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Innis Ingram’s mother is his hero. But today, she’s living in one of the worst hit long-term care homes in Ontario. She has a terminal illness. Dozens and dozens of people around her have died, including her friend and roommate. And she’s had minimal human contact for three months. But even though he can’t be there with her, Innis is determined to get her the care she needs.
COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada.
Featured in this episode: Innis Ingram, Nathan Stall
To learn more:
“Ontario LTC whistle-blower saw many incidents of verbal abuse and forced feeding” by Jill Mahoney and Karen Howlett” in The Globe and Mail
“It’s time to let families visit long-term care homes” by André Picard in The Globe and Mail
“Some Ontario doctors, families worry rules for care home visits causing harm to residents” in CBC News
This episode is sponsored by Freshbooks
Additional music from Audio Network
“Western Shores” by Philipp Weigl, adapted.
TRANSCRIPT:
EPISODE 8 – “HUNGER STRIKE”
WARNING
Hey. This is Jordan. I just wanted to give you a heads up that this episode of Commons contains references to suicide and abuse. So it may not be suitable for everyone.
COLD OPEN
[ARSHY MANN]
Innis Ingram had a rough childhood. His dad was an alcoholic and emotionally abusive. And when he was 17, he witnessed his father’s own suicide. His mother, Kathryn Robertson, looked after him and his sister through it all.
[INNIS INGRAM]
After his death, my mother took over the social, financial, emotional care of my sister and I.
She would commute to the hospital for sick kids every day. She’d have to leave at 7:00 in the morning on public transit to get there from Mississauga and get all the way back, just to keep a very meager amount of food in the house for two troubled teenagers who were obviously struggling to cope with the sudden death of our father.
[ARSHY]
Kathryn worked as a patient care coordinator in the Suspected Child Abuse and Neglect Program at the hospital.
[INGRAM]
She not only had to deal with two troubled kids of her own, but she was, on a daily basis, being exposed to all sorts of child abuse, neglect that was being perpetrated by others on their children.
[ARSHY]
As he grew older, Innis started to realize the enormity of his mother’s sacrifices.
[INGRAM]
That was the time in my life when I started really wrapping my head around everything that my mother had done for–for me and my family.
[ARSHY]
So when his mother was diagnosed with pulmonary fibrosis, a degenerative and terminal illness, Innis was determined to do whatever it took to help her through it. When he found out there was a medication that wasn’t covered by her health insurance, he tried to smuggle it in from India.
[INGRAM]
But I kept getting caught by the border authorities regardless of how it was packaged. Fortunately, the government ended up extending the health care package to cover that medication, which has, uh, significantly increased her life expectancy.
[ARSHY]
But at a certain point, it was clear that she would need to go into long-term care. After being on a wait list for eight months, she finally moved into Camilla Care Community, a long-term care home in Mississauga, Ontario. When the COVID-19 pandemic arrived, the home was locked down, like all of the others. And Camilla Care developed into the second-worst outbreak in the province.
[ARSHY]
Innis first realized something was deeply wrong in April when his mother told him over the phone that none of the kitchen staff had shown up to work. She had cold hotdogs for dinner that day.
Infections skyrocketed and many of the residents began to die all at once. After the first week of May, 48 people were dead, including his mother’s roommate, Mary Guy. Innis became increasingly frustrated. The communication from Sienna Living, which owns and operates Camilla Care, was almost non-existent.
And his mother was telling him that she’d only been given one bath in five weeks.
[INGRAM]
My mother would never voice that she’s scared, because she doesn’t want to worry myself and my sister and her grandchildren. But definitely any normal, rational person would be scared, living in a place where there’s a mass death happening, particularly when she’s in the highest risk category.
