By Heather Campbell
This article originally appeared on The Lawyer's Daily website published by LexisNexis Canada Inc.
In October 2009, Ottawa nursing home resident Peter Lee allegedly smothered his bathroom-mate to death. Police believe that the 84-year-old, who had dementia due to Parkinson’s disease, suffocated the victim, who was asleep in bed, and then dragged the body toward the bathroom. Lee was charged with second degree murder.
In recent years, tragedies like this have captivated the public. [In January 2018], a CBC Marketplace investigation reported on the “shocking rise” of abuse in Ontario long-term care homes. The episode begins with security camera footage of two elderly men having a physical confrontation in a nursing home hallway.
“One of these men will soon be dead,” says Marketplace host David Common. The video captures the aggressor punching and then shoving the 84-year-old victim, who falls to the floor. The attacker then smashes the man with a chair. Suffering a broken hip, the victim dies four days later.
Incidents like this are a double tragedy: one senior has lost their life, and another has become a killer. But after the headlines fade, we rarely hear about what happens to the aggressor. Like much coverage, the Marketplace investigation doesn’t mention it. With few exceptions, the killers’ stories remain untold. Yet these men are our husbands, fathers and friends.
Men like Second World War veteran Jack Furman, who at age 94 was charged with second degree murder after he allegedly attacked his care home roommate with a shelf; and 74-year-old Piara Singh Sandhu who was charged with two counts of second degree murder after he allegedly pried the metal base off a bedside table and bludgeoned his two roommates to death; and widower Peter Brooks, who at age 76 was convicted of second degree murder in the death of a fellow long-term care resident and sentenced to life in prison with no parole eligibility for 10 years.
These men are forgotten criminal defendants. Along with other killers with dementia, they are often left languishing in forensic hospitals and prisons, institutions that are generally ill-suited for someone with the disease.
Eight months after his bathroom-mate died, the court found Lee unfit to stand trial. He was sent to a secure forensic unit, where he was detained for over six years.
Lee was stuck in a dilemma. Each year, the Ontario Review Board found him unfit to stand trial and concluded that his detention was necessary because he posed a significant threat to public safety. The board pointed to evidence that Lee was aggressive in hospital; for example, on one occasion, he pushed pizza into a nurse’s face.
Yet as the board acknowledged, many nursing home residents engage in similar behaviours as Lee. But the prospect of finding him a nursing home bed was “extremely limited.” At first, no home was willing to take him. Seven years after the slaying, two homes were prepared to house the 91-year-old, but their wait lists ranged from about eight to 10 years.
Most people with dementia will not commit a crime, let alone murder. However, nursing home violence may be on the rise. As Marketplace reported, resident-to-resident abuse in Ontario doubled in six years, from four per day in 2011 to about nine in 2016. Several factors are likely contributing to this increase, including understaffing and increasing dementia rates among residents. Incident reporting systems have also improved, so some abuse that went unreported in the past is now being counted.
Another factor may be the well-intentioned reduction in anti-psychotic drug use, though the evidence is unclear. On the one hand, the Canadian Foundation for Healthcare Improvement has found that taking residents off the drugs reduced abusive behaviour. On the other hand, Marketplace found that as anti-psychotic use went down, resident-to-resident abuse went up.
Deadly violence by people with dementia is an extreme outcome with no quick fix. Part of the solution is increasing the number of specialized beds for persons with aggressive behaviours. Earlier this month, Ontario made strides on this front, opening a new 20-bed unit for older adults with dementia who present complex behaviours in an acute care hospital.
[Zero violence is] an admirable but likely unattainable goal. Prevention is the first line of defence for keeping persons with dementia out of the criminal justice system. But every incident cannot be reasonably eliminated.
Dementia is a condition whose symptoms can manifest as violence. Sometimes it can be fatal.
The sad reality is that a small number of killers with dementia will enter a criminal justice system that is ill-equipped to manage their needs. To improve this situation, we cannot let these forgotten men fade from public memory. Their stories must be told.
Heather Campbell is a PhD student at Queen’s University and founding director of Dementia Justice. She articled at the Canadian Centre for Elder Law and practised law in British Columbia. You can follow her on Twitter @SeniorsLaw.