Editor’s note: This week marks one year since the death of Nico Vanderstoel, the United Church minister in Sudbury charged in the death of his ailing wife Heather. He was sentenced to three years in prison in March 2014.
Laura Stradiotto is a writing a book based on the Vanderstoel case and the larger social issue of caregiving, senior care and abuse in Canada. If you have a story about caregiving you would like to share, contact her at firstname.lastname@example.org.
Days after being released from federal prison, a disgraced United Church minister lay in a hospital bed at Health Sciences North facing a grim medical diagnosis.
Nico Vanderstoel had been granted full parole after serving one-third of his sentence, leaving Beaver Creek Institution in early March 2015, and was headed to Sudbury where he would fulfill the remaining conditions of his sentence. After being convicted in a Sudbury courtroom of allowing his wife to meet a horrible death, returning to the community no doubt triggered memories he surely would rather forget. The homecoming was bittersweet for Nico because Sudbury was also home to a loyal group of friends, members of his former congregation who not only raised money to cover his legal fees, but stood by him throughout his incarceration, taking turns each week to make the three-and-a-half hour trek to meet him at the minimum-security prison in Gravenhurst, Ont. They chatted over the phone, wrote him letters and sent Christmas cards. That December in prison, Nico received 49 holiday greetings in the mail.
But within a few days of being home Nico learned that pneumonia, cancer and a blood clot were shutting down his organs, his sister Connie Van Huizen said last fall from her home in Frankford, Ont. She was surprised when her 76-year-old brother died so quickly, mere days after the diagnosis, on March 22, 2015, at Health Sciences North, in the same place where almost four years to the date his wife, Heather, died.
In March 2014, Nico made headlines when he plead guilty to criminal negligence causing death and was sentenced to three years in a federal prison for the death of his wife, Heather Vanderstoel, a retired schoolteacher who was struggling through the later stages of multiple sclerosis. They met while studying at the University of Winnipeg, and lived throughout the country, leaving the west for Toronto, then Elliott Lake and finally in Sudbury, where he was the minister at St. Stephen’s On the Hill. In Sudbury, Nico promoted interfaith worship, and was lauded for collaborating with religious leaders from other faiths.
Back home, Nico tended to his wife’s basic needs while looking after his own congregation, despite the insistence of family and friends that he should seek outside help
In her final months, Heather was bedridden, dependent on her husband to feed, bathe and change her. When Nico reached out for home care support for his wife in the spring of 2011, it was too late. Heather was found living in what was described as a state of squalor and filth, lying atop a mattress soaked in six inches of urine, blood and fecal matter. Infection from severe bedsores was poisoning her. It took six paramedics to transfer Heather to hospital, not only due to her grave physical condition, but she had grown obese and too heavy to be moved. The ambulance that transferred her to hospital was decommissioned due to the stench and residual filth of human decay. Heather passed away three weeks after being admitted to hospital. She was 66.
Heather died of complications from severely ulcerated skin, or bedsores, some of which were so deep that they created “wells” or “craters” that had to be filled with sterile gauze, Dr. Heather Gilley, a geriatric specialist hired by Greater Sudbury Police wrote in a report submitted to the Ontario Court of Justice.
Gilley noted that Heather’s condition and the extent of her bedsores is something rarely, if ever seen in the 21st century because so much is known about prevention and treatment.
“This situation, and this death, was unnecessary and preventable,” Gilley wrote in her report.
“(Heather Vanderstoel) did not need to suffer and die from preventable pressure ulcers. What would have been required to prevent this situation would be a caregiver who learns what is required to provide proper care of an immobilized person, enlists the assistance of health professionals to educate and support the caregiver, and who recognizes and tried to ameliorate unnecessary suffering.” Nico “failed” at all this and was “oblivious” to his wife’s suffering, Gilley said.
Nico never spoke publicly about the case, not even in the courtroom and in his own defence. There were many unanswered questions, especially when it came to the relationship he had with his wife, whether his intention was malicious or whether his judgment was clouded with emotional exhaustion.
Health-care professionals who cared for Heather were traumatized by her suffering and troubled by the minister’s seemingly calm behaviour in hospital, sitting at a distance as his wife lay visibly uncomfortable and in pain. Victim impact statements written by nurses, doctors and paramedics were submited as evidence, although there were six times as many letters of support on behalf of the minister from family and friends.
“Heather’s health was deteriorating slowly, yet she refused to allow professional help to come in and care for her,” wrote Greta Kosiba in one of the letters in support of the minister.
“I offered, as a friend, to help tend to some of her needs, but she refused my offer and said that she and Nico could manage very well together.”
Kosiba and Heather were close friends. The strange thing is they never met face-to-face. Instead they spoke to each other over the phone every morning, exchanging recipes and marital advice. The last time they spoke was the day Heather left her Whittaker Street home in an ambulance. Heather called to say goodbye.
Friends like Kosiba tell of an attentive husband who became overwhelmed with his role as caregiver, who encouraged outside help, but whose wife wanted none of it.
