A Silver Maple tree stump remains in a backyard after the city of Toronto cut-down the tree in April 2010. The stump is seen on December 2, 2010. JENNIFER ROBERTS FOR THE GLOBE AND MAILJennifer Roberts for the Globe and Mail/The Globe and Mail
Toronto is crafting dementia policies for departments across the city, a first for Canadian municipalities struggling to deal with the needs of an aging population and growing ranks of seniors struggling with cognitive illness.
The ambitious plan comes out of a nine-month bureaucratic tussle that resulted in the wrongful destruction of an elderly woman's tree. Ombudsman Fiona Crean's investigation into the dispute got Mayor Rob Ford's endorsement when it was published Thursday.
Ms. Crean gave the city until March to make good on its pledge, but departments that deal with bylaw enforcement have already started establishing new training regimes for their staff – giving a makeover to bureaucratic practices that are, "for want of a better word, impersonal," says investigative services director Lance Cumberbatch."
Advocates argue doing so gives attention to a disease that has been in the shadows even as it becomes a Canada-wide crisis. Cities across Canada are starting to teach everyone from transit officials to emergency responders to recognize symptoms of dementia.
But even Marion Neshevich's family is skeptical as to whether the city's plan will pan out. And some dementia experts caution against putting bureaucrats in a position where they are diagnosing or tracking vulnerable senior citizens with cognitive illnesses – and risking violating their right to privacy and independence in the process.
The Neshevich family's saga began in August, 2009 with a complaint over a silver maple in 76-year-old Ms. Neshevich's backyard. It posed a hazard, her neighbour said. A city inspector concurred, and said it should be removed.
It's here, Ms. Crean's report observes, that things started to go off the rails: A city property standards officer says he spoke with one of the two caretakers who look after Ms. Neshevich. But the caretakers said the officer likely spoke with Ms. Neshevich herself, who has suffered from dementia since 2008. Ms. Crean finds "the accounts of the caregivers more credible," as neither would have been working at the time the inspector came.
Once Ms. Neshevich's son, Kevin, found out what was going on, it took him three tries to get a property standards officer on the phone – and months more back-and-forth to determine what exactly was wrong with the tree and what options were open to him. In the process he got two private arborists' reports saying the maple posed no immediate danger. Responses were slow in coming or nonexistent, Ms. Crean found, and the city failed to tell the son about other options.
The city cut down the tree in March, 2010.
The city failed to follow its own policies and cut down a tree that should never have been removed, the report finds.
But that's not the point, Ms. Crean argues. "This is a story about a woman who had her tree erroneously cut down but, more importantly, this is about an entire class of vulnerable adults," she said in an interview. "And I think this is just the tip of the iceberg. We know dementia is now the greatest disability for seniors.
"There's a tidal wave coming, and we'd better get going and be responsive to it."
In her report Ms. Crean gives the department until March to come up with dementia-specific procedures and training for staff. City Manager Joe Pennachetti went one better: He pledged to draft dementia policies for every department in the city.
In his second day on the job, Mayor Rob Ford, whose successful campaign slammed the city's shoddy customer-service record, thanked the ombudsman for her report and vowed to make good on its lofty goals.
"This is a clear indication of the total breakdown in customer service," he said in a statement. "The needs of residents are one my top priorities and I look forward to discussing the ombudsman's recommendations, which have very clear benchmarks, with council."
The practice of training people in a variety of sectors to recognize symptoms of cognitive illness is gaining traction across Canada: RCMP officers being trained in Regina get a crash-course in recognizing dementia; the city of Winnipeg's transit staff, police officers and search-and-rescue teams are getting similar training. Many financial institutions are teaching their staff to watch out for clients no longer able to manage their assets.
"People need to have their spidey senses raised so they say, 'Okay, I think there might be someone there," says Norma Kirkby, program director at the Alzheimer's Society of Manitoba.
Norman Neshevich, one of Marion Neshevich's three sons, said the issue became less about the tree, which had been on the property since the family moved into the house in 1967, and more about the principle of the city taking advantage of vulnerable individuals.
"They need policies to deal with anyone who's not thinking as clearly as they were in the past," he said. "Someone's got to wave their arms and say, 'This is not right.' That's what we did."
With a report from Stephanie Chambers