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A Quebec woman tearfully told a coroner’s inquest Thursday that her mother, who died in a nursing home during the first days of the pandemic, had her care level lowered without family approval to a level where she would no longer be sent to hospital for life-extending treatments.

The elderly woman, Lucille Gauthier, died in what coroner Géhane Kamel described as a drawn-out agony. While the novel coronavirus was found on her body after her death, the inquest heard that in the preceding weeks her condition had declined, she was losing weight and repeatedly falling from her bed.

Ms. Gauthier’s daughters, who normally visited her, were kept out of the nursing home because of lockdown rules during the first wave. They believe that amid the chaos of the first days of the pandemic their mother was neglected and died from hunger and dehydration.

Ms. Kamel’s inquest is looking at the mass deaths of elderly residents in Quebec long-term care during last year’s first wave. Ms. Gauthier lived at CHSLD des Moulins, a private long-term care home in Terrebonne, near Montreal, where 22 residents died of COVID-19.

Ms. Gauthier, a former nurse, died on April 12, the day after an outbreak was confirmed at des Moulins. She had just returned after being hospitalized in March for shingles.

One of Ms. Gauthier’s daughters, Diane Brissette, testified that both in phone conversations with staff and in e-mails with managers, the family had said they wanted to maintain the 87-year-old nursing home resident at Care Level B, meaning limited care to prolong her life.

Instead, the inquest heard earlier, the staff lowered Ms. Gauthier’s care level to C, where comfort care would be provided in priority over prolonging her life.

Another implication was that, under a March 23 provincial guideline, people in C and D care levels would not be transferred to hospital but had to stay at their nursing home and receive comfort care. The guideline was issued at a time when the province feared that hospitals would be swamped with COVID-19 patients.

Ms. Brissette said her mother had explicitly expressed her wish while she was treated for shingles in mid-March. “My mother said clearly [to hospital doctors] that she wants to live.”

Jocelyne Bourque, a supervising nurse at des Moulins, testified earlier this week that she contacted the family on March 24 at the request of management and doctors, and asked to switch Ms. Gauthier from B to C level. “The doctors suggested that she be at C level. Of course it was because of the COVID pandemic context,” Ms. Bourque said.

Staffers described Ms. Gauthier as a resident who could be friendly but was often anxious and uneasy with unfamiliar employees. Because she choked during a meal in early March and had to receive a Heimlich maneuver, she was getting pureed food, which she didn’t like.

Her weight, normally between 110 and 120 pounds, had dropped to 87 pounds at the time of her death. Her daughters knew that she had fallen several times from her bed but said they had trouble communicating by phone or e-mail with staff.

The inquiry previously heard that des Moulins was chronically understaffed, with auxiliary nurses forced to assume the work of orderlies. Half of the four doctors were on leave when the pandemic started.

“We don’t understand why our mother wasn’t cared for properly even though she had expressed that she was in pain,” Ms. Brissette testified.

Sobbing, she added that had she and her sister been able to be with their mother, “she would never had an end of life like this.”

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