Some supporters have even gone so far to say this case is really a love story; at the heart of this matter, they say, was a pact made between the married couple. When Heather shared news of her debilitating disease with Nico decades earlier, she asked her husband to promise that under no circumstances would he send her to hospital or a long-term care facility. Home was where she wanted to spend her final days. Friends say this is what prevented him from reaching out for professional support.
“She thought, and I truly believe this with my whole heart, that if she left her home, she would never go back,” Kosiba said from her New Sudbury apartment. “She thought as long as she was there, everything was going to be OK and the good Lord would see her through.”
Several friends and family members have come forward and defended Vanderstoel, saying he did the best he could under circumstances.
He was by all means an educated man, with ambitions of his own: he considered pursuing a PhD after retirement and was learning to play the piano.
But in over 40 years of being a minister, he never took a holiday.
“He was always on-call,” said Nettie Hoffman a retired United Church minister and social advocate in Toronto who met Vanderstoel in the 1990s when he was a minister in the city’s east end.
“If she phoned him, he’d move. And yet she was a brave soul herself, up until I imagine the last several years when the disease invalided her and made her other than the Heather we had known.”
Hoffman said Nico hired a housekeeper to help around the home, but Heather fired her on her first day “because she didn’t want any strangers, I assume, seeing her in this condition,” said Hoffman.
“Increasingly, Heather was putting duress on Nico and I don’t know how he even managed to prepare a sermon with all that he was doing at home.”
There’s no doubt that Nico should have either left his job as a full-time minister to care for his wife properly, hired a home care professional or consulted with the Northeast Community Care Access Centre.
But he did none of the above. So, was he a criminal caregiver or a martyr to a system of elder care that can’t keep up with escalating demands of an aging population?
We are at a critical crossroads: Seniors are the fastest growing age group, a trend that will continue for the next few decades due to aging baby boomers and our higher life expectancy. According to 2014 Statistics Canada data, 92 per cent of Canadians aged 65 and older are living at home. Outside of home care, the responsibility of caregiver falls on loved ones, spouses and family members who provide unpaid support while balancing their own responsibilities at work and home.
And according to the Canadian Medical Association, senior care isn’t equal across the country, with services and resources available in one province yet not another. That’s why the Canadian Medical Association, through its Demand a Plan campaign is calling on the federal government to develop and implement a national strategy on senior care, with a focus on providing the care outside the hospital system. The CMA argues the health-care system needs a complete overhaul since it was created 50 years ago to meet the needs of a much younger population. Prime Minister Justin Trudeau has pledged to improve senior care with a long-term funding agreement with the provinces and territories. Canadians will know how serious this commitment is come Tuesday when Trudeau releases his first federal budget.
Senior care is a national health issue, but one that trickles down into other aspects of society. Because as the population ages, invariably incidences of elder abuse are bound to increase. In the U.S., mistreatment of older adults is criminalized through older adult specific crimes; however, in Canada, The Criminal Code applies to all adults, regardless of age. Alleged perpetrators of senior abuse in Canada can be charged with physical assault, sexual assault, theft, fraud or failing to provide the necessities of life. However, not all acts of elder abuse or neglect will result in criminal prosecution. Canadian police services are now moving toward a restorative approach when it comes to dealing with suspected cases of elder abuse.
In January, the Toronto Police College launched a five-day course on elder abuse, the first of its kind and length in Ontario. So far, police forces across the country – and the military – have shown interest in the course. In Toronto, more than half a million residents are over the age of 65 and with that comes an increase in crimes against seniors from financial fraud to physical abuse.
Det. Kate Beveridge, program coordinator said that while each case is unique, the overall objective is not to lay criminal charges rather resolve the problem with the help of community agencies to restore family life. Sometimes, she said, it’s just a matter of an officer helping families connect with agencies geared to senior care.
“It takes a village to raise a child,” she said. ” It takes a village to take care of an older person, too.”
Beveridge said cases involving seniors are “delicate investigations” because the majority involves family members. According to Statistics Canada, one-third of violent crimes committed against seniors are family related. Data suggests family violence involving seniors is highest in small cities and towns.
When alleged abusers are related, you have to recognize a whole spectrum of human emotions including the bond between the family members, between the senior and caregiver, and as a result the fear of being separated.
“You’re dealing with an adult who has life experience,” said Beveridge. “By right they should be able to make their own decisions on what they do financially or any other area of their life.” But when other factors like dementia or Alzheimer’s are introduced, it further complicates the situation, she said.
The fear of being sent to hospital to die is very real for many seniors, sick or not.
Heather was terrified to end up in a hospital. But shouldn’t she have realized that to be properly cared for, she needed help her husband could not have provided?
And as a caregiver, shouldn’t Nico have realized that his responsibility to care for his wife was more important than a promise to keep her away from a hospital?
If it takes a village to take care for an elderly person, at what point should friends and family intervene?
Such dilemmas aren’t specific to the Vanderstoels. As Canadians age, the role of caregivers – the people who provide informal care to seniors with a short or long-term health condition – becomes increasingly important.
In 2012, Statistics Canada indicated 8.1 million Canadians aged 15 or older provided care to a family member or friend with a long-term health condition, disability or aging needs.
And while not all situations involving caregivers meet such a tragic end, the story of Heather and Nico compels us to rethink the way we care for and protect our aging population.