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Seven years ago, Betty Siwicki died on the floor covered in infected bedsores. Her son, accused of neglect, went to prison, but his community rallied to help him. He says the real story is more complicated: A battle that pushed his mother’s dementia, his own health and their love for one another to the limit

Ron Siwicki, shown at Winnipeg's Kildonan Park, has served his sentence for criminal negligence after the death of his 89-year-old mother, Betty, in 2014.PHOTOGRAPHY BY SHANNON VANRAES/THE GLOBE AND MAIL • FAMILY PHOTOS USED WITH PERMISSION

Ron Siwicki emerged in the backyard with a cup of instant coffee he’d prepared for his mother, Betty, along with her packet of cigarettes.

Betty, 89, who had become reclusive with age, hadn’t set foot outside their cluttered bungalow for at least two months. But that day, Ron had finally managed to persuade her to sit at their patio table out back. He felt so pleased about getting Betty into the fresh air that he summoned their neighbours – Wally, who lived on one side of their house, and Grant on the other – to come say hello to her.

As they chatted, Betty sipped her mug of Maxwell House between smokes, while Shu Shu, her shih tzu, lay at her feet. Together, they soaked in the fall sunshine.

The date was Oct. 15, 2014.

Ron is certain of this because, for one thing, the weather that day was unusually warm for a Winnipeg fall. The temperature climbed to a high of 20 degrees.

It felt like the kind of day he and Betty, and his dad and sister, both now gone, would drive out of the city to go fishing in the summers of his childhood.

But it also stands out because it was the last pleasant day Ron recalls having with his mom before she went blind, before she fell out of bed and died unknown days later, lying in her own excrement. Before the police came and hauled him off to prison.

On that sunny October day, the world felt all right. Betty was lucid and happy and engaging, and Ron was cheered and relieved to see her acting like her old self again.

It felt like how things used to be.

Betty Siwicki with baby Ron.

On the night police arrested him, Ron felt as though everyone considered him the lowest piece of scum on the planet. He could tell from the raised voice and facial expression of one of the officers that she was livid over the state of Betty’s body. Another who sat with him at the police station asked whether he had been sexually attracted to his mother and whether he had molested her. Ron balked at the suggestion.

“People that don’t know me, they think I’m a pretty rotten person,” said Ron, who at the age of 69 has the pale, fragile appearance of having been retrieved from a dusty attic.

Ron doesn’t think he is rotten. Neither does his large and loyal network of friends. Which is why scores of them, including fellow musicians, successful business people, professionals and retired police officers, wrote reference letters to the court to vouch for his character, and why they packed the courtroom at his bail hearing and rallied to support him through the judicial process.

The facts, as they have been laid out in court documents and news reports, are grim: Ronald Siwicki, a Winnipeg musician, well known on the local rock scene, failed to seek help for his elderly mother, who had dementia, allowing her to die on the floor of their home, covered in feces and urine. She had laid there so long – at least 26 days, according to court documents – that some of the open bedsores on her legs and hips were infected to the bone. Her death, caused by complications from these infected sores, was determined to have been entirely preventable.

Presented with these facts, which Ron doesn’t dispute, it’s easy to believe Betty Siwicki died at the hands of a callous monster. But the story is not so clear-cut. According to Ron’s account of what happened, he found himself overwhelmed and ill-equipped to fulfill a duty his mother, who resolutely refused medical care, would not let anyone else handle.

While the outcome was extreme and disastrous, it points to what multiple surveys and reports reveal is a broader issue: Our health care system depends on unpaid, informal caregivers, yet they often lack the resources and skills to cope.

“A lot of people don’t see themselves as family caregivers in need of support, and so nobody wants to say ‘I need help,’” says Kelli Stajduhar, a professor at the Institute on Aging and Lifelong Health at the University of Victoria. “Nobody wants to say to their parents or their spouse, ‘I can’t do this any more.’”

The demands of being a caregiver took a heavy toll on Ron. More than six years after Betty’s death, and released earlier this year from the halfway house where he spent the last five months of his sentence, Ron must learn to live with his guilt, grief and the same questions that still whir around in his head like a hamster wheel: How did he fail his mother? What should he have done differently? What more could he have done to help her?

Amid the deaths of more than 14,700 residents in long-term care and retirement homes since the start of the pandemic, the rest of the country is grappling with similar questions. How did Canada let its older citizens die in understaffed nursing homes and leave them to languish unwashed, unfed, dehydrated and alone? If Ronald Siwicki received a two-year prison sentence and a lifetime of regret for the death of his mother, what price will the rest of the country pay?

If you ask Ron, he will tell you between long pauses, during which his throat closes up and he breaks into sobs, that he knows he should have sought outside help, in spite of his mother’s protests.

But he will also tell you what the programs manager from the John Howard Society, who supervised him while on bail, said about the first responders who came to their house after Betty died: “They were actually coming to rescue me.”

