Inquest into starvation death of Port Coquitlam woman finds caregivers should make more money and receive more oversight

Caregivers need both better pay and more scrutiny, according to a recent verdict following BC Coroners Service public inquest into the death of Florence Marie Girard.

Girard, who had Down syndrome, died in October 2018 in a Port Coquitlam home after being starved. She was 54.

Rather than deciding legal responsibility, the juried inquest is intended to consider evidence and make recommendations that could save a life in a similar circumstance.

The jury recommended an immediate increase in compensation for caregivers to ensure a living wage.

Crown corporation Community Living B.C. should also arrange for: “randomly selected and unannounced home visits” to “verify the physical and mental wellbeing and quality of life of the individuals in care,” the jury stated.

The verdict is a call for a “complete reset of the systems that are failing the estimated 28,000 people that CLBC is serving,” stated a release from Down Syndrome B.C.

The death of Girard “never should have happened,” stated a release from CLBC following the verdict.

“The system and CLBC failed Florence,” stated CLBC CEO Ross Chilton. “We failed her family who trusted that Florence would receive the emotional and physical supports she required. The checks in place at that time didn’t work.”

The organization is: “committed to taking concrete actions to address them,” according to the release.

The jury recommended providing financial, medical, and respite supports for family members interested in caring for their loved ones at home.

“If family members choose to keep their loved one in the home, they should be supported to the same level as a home share provider and must meet the same expectations.”

The coordinators who oversee caregivers should also have more manageable caseloads, according to the jury.

The province should boost funding for home coordinating agencies in order to “immediately reduce the caseload” for care workers to below 25. That formula should also account for clients who need more care due to complex needs, according to the jury.

A case management system to audit quality of life outcomes for people in care should also be implemented, according to the jury.

Presiding coroner Donita Kuzma oversaw the inquest.

‘Demonstrably unfit’ sentence

Port Coquitlam caregiver Astrid Charlotte Dahl was convicted of failing to provide the necessaries of life to Girard in 2022. Dahl, who was acquitted of criminal negligence, was eventually sentenced to 15 months in prison followed by 12 months of probation.

There had been a “loving” and “close relationship” between Dahl and Girard for many years, according to B.C. Court Appeal Justice Patrice Abrioux, who called the incident a: “most unusual and tragic case.”

Originally, the court gave Dahl 100 hours of community service along with several conditions she was to abide by.

However, that sentence was “demonstrably unfit,” Abrioux ruled in a 2023 Court of Appeal decision.

In passing the original judgment, Justice E. David Crossin found Dahl’s conduct stemmed, in part, from her compassion for Girard. While that compassion was “fatally” and “irrationally” distorted, it still mitigated her moral blameworthiness, according to Crossin.

In the final assessment, Dahl truly believed she was “doing the right thing,” Crossin wrote.

“Dahl appears firmly on a road to coming to terms with the consequences of her actions, although it appears to continue to be a lengthy road of reconciliation for her,” Crossin wrote, explaining why he found incarceration unnecessary.

Justice Abrioux disagreed.

Girard lived in Dahl’s home and was “wholly dependent” on Dahl, Abrioux wrote.

“It is hard to imagine a greater conferral of trust,” he added.

That trust, Girard’s vulnerability, and the fact paid caregivers “represent an audience for whom general deterrence is particularly important,” are all key factors to be considered, according to Abrioux.

Abrioux also differed with Crossin on the issue of abuse.

Crossin wrote: “there was no evidence of abuse as that term is understood in these types of cases.”

No matter Dahl’s motives or compassion, her actions resulted in Girard dying by starvation, which “may well have been avoided” had Dahl sought medical help. That constituted abuse, Abrioux found.

While Abrioux was influenced by Dahl’s testimony that the caregiver was trying to get fluids into Girard even at the last minute, her failure to seek medical care when it was “patently obvious” Girard’s life was in danger cannot be ignored.

Dahl ended up serving 10 months in prison.