The daughter of an 87-year-old Oakville nursing home resident is forbidden from speaking to front-line workers. Her family’s daily phone calls with her mom have been eliminated and, as of February, she’s been banned from all but two locations within the home.
The manager called her a harasser of staff. The woman said she’s still waiting to find out why.
Written accusations of “harassment” or “vexatious behaviour” exposed in a recent Star story about visiting restrictions placed on 80-year-old Margaret Calverby her husband’s Markham facility have been used within the last year by at least four other operators, a mix of for-profit, municipal and not-for-profit homes.
The pandemic has been a time of chaos in long-term careand for many sons or daughters, watching a parent decline has led to guilt, anger — and a sharp focus on the operations of homes. Tempers are high on both sides. Families are furious. And operators, like Sienna Senior Living or Villa Colombo, are defending their employees.
“Mom and I are both severely emotionally and psychologically traumatized,” said Crystal Nikolich, who is facing numerous restrictions from Halton Region’s Post Inn Village. “It’s a heartless punishment because I have been speaking up for my mother and other residents.”
What is clear is the need for a solution.
Ontario’s Fixing Long-Term Care Act — which takes effect Monday — recognizes the role of family or chosen caregivers in homes for the first time.
The act adds a few new “whistleblower protections” but with no ministry plan to resolve conflict, Ontario’s troubled nursing home system is set for more confrontation. And families are flexing their power.
Donna Duncan, CEO of the Ontario Long-Term Care Association, said recognition of the “essential role” played by family caregivers offers a “real opportunity to reset the relationship between long-term-care homes, and families and residents.”
The ministry, said Duncan, “may establish” a ‘Resident and Family Adviser Office’ to help with communication and other issues in homes.
“Families add so much to homes through their love and connection with residents,” she said, “and it’s a priority for homes to maintain positive relationships with mutual respect so issues that arise can be solved collaboratively and proactively.”
Samantha Peck, executive director of Family Councils Ontario, says homes need proactive support from liaison or social workers. FCO supports family councils in homes. “They can prevent an issue from getting to the point where it has become toxic,” Peck said.
What Ontario needs is an independent long-term-care ombud, said Laura Tamblyn Watts, CEO of national advocacy group CanAge.
Conflict will always exist in shared living or caregiving, Tamblyn Watts said. “So, to look at it critically, why don’t we do anything to help people come to a positive resolution?”
The Star has copies of the letters sent to families interviewed for this story. All homes cited the Occupational Health and Safety Act, like the 2019 “investigation” of Calver by the not-for-profit Markhaven Home for Seniors. Lawyers, however, say the act controls employers and employees, not visitors.
Calver was banned from her husband’s room but, if she met strict rules, she could see him in common areas. In the 27 months following the ban, which included COVID-19 lockdowns, Margaret said she was able to “touch” Wayne fewer than 40 times before he died last fall.
Like Calver, most visitors who received harassment letters are chairs or co-chairs of the home’s family council, an advocacy role enshrined in provincial legislation if “done in good faith.”
As co-chair of the family council at Halton Region’s Post Inn Village, Nikolich said the response to complaints she sent to managers, politicians and the ministry was “retaliation, harassment and intimidation, plain and simple.”
On Feb. 23, Halton sent Nikolich a letter saying it would no longer recognize her role on family council. It restricted visits to her mother’s room and a common area, eliminated her family’s morning “motivational” calls with 87-year-old Dagmar, and forbade Nikolich from speaking to front-line staff. She is allowed to speak to nurses.
Halton’s letter said staff had filed a union grievance due to “ongoing negative interactions with you.” It said Nikolich tried to “belittle, bully, harass, and intimidate” workers. The Ontario Public Service Employees Union said it could not comment.
“I did not harass staff,” said Nikolich, a retired lawyer. She asked Halton management to share details of the allegations but said none were provided.
“Why are family caregivers being harassed for trying to help to make things better?” she asked. “Is it because we provide oversight and report things we see or hear?”
Halton Region told the Star its workplace must be “free of disrespectful behaviour, intimidation and harassment.” It said Nikolich’s “role as caregiver continues to be respected and she has access to the home in order to visit and support her mother.”
In 2020, Julie Perl began sending complaints to government bureaucrats and politicians about the management of Toronto’s not-for-profit Villa Colombo, home to her 96-year-old mother, Clotilde.
Perl is chair of Villa Colombo’s family council. After the home announced the departure of its administrator early in the pandemic, Perl said she repeatedly complained about new management and copied her emails to multiple people, including Premier Doug Ford and Health Minister Christine Elliott.
In early January 2022, Perl sent another letter to Villa Colombo’s board of directors, again complaining about management. In response, John Hendriks, the board chair, said the home’s board and management “agree that your continued focus on the allegations you make in your electronic message serve only to create an unhealthy workplace …”
Hendriks’s letter ended with a caution: Perl’s continued “harassment” of staff could lead to a “workplace harassment investigation.”
“I’m advocating, not harassing — I’m shocked they would even suggest that,” she said. “We’re calling them on the lack of care for residents and families. Our loved ones livethere — they just work there.”
