It's a dilemma countless families face as the COVID-19 outbreak cuts a deadly swath through Canada's long-term care homes: Take loved ones home to protect them from infection, or leave them inside and hope they will be spared.

Karol Wojtak, shown here with two of his three grandsons. With many London care homes dealing with COVID-19 outbreaks, his family is keen to take him home but worry that when he returns, it might be to a different room. (Submitted by Andrea Wojtak)

It's a decision that weighs heavily on Andrea Wojtak and her family regarding her father, 94-year-old Karol Wojtak.

Since November 2018 he's been a resident of Extendicare London, a private care home in the city's north end.

Seeing the staggering death toll and increasing number of coronavirus outbreaks at Ontario care homes — including one in Bobcaygeon that has killed 26 — Andrea felt her father would be safer at home.

It wouldn't be easy. Karol Wojtak's care needs are significant: He has a heart issues and mobility challenges. A few months ago, he fought off pneumonia. Plus, Andrea Wojtak is already busy with three boys at home under the age of 12. She'd have to keep her dad on the main floor, where there isn't a bathroom (he can't climb stairs). She would also have to be the primary care giver until she could arrange home care for her father.

Big challenges for sure, but ones Andrea and her family were willing to take on for a man who survived being shipped to a Siberian labour camp at age 14. It happened when his native east Poland was occupied by Russia during World War II. It was a trip Karol Wojtak began with his father; but one his father didn't survive. Karol later joined the Royal Air Force after he was accepted as a refugee by the British government.

To keep safe a man who survived that and more, Andrea Wojtak was willing to take on all the challenges of caring for him at home.

Then the "home vs. care home" equation tipped drastically when Andrea learned that Extendicare couldn't guarantee that Karol could return to the same room if he left, even if he was away for just a day.

Switching rooms may seem trivial but for a 94-year-old in care, it's a huge upheaval and potentially traumatic.

A new room means new staff, new neighbours and maybe even a new floor on the 170-bed facility. Faced with this, both Andrea and her father decided he should stay put, even if puts him at higher risk of infection.

"My dad refuses to leave, because it's his home," said Andrea. "He has a private room, it's decorated, it has his furniture ... he psychologically could not handle giving up his home."

Provincial guidelines

In response to questions about Karol Wojtak's ​​situation from CBC News, Extendicare sent a statement from the company's head office in Markham.

It essentially says the home is following the rules set down by the Local Health Integration Network and the Ministry of Long-Term Care.

"Extendicare is implementing these policies in the best interests of its residents and staff during the COVID-19 outbreak," reads the statement from Anthony McKenzie, Extendicare's regional director of southwest Ontario.

Ontario's Ministry of Long-Term Care also sent a statement, saying admissions and re-admissions are not allowed while a care home is dealing with an outbreak to protect residents' safety.

Extendicare hasn't experienced an outbreak, but if it did Karol Wojtak would not be allowed back into his room until the outbreak is declared over.

The rules are laid out in a new COVID-19 guidance document for long-term care homes updated last week.

Even in cases where an outbreak hasn't happened, there is no guarantee residents who leave will get their same room back when they return.

Why? In short, the home can't leave beds empty in a time of crisis.

"At this unprecedented time, it is absolutely necessary that we move hospitalized seniors who are on the wait list for long-term care into more appropriate care settings as soon as possible, both to limit their risk of exposure to COVID-19 and to free up much-needed hospital capacity."

Andrea Wojtak says she understands the capacity pressures, but feels the province should be less rigid during what is a scary time for everyone, particularly care home residents and their families.

Andrea Wojtak's 94-year-old father has been at Extendicare London since November 2018. She wanted to take him home during the worst of the COVID-19 outbreak but in the end decided against it because leaving the care home might mean losing his room. (Extendicare London)

"Don't punish families who are trying to protect their loved ones. Work with families to find a solution," is her suggestion.

She believes many other families will make the same decision hers did and not move their loved ones out of care homes — despite the grave risk — because switching rooms is just too much upheaval. She's grateful for the care her father has received at Extendicare, but fears the home could be overwhelmed when the expected spike in cases arrives.

For now, she has to hope her father can survive during what promises to be a deadly few weeks in Ontario, particularly for seniors in care.



