A single mom who once advocated on behalf of all families in Ontario with severely disabled children now says a hospital has taken away her right to advocate for her own child.
Anne Larcade’s son, Alex, is 26. But his mental capacity if that of a child between the ages of two and eight. Despite his challenges, Larcade says her autistic son is usually happy and relatively independent. “He’s like Forrest Gump,” she explained, saying he has “pockets of brilliance.”
Alex was getting ready to move into a home his mother bought for him with 24-hour care.
But that plan was derailed on Dec. 21, when the combination of holiday stress and a reaction to a change in medication saw Alex’s mental state deteriorate.
“Alex eroded quickly,” she explained. “He became anxious, depressed, suicidal.”
At one point, he picked up a kitchen knife and held it to his own throat. “He said, ‘Mommy if you can’t fix my brain and get me help now I would rather die.'”
Larcade, who lives in Huntsville, called an ambulance and Alex was taken to Orillia Soldiers’ Memorial Hospital. For the first 10 days Alex seemed to be improving and Larcade visited him daily.
Then Alex was told he was going home. But when he tried to call his mother to tell her the good news, he suffered another setback. With the lone phone being used by other patients, Alex became agitated.
“They told me he started getting anxious and frustrated and swore,” she recalled.
Larcade says Alex was put in isolation.
For five days Larcade says she was kept completely in the dark about his condition and was barred from seeing him based on the fact that, even though he has the I.Q. of a child, he hadn’t granted consent.
“I’m unaware of his physical condition right now,” the frustrated mom said. “I do have knowledge from last week, he has been injected with medications, given additional, very dangerous medications.
“He has been locked in a segregation cell at one point with (his hands and feet) restrained.
“I’ve got a little boy who is scared,” she added. “Who thought that his mommy was coming to pick him up to be released…I don’t know if it’s legal, but I know it’s not right.”
In a statement, the hospital said it wouldn’t comment directly on Alex’s case, but that patients in distress are often placed in an ‘extra care’ area for “clients requiring closer monitoring or supervision.”
“Patients in this area may be in danger of harming themselves or others, or their illness may be preventing them from being able to function in a manner that would be considered socially acceptable.”
“Visiting is not permitted on the extra care unit…”
But Larcade says the hospital should have consulted with her because he doesn’t have the mental capacity to make his own decisions.
“He has an I.Q. of less than 60. I can show I’m responsible for all his financial and medical decisions … Would you let your two- to eight-year-old administer their financial and medical affairs?”
Larcade says she’s in a legal Catch-22 because of a law that states Power of Attorney can’t be granted if the person has an I.Q. of less than 70. She faces a lengthy battle for legal guardianship.
After CityNews contacted the hospital, Larcade was permitted to visit Alex, who remains in the extra care unit.
Larcade is now in talks with the hospital to try and set up a framework for Alex’s care and to develop protocols so this doesn’t happen again.
It’s not the first time she’s been the voice for the developmentally challenged and their families.
Fifteen years ago, Larcade took the province of Ontario all the way to the Supreme Court of Canada, battling a loophole that required parents of disabled children to give custody up to the Children’s Aid Society in order to get them the care they need.
Orillia Soldiers’ Memorial Hospital (OSMH) provides both inpatient and outpatient mental health services to Orillia and beyond. Our inpatient unit is an acute care Schedule 1 facility providing care to residents of the North East portion of Simcoe County and Muskoka.
The 23-bed inpatient unit includes a 4-bed ‘extra care’ area. The extra care area is more secure and is intended for clients requiring closer monitoring or supervision. Patients in this area may be in danger of harming themselves or others, or their illness may be preventing them from being able to function in a manner that would be considered socially acceptable.
Visiting is not permitted on the extra care unit, or in any of the other patient rooms. All visiting occurs in the main dining area of the inpatient unit. This is to allow people who do not wish their presence known to have the safety of their personal room and space without the potential for confidentiality breaches.
Depending on their condition, patients in the extra care area may not have the option of accessing the main dining area to see visitors, unless their symptoms stabilize.
Patients and their family, including POAs (Powers of Attorney) where applicable, are an integral part of the treatment team at OSMH and are encouraged to take an active role in the development of the plan of care. For safety reasons, there may be times that family members or POAs may not have direct, physical access to a patient but their participation and input into the care plan is always welcomed. As part of its commitment to quality and safety, OSMH must ensure a safe environment for all patients, visitors and staff.
When a patient is unable to provide consent, for whatever reason, the hospital will turn to the patient’s Substitute Decision Maker (SDM). I’ve provided a link with additional information on the SDM Act. https://www.attorneygeneral.jus.gov.on.ca/english/family/pgt/pgtsda.pdf
Regarding your question about use of restraints, OSMH utilizes a Least Restraint policy. The decision to use restraints is based on the principle that least restraint and use of alternatives are best. In hospital, all patients are cared for in a fashion that respects their dignity, independence and freedom and provides for the safety of patients and staff. Restraints shall be used only after the patient has been assessed and when there are reasonable grounds to believe that there is a potential for injury/harm to the patient or others if restraints are not used. Such situations will be exceptional and temporary and only necessary when less restrictive measures or alternatives have been attempted and proven ineffective.