[ARSHY]
What made it all worse was that he couldn’t walk into the facility to help her out. He couldn’t be there to give her the care she needed or to make sure she was being treated properly. So Innis started to organize with the families of the other residents. One of the first things they did was create a memorial outside of Camilla Care for all the people who had died
[INGRAM]
A nonstop string of people. People walking by on the sidewalk and stopping to pray. Uh, one gentleman comes every day just like candles, doesn’t say a word to anyone. He just comes up, lights candles and leaves.
And the second function of the memorial was to draw public attention to the second largest outbreak in the province. Up until that point, there hadn’t been any kind of intervention, to our knowledge.
[ARSHY]
Despite the severity of the outbreak, Camilla Care wasn’t one of the five in Ontario that got assistance from the Canadian Armed Forces. But on the day the news broke about army whistleblowers calling out abuses in those five homes, Innis decided he had to do something more drastic.
[INGRAM]
And to be honest, my initial idea was to call the– call the media contacts that I had acquired through my involvement with the memorial and let them know that I was going to just basically storm the gates at Camilla Care and get arrested, trying to see my mother.
[ARSHY]
His sister talked him out of that plan. But while he was in the shower, he had another idea.
[INGRAM]
In between singing songs I… You know, I was obviously infuriated by the Canadian Armed Forces report. So my mind obviously went immediately to “What can I do about this?”
[ARSHY]
He’d always been struck by the story of Bobby Sands, the IRA prisoner who died while on hunger strike in Northern Ireland during the Troubles.
[INGRAM]
I also often thought that, like, thank God I live in Canada where we don’t need to do things like hunger strikes to draw attention to mass death.
[ARSHY]
But here it was, happening in Canada, and with his own mother’s life on the line. So he went to Home Depot, bought himself a chain, went to Camilla Care, and chained himself to a tree. Innis Ingram was on hunger strike.
I’m Arshy Mann and, from CANADALAND, this is Commons.
PART ONE
[INGRAM]
This is Canada. Like, it’s supposed… We like to think this is the greatest country on Earth. And why am I chained to a tree to get the government to do its job?
[ARSHY]
The same day Innis Ingram began his hunger strike, the Ontario government announced that Sienna was no longer going to manage Camilla Care. Instead, Trillium Health Partners, a nearby hospital network, was going to take it over.
[INGRAM]
So, the way I look at it is, my mom’s in there, not getting adequate nutrition. I’m out here not getting adequate nutrition. And, uh, me being here, even though I’m not kind of with her physically and I can’t be, I can be with her in spirit by being here and kind of experiencing some of the stuff that she’s experiencing.
[ARSHY]
It’s day one of Innis’s protest. He’s sitting under the tree and broadcasting on Facebook Live to a growing number of supporters and friends.
[INGRAM]
It means a lot and, you know, it’s giving me a kind of fuel to stay out here. I didn’t eat at all today. The hunger strike officially started at one, but I didn’t eat anything since last night because I figured it might create washroom issues. I’m already hungry. I’m already thirsty. Let’s hope that those stories about how you can live without water for three days are true.
[ARSHY]
Innis is quite a sight in these videos. He’s a tall guy with red hair and a beard, and tattoos all over, including some on his face. He’s wearing all black, including a black baseball cap. He’s not your stereotypical image of a hunger striker.
But from the outset, Innis is clear about his demands. He wants a provincial inspection of Camilla Care and he isn’t leaving until he knows that’s going to happen.
[INGRAM]
I’m basically at a point where I’m… If I can do anything that I can do to, to help my mom, uh, I’m going to do it. And if that means, you know, not eating for a while, I-I can deal with that. And no–no water, I can deal with that. I’ve been through worse. And I absolutely hate that my mom is having to go through almost… Like almost an identical situation in a home that we’re paying for.
[ARSHY]
Here he is later that same day.
[INGRAM]
My body, I think, is starting to switch into, like, conservation mode. So I’m not feeling super hungry. As you can see, I got cooked by the sun. Curse of the ginger. It’s probably gonna be a long night here because I don’t expect that the Ford government is going to be sending out experience– inspectors, rather, tonight.