Ron and Betty once shared this Winnipeg home, which Betty and her late husband bought in the 1980s.

In the final years of Betty’s life, it was just her and Ron, not counting little Shu Shu. That’s what happens with age. Your world contracts with each friend and family member who passes away.

The bungalow on Arrowwood Drive North., a quiet, tree-lined street in Winnipeg’s Garden City neighbourhood, had been Ron and Betty’s home for more than three decades, and within it accumulated the artifacts of those many years.

As disorderly and crammed with possessions as it eventually became, the house was Betty’s private sanctuary. And she was the boss of her domain.

Even when her husband Peter was alive, the two weren’t the type to entertain guests. Ron, their bachelor, live-at-home son, was usually the one to bring friends home to listen to records on his $20,000 stereo system, which he had purchased while working at the Advance Electronics hi-fi store.

As pet owners, the Siwickis could have been more attentive. Ron recalls his parents never walked their dogs, and instead, let them do their business on the carpeted floors inside. (Before Shu Shu, there were two earlier Shu Shus, phonetically named after the French term of endearment, “chouchou.”) But few outside the family knew the Siwickis also developed a problem with hoarding papers, old clothing and all manner of miscellany – until after Betty’s death.

Ron’s father died of heart failure in 1996, and his sister Carol passed away of ovarian cancer in 2011. Their deaths, both in hospital and too swift and unexpected for his mother to bear, entrenched Betty’s fear of doctors and hospitals. Even though she had high blood pressure, glaucoma and hypothyroidism, Betty, who became increasingly frail, stopped seeing her doctors and told Ron she didn’t want to die anywhere other than in her own home.

Carol had been one of few visitors who came to the house, and with her gone, Betty increasingly sealed herself from the outside world. Whenever anyone came to the door, she would remind Ron not to let them in.

Ron’s closest friends at the Pony Corral, a restaurant in Winnipeg’s Grant Park neighbourhood where he played on Friday and Saturday nights with the house band, knew he was struggling to take care of his mother.

After their shows, instead of lingering with his bandmates over beers, he would pick up pizza from Jumbo Pizza or Betty’s favourite, chicken chow mein from Ken’s Restaurant, and bring them home for her.

His friends knew Ron was frustrated about his mother’s reluctance to see a doctor and that his own health was deteriorating, too. But as his long-time friend and bandmate David McCrea explained, “We really didn’t know how bad it had become.”

They didn’t find out until it was too late.

Betty and Peter Siwicki.

In old black-and-white photographs of them as young adults, Ron’s parents are a handsome pair. In one image, taken of the two strolling on Winnipeg’s Portage Avenue, Betty is dressed in a fur-collared coat. She smiles directly into the camera, with a dainty gloved hand tucked in the crook of her strapping husband’s arm. They look straight out of a Hollywood movie.

While Betty would give up bathing and showering in her senior years, the photos of her younger self show a bright-eyed blonde in carefully co-ordinated outfits and salon-set curls.

Carol, the eldest of their two children, was a quiet, bookish brunette. Shy, meek Ron was born seven years later. The females of the family were strong-willed; Peter and Ron followed their lead. While Betty stayed home to raise the children, Peter held various jobs, including as a plumber and a taxi driver. Eventually, he was hired to build airplane engines at StandardAero Ltd. and ended up working there for more than 10 years.

When Carol and Ron had grown, Betty got herself a job at StandardAero, too, since the house felt empty without them. She and Peter would set off for work together and eat lunch with each other every day. Her husband was never far out of reach.

Ron, too, stayed close within her orbit. Introverted and somewhat awkward, Ron might have remained a shy loner if it weren’t for rock ‘n roll. His parents loved music. But it was his sister’s record collection that made Ron buzz. The Beatles ignited in him a desire to not just consume music, but to make it. So in Grade 7, as the Fab Four made their 1964 world tour, Ron convinced his parents to enroll him in vocal and guitar lessons.

He took formal lessons only for a few years, but learning to play and sing was transformational. When he performed, shy Ronnie disappeared, replaced by a cooler, more confident version of himself. It was a rush.

Ron went on to study general sciences at the University of Winnipeg, but he dropped out after about a year, preferring instead to work as an audio hi-fi consultant at Advance Electronics. In the meantime, he played in countless bands of various genres – rock, blues, jazz, country – including with Juno-nominated country singer Cindi Cain – and in international recordings. He keeps a poster, signed by Canadian country artist Michelle Wright, addressed, “To one of Canada’s best guitar players Ron.”

Those who knew him in the late 1970s and early 1980s describe him as odd, yes, but friendly and possessing a peculiar brilliance. Then, as now, he had an encyclopedic memory for names and dates and the kind of dry information people nowadays just Google, especially when it came to music. Ron could tell you who played what specific model of instrument, how many gigs they played, on which dates and in which cities.

