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Nursing home replaced tubs after senior's death: inquiry
Last updated Dec 1 2005 10:24 AM MST CBC News
The bath water that an elderly woman was immersed in may have been as hot as 55 C, a fatality inquiry into her death heard Wednesday.

Maintenance staff testified that tests after 90-year-old Jennie Nelson died, tests were done on the tub which showed the water could have been 10 degrees hotter than the standard set by the health region.

The inquiry, expected to wrap up Friday, has already heard that the temperature gauge was faulty and staff rarely used it, instead testing the temperature with their hands.

On Jan. 11, 2004, the day Nelson was bathed, the aide who filled the tub thought the woman bathing her would test it, while the woman bathing Nelson thought the woman who filled the tub had done it.

Nelson, who had Alzheimer's, died after receiving second-degree burns during a bath at the Jubilee Lodge in Edmonton.

Staff noticed redness on her legs when they removed her from the water.

After her death, the Jubilee installed devices that automatically shut off the water when the temperature reaches 41 C.

"We have three of the bathtubs totally replaced," Gregg Ulveland, president of Qualicare, said. "We've revamped our hot-water heating system in terms of a mixing valve, individual control valves on each bathtub."

He told the inquiry that the nursing home's equipment had passed safety checks six months before Nelson's death, and that management has since spent $250,000 on upgrades.

"The safety of our residents, it's our highest priority," Ulveland said. "We put processes in place that, at the time, we thought were correct. This worked for almost a million baths, 800,000.

"When something happens that shows you it's not working or created an incident, then we do whatever we can to prevent it from happening again."

Nelson's family has been attending every day of the testimony, hoping that their mother's death will lead to safer care facilities.

"Better late than never, that's for sure," Nelson's daughter Ethel Robinson said. "But it took our mom's death to bring this to the forefront

http://www.cbc.ca/calgary/story/ca-inquiry-senior20051201.html

 

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