<horns honking>
You’ll hear horns honking in the background, too. There’s a lot of people honking to show support.
[ARSHY]
By the second day, he’s clearly getting worn down.
[INGRAM]
<construction noise> I really didn’t sleep at all. I slept about 30 minutes altogether. And of course, there’s construction obviously.
<construction noise stops> Oh, thank God they stopped for a second. And for those of you that know, I have PTSD as well, so I have to take medication for sleep. I even took that and I still wasn’t able to–to fall asleep. But is what it is. Uh, whatever conditions I’m going through. I can only imagine what the–the residents themselves are going through.
[ARSHY]
Innis started to get messages from across Canada, and even around the world, supporting him. He even got one from Belfast, Ireland, where Bobby Sands and other Irish prisoners had staged their hunger strike decades ago.
Two days after he chained himself to that tree, the chief operating officer of Trillium, came to see him.
[INGRAM]
I communicated those demands to her and she was very, very open to everything. But I also told her that I wanted it on paper because I’d reached a point where I was kind of done with lip service being done to the situation by politicians and the delay in an actual action happening.
[ARSHY]
The executive went back to the legal team, drafted a letter with their commitments and brought it back to Innis. It was what Innis had been waiting for. He’d secured a commitment in writing that outside inspectors would be coming to Camilla Care immediately. Someone would be going in to check on the well-being of his mom and the other residents. His hunger strike was over.
So Innis went back home. He ate some Chinese food and pizza donated by a local restaurant.
[INGRAM]
And they came and brought us a few pizzas, wings and everything, and, uh, you know, my eyes were much bigger than my stomach. I guess my stomach had shrank while I wasn’t eating. So I ate about two slices and passed out, and ate quite a bit more when I woke up the next day.
[ARSHY]
And as Innis was recovering, he got an email. It was from a Trillium employee who had been working at Camilla Care for the last few weeks.
[INGRAM]
In this email, she outlined various abuses that she’d witnessed. Things like residents being smacked, force-fed. Uh, there was one instance where someone who had passed was still being force fed, and food had to be suctioned out of the mouth of the dead body before the funeral home came to pick it up.
[ARSHY]
Innis was able to connect her with journalists at the Globe and Mail, who broke the story. A police investigation is ongoing and four Camilla Care, and one Trillium staffer, have been placed on leave. The allegations are almost unbelievably horrific. But other Sienna-operated homes have been facing similar ones. Canadian soldiers alleged that severe understaffing and mismanagement were harming long-term care residents at Altamont Care Community, which is owned by Sienna.
At Woodbridge Vista, where 23 people have died of COVID-19, a coroner found that an 82-year-old man had died of malnutrition. It wasn’t the virus that killed him. It was a lack of care. And all of this came at a time when Sienna’s upper management was under fire.
[NEWS CLIP 1, FEMALE]
Sienna Senior Living has fired Joanne Dykeman, its executive vice-president of operations. The company says it was altered to comments she made after a video conference with families of residents last night. Anthony, what did you hear?
[NEWS CLIP 1, MALE]
When the meeting was done, which we really didn’t get to say very much, um, everyone logged off but her. And she just closed her laptop and the audio kept going. As soon as she closed it, um, she called us “bloodsucking, class-action lawsuits people.”
[ARSHY]
Innis thinks that’s indicative of Sienna’s priorities.
[INGRAM]
You know, if you just look at it just as that… Okay, great. She’s fired. But the fact that she felt comfortable enough with her fellow executives to make those kind of statements and jokes and engage in that mockery really speaks to the corporate culture at Sienna. She might have been the one to get fired for it. But she was also in a room full of people who thought it was acceptable.
[ARSHY]
Last week, Sienna’s CEO Lois Cormack also resigned, citing personal reasons. According to a Toronto Star report, Sienna Living has paid out just under $40 million to its executives over the last decade. And during that same period, they’ve given out over $300 million in dividends to shareholders. Almost every member of Sienna’s board is an expert in real estate. None of them have a healthcare background.
