Whitehorse General Hospital is so crowded officials have started moving patients to the communities with or without permission from them or their families.
Since July the Yukon Hospital Corporation has been moving about four people a month from Whitehorse to either the hospitals in Watson Lake or Dawson City to help spread out the demand for beds.
But the decision has left some family members far from their loved ones, forcing them to drive hours out of the way for a chance to see them.
It means that Audrey Brown has to travel more than six hours from her home near Haines Junction to Watson Lake to see Fred, her husband of more than 60 years.
Fred spent weeks in Whitehorse General Hospital after a fall at home. About a week ago his family found out he was being moved to Watson Lake.
Audrey said she wasn’t home when the hospital called. By the time she spoke with officials the next day and drove back to Whitehorse there was already staff ready to take Fred away.
“They didn’t give me time to discuss with him what’s going on,” Audrey said.
The family says staff were talking with Fred about going to Watson Lake. But Fred doesn’t hear well, said his granddaughter Kathleen Jones. He’s also suffering from dementia.
“He has the mind of a child right now,” she said. “I don’t mean to sound disrespectful but that’s how it is right now.”
Audrey said she was angry when she found out her husband was being moved.
“I mean, what do they think this is, residential school days, to just grab somebody and take them away from home? We don’t know nobody over there.”
Supply and demand
Last year the Whitehorse hospital’s 55 beds were at an average of 96 per cent capacity, said hospital spokesperson James Low.
“What that really means is more than half the time we didn’t have beds to meet the demands. Fifty per cent of the days last year we were at 100 per cent or higher.”
The ideal hospital occupancy is 75 per cent, he said.
While the Whitehorse hospital is full, hospitals in Dawson City and Watson Lake have more room. Both community hospitals have six beds each. From April to September 2017, Dawson occupancy ranged from 35 per cent to 62 per cent and Watson Lake ranged from 28 per cent to 59 per cent, Low said.
Moving people to the communities allows the Whitehorse hospital to reduce occupancy and make better use of hospital beds overall across the territory, he said.
While families and patients are told about the possibility of a move, the final decision about whether or not a patient is cleared to transfer is made by a doctor, Low said.
“All their concerns are considered, but ultimately the decision is based on clinical criteria and our need to provide appropriate care to all of our patients.”
Patients are moved only if it wouldn’t reduce their quality of care, Low said.
Patients are not moved, for example, if they need palliative care, if they have physiotherapy needs that can’t be met in the communities or if they need more than one nurse to help them, he said.
“Bottom line, if a patient, if their clinical or therapeutic needs, cannot be supported in the communities, then they won’t move.”
Jones said the hospital needs to do more to consult with families before making these decisions.
“If my grandma didn’t call the hospital the very next morning he would have been shipped off without any of us knowing. We would have went to the hospital to go visit him and he wouldn’t be there.”
Jones said the family hasn’t spoken to a doctor about the situation, only the hospital’s First Nations liaison.
When Fred was in Whitehorse, family visited him almost every day. Now they’re worried that he could die alone. “If his body does start failing him how are they supposed to rush him out right away so we can have our last time with him,” Jones said.
“It’s just precious time we don’t want to lose out on,” said granddaughter Karrie Brown.
Low acknowledged the “transfer process is going to be stressful and difficult on patients and families. But the criteria that we use to determine whether they move is purely clinical.”
Audrey has been able to spend a few days with her husband in Watson Lake.
“When I got there he said he felt really lost,” she said.
One night she rented a hotel room and the other night hospital staff let her stay at the hospital.
Audrey said she thinks her husband is getting good care at the hospital in Watson Lake, but she wants him closer to home. They’ve never been apart this long, she said.
“I don’t want him that far from home. When he’s here (in Whitehorse), some of us go there every day to see him. We make sure that he’s OK. I didn’t really like what they did to him.”
Michelle Boleen, a spokesperson for the Department of Health and Social Services confirmed that travelling to see family members who have been brought to the communities is not covered by the Yukon’s medical travel subsidy.
The family hopes a bed can be found for him at Whitehorse General Hospital.
“It makes more sense for us to actually be able to go see him there. I know it’s not possible to get him a continuing (care) bed because the wait list is really long right now,” Jones said.
Low said most transferred patients stay in the communities about three to four weeks at a time.
The decision to move patients to the communities has relived some pressure on the Whitehorse hospital, Low said, though it’s not at the ideal 75 per cent occupancy.
The high occupancy at WGH can be traced back to a lack of continuing care beds in the territory, Low said. About 30 to 40 per cent of the patients that are at WGH should actually be in another type of facility, mostly continuing care.
That pressure will likely ease when the first phase of the 150-bed Whistle Bend continuing care facility opens up. That is slated to happen in the spring of 2018.
For now, Low said patients need to be prepared to move if the hospital deems it necessary.
“I think it’s just reasonable to set the expectation with Yukoners that if they come to (the) hospital they may receive care at any one of our three hospitals.”
NDP health critic Kate White said the hospital should be getting “free and informed consent” from patients before they are moved.
“We all understand the importance of having visitors and family. So if you’re moving someone from already a rural community from Whitehorse to a further hospital than you’re removing their ability for visitors.”
If this is how overcrowding is going to be dealt with for the foreseeable future, the government needs to do more to help families who are forced to travel the extra distance, she said.
“As it stands Yukon health is not going to support your family member travelling from their home community to the community you get taken to. If Yukon health was to look at that then maybe our opposition would soften, but they aren’t and it won’t.”
Both White and Yukon Party health critic Brad Cathers said the bed situation could also be improved by improving the territory’s home care program.
“What can fix the bed situation is primarily a combination of two things. One is new continuing care beds, the other is if some of those people through improvements to the home care program can be able to stay at home or avoid getting into the hospital in the first place,” Cathers said.
Contact Ashley Joannou at firstname.lastname@example.org