from doctors and nurses, and every time, they were like, her physical health is perfectly fine. But they didn’t talk about how her mental health is doing,” said Cheung. “For someone whose mind is going, and who relies on the physical proximity of people, I started to worry if it would cause her to not be happy anymore.”

When she lived independently, Wan was a social person outside of family life. She volunteered at the Ray-Cam Cooperative Centre, prepping snacks for children’s programs, delivering food to other seniors who lived nearby and teaching crafts. Beading and bingo were her favourite pastimes. When her dementia set in, she wondered if her Mao Mao had been a bingo prize.

In November, Wan’s family received alarming news. Her care home, Little Mountain Place, had an outbreak of COVID-19. It would become the province’s deadliest.

When considering a care home for Wan, Little Mountain Place — named for its neighbourhood — was the obvious choice. Wan’s late husband had lived there, and Wan lived in an apartment next door. While it isn’t a specifically Chinese care home, which are rare in the region and have long waitlists, Little Mountain does have many Chinese residents and provides some culturally-focused care like food and activities, as well as some translation services, such as for the facility’s event calendars.

A Cantonese-speaking social worker who worked with Wan was of great help to the family, said Cheung, especially during the pandemic with the Zoom calls and window visits.

It was hard to explain to Wan why the family wasn’t visiting, said Cheung. “Every time, we’d say there’s a disease out there, and we’re not allowed to come in. I think she was confused. It was very much one-way conversations.”

Early on, Little Mountain Place seemed to be doing well protecting its residents and workers from COVID-19, with only one staff member catching the virus last March.

By contrast, Lynn Valley Care Centre, home to Canada’s first outbreak, had 82 cases, with 20 residents dying of the virus. That death toll was later surpassed by other care homes.

On Nov. 20, Little Mountain Place emailed families to tell them an employee had contracted COVID-19 and was in isolation. A Vancouver Coastal Health officer determined that there was “minimal exposure risk” and didn’t declare it an outbreak. The health authority placed the home on “enhanced surveillance,” yet still welcomed visitors and continued group activities.

Four days later, Cheung was alarmed to see the care home added to the list of outbreaks on the Provincial Health Officer’s website. Cheung’s mother called the care home and was told the health authority was attending and not to worry.

“There was no indication that things were getting out of hand at all,” said Cheung.

On Dec. 7, the family received an email from the care home notifying them of a Zoom meeting that night.

“We were finally told that actually the positive cases were really high, up to 59 cases,” Cheung said. “It didn’t seem like anyone had prepared us for the severity of how the numbers were trending. Every time my mom had called them, they told her not to worry.”

There were more Zoom meetings after that to keep families updated. At first, they had the chance to ask questions through the chat on Zoom.

“But later in December, they disabled the chat function, so we didn’t have the ability to message each other or message our questions. It took away the expression of families in general, to see what other families were trying to ask. We’d have to submit them through an email first. And then they could pick and choose which questions to answer during the call.”

One additional stress for the family was the departure of the Cantonese-speaking social worker who’d been so helpful facilitating communication with Wan. The care home offered no explanation for the worker’s departure, and her replacement only spoke English.

When Cheung’s family questioned what language supports would now be available, Little Mountain Place said it had come up with creative ways of engaging non-English residents, such as asking them to point to language flash cards.

This wasn’t helpful for Wan with her dementia, said Cheung. On one occasion, Wan pointed to a Tagalog card.

On Dec. 13, a doctor called the family and told them that Wan was being put on oxygen support and that she was going to be tested for COVID-19. Two days later, they confirmed that she’d contracted the virus.

“That week, we basically got called every day to update us about how my grandma was doing,” Cheung said. “It kind of oscillated. She’d be fine one day, then put back on oxygen.”

Cheung’s mother and sister were allowed an essential visit to see her.

Yuet Sheung Wan died on Dec. 20. She was 94.

“We were given hope, but then another day, it wasn’t good,” said Cheung. “That’s the nature of COVID — it’s hard to predict. It all happened in a span of five days. I’m really glad she didn’t have to suffer for too long.”

The family held a small funeral of 10 people, adhering to provincial guidelines. Health Minister Adrian Dix gave Cheung a call, a “nice gesture,” she says, but he didn’t share anything revealing about the outbreak.

Dissatisfied about Little Mountain’s handling of the outbreak, Cheung continued to attend the Zoom meetings. On Dec. 29, Dr. Andrew Hurlburt, a Vancouver Coastal Health prevention and control physician, told families that the outbreak was due to a “perfect storm” of being short-staffed, improper PPE practices and “presenteeism” from infected workers who continued to show up because they wanted to help out. These workers, either asymptomatic or having failed to recognize and report their symptoms, interacted with residents and other workers.

“The facility should’ve been telling us this in the calls,” said Cheung, who wished the care home took more accountability over its actions early on as cases and deaths climbed.

By the time the outbreak was declared over on Jan. 29, it had become B.C.’s most fatal, with 171 cases and 41 deaths. Ninety-nine residents were infected in the 116-bed care home.

In a call to Little Mountain Place this week, the care home directed media questions to Vancouver Coastal Health. The health authority told The Tyee that it takes all concerns raised by residents and families seriously, and that “any allegations of insufficient quality of care are investigated.”

In the case of Little Mountain Place, a investigation by Vancouver Coastal Health concluded on Feb. 2 that the care home indeed did not have adequate staffing and cleaning during the pandemic. After these areas were identified, the health authority deployed more staff and ensured cleaning was done to standard.

Later that month, the care home’s executive director, Angela Millar, resigned.

A few families of residents shared their experience of the outbreak with news media. One told CBC that another resident entered her COVID-positive mother’s room to give her a hug. Another told News1130 that she was asked by the care home to pick up her late mother’s possessions, but when she arrived, staff couldn’t find them.

Family members of a Little Mountain Place resident who died prior to the pandemic have just launched a lawsuit against the care home, claiming poor regulation and quality of care.

Cheung’s advice to other families who have relatives in care homes with COVID spread is to “demand answers.”

At the very least, she said, care facilities should be providing families with updates about positive cases, what’s being done, how staff are using PPE and who’s being screened for COVID.

“Just tell us what the protocols are and as soon as an outbreak is called,” said Cheung. “We were thinking, should we have removed grandma from the care home? Would she have been better off staying with the family if the care home wasn’t able to keep the spread at bay?

“As I reflect on why I want to share her story, the main takeaway is really to honour her and show that she was so much more than just a COVID statistic.”

In the homes of Cheung’s family members, there is a lot Wan’s knitting and beadwork to remember her by.

“I’m still frustrated by the injustice of her life being taken away from us as a result of Little Mountain Place’s poor management,” said Cheung. “But I also know that she led an impactful and full life.”  [Tyee]

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