A Sienna worker at Camilla Care also reached out to Innis with more disturbing news.
[INGRAM]
She told me a story of a resident that died as a result of a fall that was easily preventable, had they had the appropriate staff.
[ARSHY]
We reached out to Sienna for comment about the allegations of abuse and neglect at Camilla Care. In an emailed statement, they said they will take immediate action if the allegations are proven true and that in the meantime, the staff who have complaints against them have been put on leave. They also noted that they had self-reported these allegations to the Ministry of Long-Term Care and to the Peel police.
Sienna says that they have a six-point action plan which includes a company-wide review of policies, and that they’ve brought on Joseph Mapa, the former CEO of Sinai Health System, to be an executive advisor to their board of directors.
PART TWO
[ARSHY]
If you’ve been listening to this podcast, you know that a lot of the very serious issues in long-term care are caused by chronic understaffing. And that’s gotten worse during the pandemic. Not only because staff are getting sick or quitting, but because these facilities are now locked down and families can’t visit. Family members used to do so much of the work, both the physical care, like feeding, as well as the emotional work to ensure their loved ones didn’t feel alone.
Nathan Stall is a geriatrician with St. Joseph’s Health Network and a voice you might remember from one of our first episodes in this series. And he says the lockdowns meant to keep the coronavirus from spreading are themselves causing severe health problems.
[NATHAN STALL]
I’ve seen residents who have been severely dehydrated, uh, and that’s been well reported. I’ve seen people who’ve broken their hips because they de-conditioned, because they’re not allowed out to exercise and maintain their function, and they may never regain their ability to, you know, return to the level of independence they had before. We’re seeing people who cognitively decline, who already have cognitive impairment. And when you don’t have social stimulation, you don’t have programming, you don’t have a routine like you normally did.
[ARSHY]
When we spoke to Innis, he hadn’t seen his mother in months. Long-term care residents can’t even go outside to get some air.
[INGRAM]
The things that my mother is dealing with and having to deal with them completely alone, being her terminal illness, loss of her roommate and friend, and also being in complete isolation to do all that, not having her family available to, like, come and visit and sit with her. You know, I got one message from her, saying, “I just wish you could come here and hold my hand.” And that’s just not reality. It’s not something that can happen. It’s just a really, really terrible situation. And I can’t imagine what she’s actually mentally going through.
[ARSHY]
Nathan Stall thinks that has to be remedied immediately.
[STALL]
It has just gone way too far. It’s cruel, it’s inhumane at this point to be doing this. And frankly, this is not an informed decision for these nursing home residents. If you talk to many of them, many of them would probably accept the risk of COVID to see their loved ones instead of dying in isolation or dying lonely.
[ARSHY]
Family members are also among residents’ best protections: Their presence helps ensure that abuse and neglect isn’t taking place behind closed doors.
[STALL]
And these are people who are already experts in caring for their loved ones, who could easily be trained to use personal protective equipment, who could easily be trained in infection control procedures and hand hygiene. And these are things we should be doing. We should not be shutting the doors on them. We should be welcoming people who want to provide care and be there for their loved ones in a safe way.
When you’re talking about things like calling in the army. There is an army of family members. And I don’t want to speak for everyone, but they can come in and help with some of these things.
[ARSHY]
This has become a preoccupation for Nathan Stall, not just in his medical practice, but in his personal life as well. His grandmother is 91 and lives in a retirement home that’s been closed to visitors.
[STALL]
Her unit is no more than five or six hundred square feet. She’s been in there for three months now, with meals delivered to her, uh, not socializing. De-conditioning physically. You know, it’s a horribly depressing condition. There is no hope because there’s no end-date for this until there’s a vaccine.
[ARSHY]
He had booked a visit for her birthday in a specially-built plexiglass booth that had been put together in the retirement home. But they had accidentally double-booked it.
