After over four decades in geriatric nursing, Karen Biggs thought she had done and seen it all.
Then, the COVID-19 pandemic spread quickly through Canada and exposed the most vulnerable to a deadly virus. The first reported death in Canada was a man in a care home in North Vancouver, B.C., not far from Menno Place in Abbotsford, where Biggs has worked as the CEO since 2013.
Menno Place is one of the largest seniors’ care campuses in the province. Its sprawling grounds comprise six buildings on over 11 acres, with 675 staff members offering multiple levels of care, from independent living to 24/7 nursing home care.
But for Biggs, it wasn’t just business. As sickness from COVID-19 loomed, she was trying to keep 700 residents alive, including her husband, Peter.
They had dreams of living on a houseboat by the water but two and a half months after their wedding in early 2020, Peter collapsed. He was diagnosed with a brain tumour and after surgery to remove it, he contracted COVID-19 in the hospital.
Peter was moved to acute care at home but without adequate support, his treatment was too much for Biggs to sustain alone.
Biggs decided to transfer Peter to Menno Place, combining her personal and professional lives, at a time when workers in long-term care faced the toughest challenges.
“I can honestly say that in my 46 years of nursing, it’s been the hardest time of my career,” she said.
At the outset of the pandemic, residents at Menno Place, who have an average age of 87, went into strict isolation. Family members were turned away.
“It would break my heart when I saw people coming to our windows to wave at their parents,” Biggs said.
Some families and residents complained that Menno Place, which long prided itself on being warm and welcoming, became like a prison.
“I had one of my seniors who went through the Second World War saying, ‘This is like being in prison,’” she said. “Their rooms are so small, so to restrict them to their rooms, it just felt like punishment.”
Restrictions limited staff, too. In late March 2020, a provincial mandate prohibited staff from working in multiple care homes, something that was common before COVID-19. The single-site order helped limit the spread and the provinces that waited to put similar policies in place, such as Ontario, had worse outbreaks.
Biggs lost 39 staff members when the mandate took effect and while she agreed with the order, it meant that those remaining were stretched thin.
“They’re working double-time often. Our resident care coordinators are working over the weekend. They don’t get time off because we don’t have anybody else,” she said.
The early restrictions worked. Menno Place was COVID-free for the first nine months of the pandemic. But when another wave hit in November 2020, it was devastating.
An outbreak spread through a unit with 45 residents; all but two tested positive for COVID-19.
“In those days, we didn’t know it was airborne. And it started with one resident who came back from the acute care hospital COVID-19-positive and we didn’t know because she was only there for five hours,” she said.
“Every two days we got another positive, and another positive. And at the end of that, we had lost 16 dear seniors.”
Biggs was living a nightmare. Menno Place didn’t allow visitors at the time of the outbreak, leaving many families to cope without saying goodbye.
“It was profoundly upsetting to us because you’re so attached to the residents. You know, they become your family. So our staff were the only people seeing those people,” she said. “Even when they were dying.”
A faith-based facility, Menno Place is owned and operated by Mennonites and roughly 25 per cent of the residents who live there identify as such. While some may normally have turned to the on-site chapel during the early, uncertain days of the pandemic, they couldn’t. The last service was held in March 2020. Since then, it’s been a storage area for sanitization supplies, in case a resident tests positive for COVID-19.
During that outbreak in late 2020, 25 staff members also contracted COVID-19, which meant the shortage was so acute, patient care suffered. Bathing was less frequent and residents were left in bed all day.
Biggs, a problem-solver, had an idea in the middle of the night. She wanted to recruit family members of residents — familiar faces — to fill the gap.
“I was absolutely desperate because at that time we had an outbreak and we had to put in extra enhanced cleaning. And we just didn’t have anybody,” she said.
Biggs sent out an email blast to 5,500 people on the mailing list and ended up hiring nine family members, who cleaned when no one else was available.
Thanks to vaccines, the death rate from COVID-19 in Canadian care homes has plummeted. But a national staffing crisis remains.
Menno Place lost nine regular staff members and 29 casual workers when the provincial vaccine mandate for long-term care took effect in fall 2021.
Among those who refused to get vaccinated against COVID-19 was a licensed practical nurse (LPN) who happened to be the longtime caregiver for Biggs’ husband. Biggs said she spoke with the LPN nearly a dozen times, but nothing changed her mind.
“She was so kind and I did not want to see her leave; she was a single mom,” she said.
“I tried every argument in the book and she said, ‘No, I read something that a doctor in the United States put on Facebook. And it’s going to alter my DNA.’ I couldn’t convince her. I couldn’t convince her that that one story wasn’t a true story.”
Biggs said she supports mandatory vaccination and has seen how it limits the severity of the virus.
“The risk is too great for our seniors. You know, we had an outbreak last September on a unit where everybody was double vaccinated,” she said. “The good thing is we didn’t have people die this time.”
In the last year, Menno Place has recruited 222 staff members, but they’re still desperately short. Nurses, including LPNs, are the hardest to recruit.
Biggs is focused on solutions for the shortage and doesn’t think pay is the problem, at least not in B.C.
“The salaries are excellent. You know, if you look at care aids, they’re making $25 an hour. You know, our nurses are making probably about $55 an hour and the benefits are amazing,” she said.
Nationwide, there are more than 30,000 vacancies in nursing and residential care facilities, according to Statistics Canada. Compared with pre-pandemic numbers, the vacancy rate has nearly doubled. That’s even more dramatic when you consider the need for nurses is higher now than before the pandemic.
Biggs said the pandemic may have scared people away from working in care homes and has burned out nurses everywhere.
“It’s harder for nurses than any other sector because nurses take longer to train, right? And we’re not graduating enough,” she said.
“One of the mandates that we’ve been pushing … is to try to make it easier for internationally trained nurses to come to Canada. We have got wonderful, internationally trained nurses working as care aids because they can’t get the paperwork through.”
She’s also trying to recruit more men.
“We haven’t traditionally recruited men well. So we have to figure out how to tell men that they can really feel very valued in this setting,” she said.
Biggs is hopeful for meaningful financial investment and improvements in long-term care over the next 20 to 30 years.
To her, finding solutions to the shortage is a necessity, knowing first-hand the need for staff will only grow as we all get older.
“The rewards of working with seniors are absolutely immense. I was fortunate enough to really be touched by the seniors when I worked in Victoria as a new grad when I was 25. It’s a calling,” she said.
“We weep when they’re sick, we weep when they die. We become their family, and that’s a precious, precious gift.”
Biggs resisted moving Peter into Menno Place at first, but now feels it’s the best thing she could have done.
“It’s been really good for my husband,” Biggs said.
“As a CEO, it’s freely affirmed for me the amazing care that my staff give because now I see it every single day when I visit. It’s not my husband that gets special care, all the residents get special care and the hearts of my staff show through all the time.”
Biggs admits having Peter there is good for her, too, as she gets to witness her husband showing signs of improvement daily.
“He’s getting better every day. You know, the challenges aren’t over, but he’s starting to eat, he’s starting to talk, and hopefully one day we’ll get him walking again.”
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