Manitoba Crown prosecutors are facing a tough decision on whether to lay criminal charges against an elderly man with dementia in the 2017 death of a 74-year-old woman at a Winnipeg personal care home.

The incident that led to the death happened at Southeast Personal Care Home on Sept. 19, 2017. It was never made public but CBC News learned of the details in court documents filed by Winnipeg police this past March.

Officers sought, and were granted, authorization to obtain the mental and physical health information of the accused, Clifford (Orville) Peebles, now 87 and living at another Winnipeg care home. Police also obtained a warrant for notes taken by Southeast staff during the 2017 incident.

According to a police affidavit, it is alleged that Peebles, then 84, pushed Claudia Berens, 74, after she accused him of stealing a TV remote in the common room of the care home.

Berens — who was frail and also suffering from dementia, according to the affidavit — fell and broke her hip. She died four days later.

No one witnessed the fight, but police said a registered nurse at Southeast Personal Care Home told police Berens had accused Peebles of stealing her TV remote earlier in the evening. The nurse said she had explained to Berens that Peebles didn't have it, and she believed that was the end of it.

Frank Alexander, who had Alzheimer's, died in 2011 after being pushed by another resident at his personal care home. (Submitted by Joanne Rislund)

"This is a really difficult issue," said Neil McArthur, director of the Centre for Professional and Applied Ethics at the University of Manitoba.

Some seniors with dementia know the difference between right and wrong, McArthur said, but there are other things for police and the Crown to consider when deciding if criminal charges should be laid in cases like this.

"Punishment has to have a purpose," he said. "And so I think we really need to ask ourselves, 'Are we achieving any social objectives by punishing an elderly man with dementia?'"

Affidavit mentions 'previous outbursts'

Southeast's executive director told officers there had been previous incidents between Peebles and other residents in the past years, "sometimes involving violence."

But the only other incident described in the affidavit took place four months earlier, when Peebles allegedly pushed a female resident down and she broke her hip. The executive director said the woman had "provoked the incident and has since moved from the care home."

'You can't just shove everybody in one nursing home and expect a good outcome,' said Joanne Rislund, whose father died after a violent incident at a care home in 2011. (Tyson Koschik/CBC)

In 2011, another death was attributed to a shoving incident in a Winnipeg care home. Frank Alexander, 87, died after being pushed by Joe McLeod, 70, at Parkview Place, a long-term care home in the city's downtown.

The shove caused Alexander to fall backward and hit his head; he died of head trauma four days later. Alexander had been living at the care home for just three months.

McLeod, who had Alzheimer's, had a history of violent outbursts, even before moving into Parkview Place. He was charged with manslaughter in Alexander's death, but was found unfit to stand trial after a psychiatric assessment.

"It shouldn't be happening," said Alexander's daughter, Joanne Rislund, of this latest incident. "We held the nursing home responsible because they are the ones who see this go on and on, and if they don't take action to contact WRHA [Winnipeg Regional Health Authority] and get a bed that's more suited to their needs, it's not going to stop."

A 2015 inquest into Alexander's death recommended the creation of a specialized unit in all personal care homes to house residents who are violent or exhibit high-risk behaviour.

'If someone is not of sound mind, then we don't hold them responsible. But the problem with dementia is, it's a spectrum,' said ethics professor Neil McArthur. (Warren Kay/CBC)

The province said it has provided funding for dementia education for personal care home staff, but noted that specialized units might not make sense for all facilities.

"In a small personal care home, this approach may not be the best model of care," a Manitoba Health spokesperson said in an email to CBC News. "For example, having a locked unit in a 10-bed personal care home would mean installing a locked unit to ensure one bed was available, which may not be the best way to care for an individual."

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In 2011, there were 26 special needs behaviour beds in Winnipeg. There are currently 74 beds, with 30 people on a 12-month wait list for a spot. According to the Winnipeg Regional Health Authority, another 10 beds are also in the works.

"Ongoing work continues to examine other opportunities to further add to this specialized capacity, understanding that the demand may continue to increase," a WRHA spokesperson said in an email.

The WRHA said it couldn't speak to this specific case, citing privacy issues, but the authority said: "We continue to monitor individual situations and work with the residents, families and facilities to ensure appropriate and safe care and supports."

Case under Crown review

In June 2018, the file on the Southeast incident was sent for Crown opinion on a charge of manslaughter. In March 2019, the police affidavit said investigators believed the evidence would support a charge of assault against Peebles.

Ethics professor McArthur said unlike other mental health issues, dementia is a spectrum. So while some patients may be able to care for themselves and handle their own finances, others can't.

"Often judges and juries will sort of look to experts to say where's the line," said McArthur. "And the fact is we don't really have a line that we can say: At this stage of dementia, you are responsible; and at this stage of dementia, you are no longer responsible for your actions."

Even if charges are not laid, or they don't lead to a conviction, Rislund said she believes police should still investigate.

"If my dad had gotten attacked out on the street by somebody … who had dementia, it would have been a different story. But there's something about being at the nursing home, the police don't like getting involved," she said.

The Crown told CBC News the file remains under review, and no decision has been made as to whether charges will be laid.

Manitoba Crown prosecutors are facing a tough decision on whether to lay criminal charges against an elderly man with dementia in the 2017 death of a 74-year-old woman at a Winnipeg personal care home. 2:01

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