[STALL]
And as a special sort of thing, they allowed her to sit… There was sort of a distanced patio, so we were still several meters away from her and she was able to see her family and her grandchildren, like myself and my kids. She said for the 20 minutes that existed at this distanced visit–no food, no drinks, no fanfare–this was the best moment of her year.
[ARSHY]
The Ontario government recently announced that they would be allowing visitors to some long-term care homes and letting residents occasionally leave the facilities. But Stall worries that this won’t amount to much.
[STALL]
The government has given directives, but they put this in the hands of the homes to oversee it.
At this point in the pandemic, you know, we have to realize, when we put the power in the hands of the long-term care homes, they have differing obligations. And one of their obligations is to the residents. But they have obligations, particularly when, you know, many of the homes in our province are run by for-profit entities to their shareholders and to their investors.
And at some point, you have to question, “Who are you doing this for?” Right? Because COVID-19 is certainly bad for business. Loneliness and social isolation, not as much of a deterrent for business, because often people have, you know, no option or limited options when they enter into a nursing home.
[ARSHY]
In other words, If someone dies of COVID-19, that could result in a lawsuit that costs shareholders money. But if residents are driven to despair by forced isolation, that’s just not as likely to end up in the courts. So there’s less incentive for these companies to devote resources and care to opening up safely.
On Monday, Innis Ingram and a number of other people with family members at Camilla Care were preparing a vigil for World Elder Abuse Awareness Day. Camilla Care had started allowing residents to occasionally leave their rooms and go outside last week. And while Innis was doing a TV interview promoting the vigil, he got a call. It was his mother. It was her turn to go outside.
Here she is, waving at his camera.
[INGRAM]
Say something.
[INNIS INGRAM’S GRANDMOTHER]
Okay. Hi!
[INGRAM]
<laughs>
[ARSHY]
Innis still can’t help feed her or bathe her. He can’t even hold his mother’s hand. But three months after being locked down, and two weeks after Innis went on hunger strike for her, Kathryn Roberts was finally able to see her own son in the flesh.
OUTRO
[STALL]
Older adults have been sort of… They’ve been punished many times during this pandemic. They were sort of punished early on when people didn’t want to change their behaviour because they thought this was a condition that only affected older people. They were punished when we failed to act, uh, in long-term care homes and retirement homes to protect them until it was, you know, well into the outbreaks and deaths. And now they’re punished because we’re asking them to sort of remain isolated while everyone else opens up.
[ARSHY]
Innis Ingram thinks that these sacrifices need to be honoured.
[INGRAM]
I want my mother to not… And everyone else’s parent and grandparent and aunt and uncle and brother and sister… I want them to not have gone through all of this for nothing.
I mean, that generation really has already given so much to our country and to our way of life, being born before, during or shortly after World War Two. You know, the fact that they’re not even being asked. They’re being forced to make yet another sacrifice for our country. So my hope is just that, you know, that sacrifice isn’t in vain and that if that’s real change.
[ARSHY]
Kathryn Robertson helped victims of abuse and neglect throughout her career. Now she’s the one who’s vulnerable and needs to be protected. For Innis, that means we are all responsible for making sure the long term care system becomes far more humane.
[INGRAM]
I learned firsthand that, you know, getting out from behind a keyboard and doing something, can have a real result. One person can do that.
END CREDITS
[ARSHY]
That’s your episode of Commons for the week. If you want to support us, click on the link in your show notes or go to commonspodcast.com. We could really use your help.
This episode relied on reporting from Sabrina Gamrot from Mississauga News, Jill Mahoney and Karen Howlett at Globe and Mail, Marco Oved, Kenyon Wallace and Brendan Kennedy at the Toronto Star and many, many others.
If you want to get in touch with us, you can tweet at us at @COMMONSpod. You can also email me, Arshy@canadalandshow.com
This episode was produced by me and Jordan Cornish, with additional production by Tiffany Lam. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.
If you like what we do, please help us make this show. Click on the link in your show notes or go to commonspodcast.com
