Family fights for Ricky’s care
By Hugh Adami, The Ottawa Citizen August 29, 2010 7:37 AM

Ricky King, 21, suffered severe head injuries in a car accident in 2006 and remains in a semi-comatose state. His parents, Roger and Nadira King, have for the last four years provided round-the-clock care for Ricky, putting their own careers as a massage therapist and an acupuncturist on hold. The stress and pressure are catching up. They can’t get sick, they say, because Ricky needs their care. They’ve asked a home-care agency to provide a nurse for a five-hour shift every other week so they can go out with family or friends, but they say they aren’t getting the response they need.

OTTAWA — Their son is their top priority, but the Kings feel they’re not getting the support they need Roger and Nadira King’s mission is unrelenting, exhausting and certainly wrought with emotion.
The days really never begin or end for the couple. Any sleep is a luxury, especially for Roger.
But the two don’t complain about their full-time jobs as caregivers to their son, Ricky, who suffered severe head injuries in a car accident in 2006 and remains in a semi-comatose state.

“Miracles do happen,” says Nadira, as they wait for one to bring the 21-year-old completely out of his coma. Nadira says she wants her son, who was “always smiling, always laughing,” to be able to speak, eat normally and “see the beauty of life again.”

Despite their troubles, the couple are locked in a fight with Eastern Ontario’s home-care agency, which doesn’t think Ricky’s condition is critical enough to warrant the level of care the Kings have requested. They want a nurse three times every two weeks.

The Community Care Access Centre (CCAC) is offering a personal support worker, whose duties normally involve such tasks as feeding and washing clients, and helping them get in and out of bed. The CCAC is promising to have a nurse train the support worker so that Ricky can be properly helped if an emergency arises.

The Kings say there are too many risks involved without a bona fide health worker being present when they are not there.

On Sept. 28, 2006, Ricky and his younger brother, Stephen, got into their mother’s car to begin their drive from their home in Limoges, about 30 minutes east of Ottawa, to St. Francis Xavier High School in Hammond. Ricky was driving, and as the car descended a steep hill, he lost control. “Oh, shit,” was the last thing Stephen heard him say. The car rolled several times before landing upside down in a ditch.

While Ricky was critically injured and very close to dying for weeks, Stephen escaped with cuts and bruises. Not realizing his brother was unconscious as he pulled himself from the wreck, Stephen jokingly scolded Ricky about ruining their mother’s car.

Ricky spent three months at the Children’s Hospital of Eastern Ontario before his parents brought him home.
Ricky starts waking around at 7 a.m. and by the time he’s up, washed and fed breakfast in his wheelchair, it’s almost 11. His eyes sometimes react to voices or noises around him. He has made grunting sounds to his neurological physiotherapist, leading her to believe that Ricky “is locked inside his body,” Nadira says.

Emergencies often arise because of his condition. He is prone to seizures and choking spells — the latter requiring a suction device to clear his throat. Fresh vegetable, fruit and broth purées are fed to him by spoon and a nutritional formula passes through a gastric tube. He has to be turned frequently when he is asleep to avoid bedsores.

Caring “24/7” for Ricky forced Roger, a massage therapist, to virtually put his career on hold. Nadira, an acupuncturist, works part-time at best, seeing a patient or two at their home when time permits.

Their jobs are one thing. But their health is another. The stress and pressure of the last four years are clearly catching up. Nadira says she knows Roger is burning out, and she’s frequently tired, too. They can’t get sick, they say, because Ricky needs their care.

To help them get some rest and recharge their batteries, the Kings approached the CCAC with their request for a nurse. They asked that once a week, a nurse work an overnight shift to watch over Ricky so they can get a full night’s sleep. The Kings are also asking the agency to provide a nurse for a five-hour shift every other week so that they can finally go out with family or friends.

They realize they need to connect more with their three other children, all of whom have expressed worry about their parents’ health and fatigue. Leonora, 28, attends university in Montreal, Mariotti, 27, operates a home renovation business in Limoges. (His parents say he is deeply affected by Ricky’s condition and struggles even to say hello to him when he visits.) Stephen, 19, lives at home and attends Algonquin College.

The CCAC doesn’t seem to put much stock in the advice from Ricky’s physician. Dr. John Kindle, wrote the agency, saying “it would be prudent to provide a nurse for respite care.” The CCAC is basing Ricky’s needs on its own assessment.

Kim Peterson, CCAC’s vice-president of client services, could not discuss Ricky’s case, but says nurses train and supervise personal support workers before they are allowed to work alone with a patient requiring special care. As well, other support workers are trained for the same patient in order to provide an immediate replacement if necessary.

Support workers and nurses are hired under contract from eight agencies in Eastern Ontario. While nurses are paid considerably more than support workers, Peterson says wages play no part in deciding what level of home care a client receives. Peterson also says the CCAC is not facing any deficit problems, as it did earlier this year, and a shortage of nurses does not exist, as Nadira says she was led to believe.

But the Kings’ experience with personal support workers since 2008 does not give the couple much confidence that care will be better. They say the support workers were only performing their basic chores in the past and, many times, they were doing those inadequately. They shudder at the thought at what a support worker, with just a few weeks extra training, would do if an emergency arose with Ricky. The Kings say they will end up doing what they did with previous support workers — not leave their house.

They also say absenteeism was high in the past, replacements weren’t provided and some were simply too nervous to watch over Ricky because of his frail condition. There was even a nurse who quit coming to their home for that reason, Nadira recalls.

The CCAC offer has upset neighbour Eileen Klyszejko, who recently started a petition on behalf of the Kings, to pressure the agency into providing the family with a nurse. “In Ricky’s case,” the petition says, “the help that is needed to allow his parents to continue caring for their son in his home is a fraction of the cost of institutional care to the government, but the proper help is just not forthcoming.”

Says Dr. Kindle in his letter to the CCAC: “Ricky is a very complex care case … It has been impossible for (the Kings) to have confidence in respite care that is not provided by adequately trained personnel because they have seen for themselves how quickly Ricky can run into problems.”

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