There is no denying the devastating impact of smoking on health.
Notices posted in convenience stores and other outlets where cigarettes are sold indicate they will end up killing half the people who use them. Cancer specialists have gone on record as saying lung cancer would be a relatively rare disease were it not for smoking. But cancer is only part of the tragedy – health risks also include heart attacks and strokes, since nicotine negatively affects the blood vessels.
That said, an argument might still be made for providing residents (and staff) of long-term care facilities with an indoor space where they can smoke, to reduce another risk.
There are reports that a resident of the facility in L’Isle-Verte, Quebec where 32 residents were killed in a horrible fire, had asked staff for permission (denied) to go outside for a smoke. Apparently it happened in the section of the retirement home that was destroyed, shortly before the fire broke out. The sole employee on duty at the time claims to have seen smoke coming from the resident’s room.
Smoking has not been listed as the cause of the deadly fire, but most of us can do the math.
In Canada, no government, municipal right on up the food chain, has banned tobacco products. They use a combination of public education programs, regulations against smoking in public places (including some outdoor spaces like sports fields), and penalties for selling tobacco products to minors, to encourage people to quit smoking and to protect people from second-hand smoke.
About the only place people can be sure of being able to smoke is in the privacy of their own homes – unless the person is elderly, possibly with dementia, and probably with mobility issues. Then they have to go outdoors.
Long-term care homes are health-care facilities with staff who must be protected from second-hand smoke. At the same time, they are people’s homes. Is it worse to provide a safe indoor space where an elderly resident can smoke, or to force the resident to go outside in sub-zero temperatures? The cigarette is a proven health risk, true, but so is falling on ice, catching pneumonia, or sneaking a cigarette in one’s bedroom.
The argument has already been won by the no-smoking side, but perhaps the issue warrants a second look.
There is no second look needed for the issue of sprinkler systems and staffing. No matter how many times we read the facility in Quebec was top-notch and met all the standards, we always get back to one basic fact – the high death toll in the older part of a wood-frame building that had no sprinklers. They were not required.
We are told we have only a minute or two to get out of a burning house, and that rooms fill with toxic smoke in seconds. Add wheelchairs, walkers and in some cases mental confusion due to dementia or medication; subtract the elevator (those cannot be used in a fire); subtract hearing aids that allow the hard-of-hearing to hear the fire alarm (people take them out at night); consider the fact that staffing in any long-term care facility, no matter how wonderful, is never enough, and the need for sprinklers becomes obvious.
Getting down on one’s hands and knees and crawling to safety is not an option for most nursing home and retirement home residents. They will need help to escape. The Quebec facility had only one person on duty the night of the fire – one person to help more than 50 people. Sprinklers may not have extinguished the fire but they would have bought time for help to arrive.
Our hearts ache for the people who lost loved ones in that fire. About the only thing worse than what they are going through is the knowledge it could happen again. Every province in this country needs to adequately protect people in long term care facilities, and that means working sprinkler systems and adequate staffing.
The question to ask is not if the home complied with regulations – it apparently did, but if the regulations offered adequate protection to very vulnerable people – they clearly did not.
Changes to those regulations are tragically overdue.
- Special to The Banner