Caretaker in B.C. woman’s starvation death says she got little management support

The caretaker convicted for her part in the starvation death of Florence Girard told a coroner’s inquest in British Columbia Wednesday that she wouldn’t have gone into home care had she known how little support would be given to her.

Astrid Dahl also criticized the homecare organization she worked for when Girard, who had Down syndrome, starved to death in her care in 2018, telling a coroner’s inquest that Kinsight Community Society put “paperwork before people” and provided little support for things such as prescribed pain medication or health expertise.

“The whole program has to change from top to bottom,” Dahl testified when asked about Kinsight’s handling of the home-sharing service in cases such as Girard’s. “It needs to go back to the way that it was, which is individualized programming.

“Everyone’s different. Everyone needs to be treated differently. Everyone’s behaviours are different. Everything’s different. You can’t loop everybody in as one system and expect it to run properly. It doesn’t work like that.”

Dahl was convicted in 2022 of failing to provide the necessaries of life to Girard and testified at the inquest into her death on Tuesday that she had been in “denial” about the declining condition of the woman she said she had known for 30 years.

But she also blamed Kinsight’s lack of support and organizational culture for the tragedy.

Girard weighed about 50 pounds when she died, and Kinsight oversaw the home-sharing service where Girard lived with Dahl under a contract with provincial Crown corporation Community Living BC.

Dahl said she could not contact Community Living BC directly about the lack of support because of fear of termination from Kinsight.

Taryn Urquhart, one of the lawyers for Kinsight at the inquest, questioned Dahl’s opposition to updated care plans in the home-sharing program with increased requirements, which the caretaker had criticized as doing little to improve care for individuals such as Girard.

Dahl had told the inquest that she thought Kinsight was “being quite invasive” when the organization said it wanted to visit the caretaker’s home once a month during Girard’s stay, and Dahl had complained.

“Wouldn’t you agree with me, Ms. Dahl, that if you had put more detail into your reports, if there had been more monitoring visits, maybe this death would have been prevented?” Urquhart asked.

“I don’t know,” Dahl said. “I can’t answer that.”

Dahl testified Wednesday that she switched to a cheaper, weaker painkiller for Girard despite her increasing pain as she got older, partially because Kinsight didn’t pay for stronger medicine that had been prescribed.

Dahl said the stronger drugs also weren’t as effective and contributed to her decision to switch the medication.

Urquhart asked the caretaker why she filed a written report saying the “medication will continue to be given as prescribed” despite these changes to pain management.

Dahl said she didn’t take the written reports for Kinsight very seriously since “no one’s reading them.”

She said throughout her testimony that she could not remember files brought up by the lawyer about Girard’s condition and care plan.

When asked by a lawyer for Girard’s family what she would do differently, given Girard’s death, Dahl said she would “not do home share.”

“(I’d) advise anyone not to do home share,” she said.

“With Flo, I was so zoomed in on Flo that I didn’t zoom out and take a look at the big picture,” she testified. “So, that’s on me. But because I wasn’t getting any sort of support from who I was expecting support from … I just took all the decisions on myself.”

Dahl told the inquest that Kinsight gave no nutritionist support when Girard began losing weight, so she instead consulted her mother, a former nurse.

She estimated that she was being paid about $2,000 a month to care for Girard, and the caretaker did not have any time off during her eight years of home-share care.

Girard was living with Dahl as part of a program for people with developmental disabilities.

When asked by the lawyer representing Girard’s family if she was sorry about what happened, Dahl responded by saying she was “beyond” sorry and she viewed Girard as a member of her own family.

A coroner’s inquest does not assign fault or blame and the jury is given the goal of fact-finding. The inquest has been scheduled through to Jan. 22.

This report by The Canadian Press was first published Jan. 15, 2024.

Chuck Chiang, The Canadian Press