In a statement to the Star, Hendriks said Villa Colombo “takes quite seriously” its obligations under the health and safety act but privacy rules prevent him from commenting. He said, “however much Villa might wish to provide you its perspective … we simply cannot do so.”
In a 12-paragraph statement, a Sienna spokesperson described a “culture of fear within our homes.” Some behaviour, it said, “goes well beyond advocacy or constructive criticism.”
Sienna said staff have faced “yelling, profanity, comments on physical appearance and intelligence” along with “public shaming on town hall meetings, in the media, and correspondence to long lists of public officials” that name employees with demands they be fired.
“This is where we, as an employer, have a duty to act. Not only to help team members cope but to protect and prevent harassment from occurring in the first place,” Sienna said. The well-being of workers, it said, is equal to the well-being of residents. “One can’t be achieved without the other.”
Two families interviewed by the Star spoke of rushed staff, falls that caused injuries, a ministry abuse violation and their allegations of management incompetence.
Mary Hunka’s 98-year-old mother, Vittoria, lived at Sienna’s Weston Terrace until she died in February. Hunka said she lashed out in frustration and anger at the home’s response to a ministry inspection report that concluded two workers had abused her mother.
A video camera in Vittoria’s room recorded the workers standing on either side of her bed as they changed her clothes. The ministry inspection report described what happened next: the workers quickly pulled Vittoria upright and she cried out as “both staff released their hold … allowing the resident to abruptly fall back into bed without support.”
One worker is no longer at the home. The other was sent to a different unit and Hunka has repeatedly demanded her termination.
During a Zoom “town hall,” Hunka said she told managers that, rather than sit in their offices, “why don’t you get off your fat asses” and fix the problems. Another time, she said she spoke to a social worker, who walked away. Later, in the lobby, the same worker spoke to Hunka and Hunka told her to “run back to your office like a little rat.”
A civilian employee with the Ontario Provincial Police, Hunka told the Star she spoke out of frustration. “I just lost it and was so tired of listening to the same crap over and over. They always had an excuse. Just do your job. That’s all we’re asking.”
Last summer, Sienna sent letters alleging harassment to Hunka and Nick Puopolo, chair of the family council at Woodbridge Vista.
Sienna told the Star its harassment letters followed previous efforts to address concerns through written communications, telephone calls, in-person meetings, and “offers to engage with a neutral third party to help mediate our discussions, which were refused.”
Sienna’s letter told Hunka to communicate through a general email address that would be monitored regularly. If the relationship could not be repaired, Sienna said it would help her mother find a different home. A second letter, noting the “rat” incident, said her actions caused “anxiety and stress.” It limited Hunka’s visits to her mother’s room and the outdoors, telling her to “make every effort to stay away from staff.”
In her response, Hunka told Sienna the “consequences of removing me from meaningful involvement in my mother’s care will be devastating given her age and health. I believe you are exploiting this circumstance as leverage to cause me to comply with these limitations or alternatively to remove my mother from the home.”
In June 2021, Sienna sent a letter to Puopolo telling him “your behaviour has resulted in team members feeling intimidated and harassed and feeling that if they are not able to meet your demands and expectations, they will be subject to public humiliation.”
Sienna told him all future communication must go through the general email address. He faced no other restrictions.
Puopolo’s 87-year-old mother, Saveria, lives in Woodbridge Vista, a home that struggled during the first wave of COVID. The Canadian military was sent in and, like a number of other homes, it was placed under temporary hospital management.
In his response to Sienna, Puopolo wrote, “It is clear that Sienna has no genuine intention of responding, in a timely and transparent manner, to the issues and concerns which I have raised on behalf of the family council. To the contrary ... Sienna’s focus is now directed to attacking the conduct of the family council and threatening me personally.”
In interviews with the Star, Puopolo said he is offended at Sienna’s suggestion of harassment. “Where is their evidence?” He said he has never behaved abusively. Instead, Puopolo said he sticks to carefully written letters “with facts” that include violations from ministry inspection reports. His lawyer, at Gowling, often helps him craft letters.
Puopolo was adamant that he has never yelled at managers. “I’m Italian and I’m a big guy, so when I’m speaking to somebody directly and looking right into their eyes, asking them why they’re refusing to respond to my letters, they could take it a different way.”
He said he had a good relationship with a recent administrator who adopted some of the family council suggestions. She took a leave of absence.
Early in the pandemic, Puopolo released an audio recording of a Sienna executive who, after the meeting ended, said, “Here comes another bloodsucking lawsuit.” She was fired. The company is now under new leadership.
Puopolo has expanded his role. He’s running an informal family council for all Ontario Sienna homes. He’s part of a new “family council action network” that includes Nikolich and Calver. Last year, he lobbied for staff vaccine mandates and air conditioning in resident rooms. And he helped Hunka with her letters to Sienna. “My wife describes me as tenacious,” he said.
Now, Puopolo said he gets emails from families across the province and tries to respond to all.
“I have a very Type A kind of personality,” he said.
“Most familiesget intimidated. I’ve been sending this stuff to the ministry and Premier Ford. And they’re just not listening.”