Elderly may be hardest hit by ER hospital closures

Written By Rob Shaw

“They go there… because that’s their emergency department that they’ve always gone to.”

Isobel Mackenzie

A Merritt senior found collapsed outside a hospital emergency department that was closed due to a staffing shortage is just the tip of the iceberg for how the elderly in rural British Columbia are grappling with the province’s ongoing healthcare crisis.

Seniors Advocate Isobel Mackenzie said the constant last-minute diversions of hospitals in small rural communities can catch seniors totally unaware because they often aren’t tuned in to the social media and online sources that broadcast the closures in real-time.

A Merritt senior was found in distress in the middle of the night outside a closed ER.

“This recent incident is emblematic of a larger issue,” Mackenzie said in an interview.

“We issue these bulletins that an emergency department is going to be closed on Friday and Saturday night — okay, you and I hear that because we’re plugged in. But the frail elderly person doesn’t hear that. So they go there… because that’s their emergency department that they’ve always gone to.”

The senior in Merritt was found in distress in the middle of the night outside Nicola Valley Hospital, which had been closed for the evening due to a nursing shortage. They were transported to Royal Inland Hospital in Kamloops, an hour away, where they are believed to have been treated and released.

ER closures amplify health issues for the elderly

The Nicola Valley Hospital has been closed more than a dozen times due to staffing since January. It’s a familiar story for many small-town B.C. communities in the interior and north, where repeated closures of ERs and hospitals force residents to drive hours to the nearest facility for care. 

Unlike in urban areas, where staff can be shuffled from city hospitals in close proximity, there is little backup when key physicians or nurses call in sick, burn out, move away or are called to help in other emergencies in rural B.C. 

“It’s amplified when you’re a senior because some of the fixes we have, such as you go to the walk-in clinic and go down there to line up at 5 a.m. — well a 95-year-old can’t do that, right?” said Mackenzie.

“We issue these bulletins that an emergency department is going to be closed … but the frail elderly person doesn’t hear that.

Isobel Mackenzie

“There’s evidence to suggest that they’re simply going to the hospital … that issues that could be resolved simply, if resolved earlier, aren’t resolved and so they become more complicated and more difficult to resolve.”

Opposition BC United leader Kevin Falcon said the decline in care in rural B.C. is typified by the Merritt case, where a confused and frail elderly resident is left to languish outside an ER in desperation.

“It encapsulated everything that’s wrong with the system right now after six years of NDP governance,” Falcon said in an interview.

“When you travel around rural B.C. and talk to people about healthcare you will get an earful. Because they are accepting a situation where in Vancouver people would be rioting in the streets. It’s unbelievable.”

“In Vancouver, people would be rioting in the streets.”

Kevin Falcon

Mackenzie said the confusion over accessible healthcare for seniors is also playing out over the location of cooling centres in the summer’s record-hot weather. The 2021 B.C. heat dome killed 619 people, many of whom were older adults with health concerns who live alone and are less likely to be able to find the location of cooling centres or travel to them if available.

Nicola Valley Hospital closure ‘absolutely unavoidable’

Health Minister Adrian Dix said Interior Health has put a priority on stabilizing the Nicola Valley Hospital. He said progress has been made because prior to last week, there had only been one diversion since April.

Last week’s closure was “absolutely unavoidable” and occurred at the last minute, said Dix. It was reportedly due to a nurse en route to Merritt who was recalled to respond to a vehicle crash near Revelstoke.

“We were unable to redeploy quickly enough to maintain the service and we had to divert in that evening,” saidDix. “It was extreme reluctance. And massive efforts are going on and have been going on there incentivizing staff, working with supports for both physicians and nurses to see that the Merritt Nicola Valley Hospital is stabilized. 

“We were unable to redeploy quickly enough to maintain the service.”

Adrian Dix

“So it’s extremely important to us, it’s extremely important to the community, we’re taking very significant steps to do that.”

Dix pointed to Clearwater, which had suffered healthcare closures and ambulance shortages, but is now in a much better position after work by officials and the local mayor to stabilize staffing. But other communities continue to struggle, including Grand Forks, Mackenzie, Williams Lake and more.

Expand telehealth and housecalls for elderly, says advocate

Sometimes, even keeping a facility open is not enough. Seniors aren’t always able to transport themselves to the doctor, or the hospital, said Mackenzie. She urged the province to expand both telehealth service for seniors and integrated teams of doctors and nurses that go to the homes of the elderly.

“That’s a very effective model, and hopefully we’re going to see that scale up,” she said.
In the meantime, the healthcare complications in rural B.C. continue to disproportionately hurt seniors. In Merritt, where the mayor publicly blasted the government over the closures, conversations about longterm solutions are ongoing, said Dix.

“We are moving mountains to ensure that we keep this emergency room open,” he said. “And we’re going to continue to do that.”