As Winnipeg entrepreneur and former broadcaster Michael Gillespie explained, having a conversation with Ron was like getting “an explosion of information – not necessarily what people were interested in sitting and listening to.” Yet there was something about him people found endearing. He seemed almost childlike, incapable of harbouring petty jealousies.

Ron was, and is, “the gentlest soul you’ve ever met in your life,” said Mr. McCrea, his long-time friend, who is a professor emeritus of physiology and pathophysiology at the University of Manitoba.

As much as Ron emulated the sounds of his music idols Janis Joplin, Jimi Hendrix and Cream, he didn’t adopt their rock ‘n roll lifestyle. He never smoked and avoided illegal drugs and alcohol. And while Ron says he’s had multiple girlfriends throughout his life (court documents state he dated two or three women, but did not have any long-term relationships), he never married. As he will tell you, his mom wanted him to find a nice nurse with whom to spend the rest of his life.

Some might have characterized Betty as controlling; Ron says she was his biggest fan.

“I guess my mom just didn’t wanna let go. And ... and I sort of got used to that.”

Ron in his younger years, playing guitar. Friends remember Ron as a fountain of information about different subjects, but especially music.

Betty had a hard time letting go of anyone in her family. When her own parents died in the 1970s, she went “berserk,” Ron said. He recalled she screamed and shrieked and ran around the house, saying it couldn’t be true.

The death of her husband at the age of 77 broke Betty. But the death of her daughter shattered her.

Until Carol died, Betty spoke with her on the phone every day. The two often quarrelled, and Betty’s peccadillos, like her habit of burning toast in the oven because of lack of vigilance, drove Carol up the wall. Nevertheless, they loved each other, and Carol was the only person who could make Betty visit the family doctor and take her blood pressure and thyroid pills.

In 2010, Carol told Ron she noticed Betty’s memory was starting to fail her. Betty had reacted with surprise when Carol reminded her she needed to take medication for the rest of her life. “I didn’t know that,” was Betty’s reply.

Ron, too, saw signs of his mother’s decline. For years, he regularly drove Betty and her sister Ollie, who lived about 20 minutes away, to the McPhillips Station Casino or the Club Regent Casino. There, the sisters would play the machines, while Ron went to his gigs at the Pony Corral. When he finished, sometimes as late as 3 a.m., he would pick them up and drive them home.

Betty and Ollie were proud women, and they regarded the other folks at the casino who used walkers, wheelchairs and motorized scooters with a certain smugness. If they ever needed mobility devices, they told Ron, they’d stop coming to the casino altogether. Better to stay home, they thought, than be pitied.

Yet neither woman was as sure-footed as she used to be. Ron noticed both now steadied themselves with a hand against a wall when they walked.

In the end, it wasn’t the decline in her mobility but in her cognition that made Betty quit going to the casino. On one trip, she couldn’t remember how to use the machines and asked Ron to show her. Having no clue how to gamble, he made a poor teacher. Thus, stunned and saddened by the realization of how serious her memory loss might be, he brought Betty home. They never went back.

In January, 2011, Carol was diagnosed with ovarian cancer. She received treatment, but that December she was hospitalized in extreme pain and with fluid build-up in her lungs. Although Ron suspects his sister knew she was dying, he and Betty were taken aback when her oncologist informed the family Carol wouldn’t make it through the weekend. She died in hospital on Dec. 26, 2011.

Ron says he believes Betty lost her will to live then. While things were already starting to unravel, Carol’s death was a turning point. Everything began to spin out of control.

Betty spent a lot of time at McPhillips Station Casino before, in her dementia, she forgot how to gamble.

For about a week after Carol’s death, Betty did little but sleep. She didn’t even get up to have her cigarettes, which was unheard of, Ron said. Instead of addressing Ron directly, she spoke loudly to the dog, saying things like: “Shu Shu, tell Ronnie I’m hungry,” or “Shu Shu, tell Ronnie I’m thirsty.”

From then on, Betty would periodically have episodes like this, where, as Ron put it, she “would be kind of goofy for about a week,” then “wake up” and become lucid again. While in her confused state, Betty would wet the bed, then rouse herself and blame the dog. She would take off all her urine-soaked clothes, but he could not persuade her to bathe or shower, even though he had installed a safety bar and a shower chair in the bathroom.

She no longer properly or completely wiped herself after using the toilet either, Ron said, adding, “she sure would not let me or anyone touch her.”

The idea of seeking home care, however, was out of the question. When Ron suggested it to her, her answer was “no way.” (Had she agreed to it, they might not have waited long. According to the most recent data from the Winnipeg Regional Health Authority, the overall median wait time for home-care services, which typically includes help with bathing, toileting, meals and light housekeeping, is two days for clients 65 and over.)

Ron never raised the idea with Betty to apply for long-term care, which he said he now regrets. But he was certain she would have refused that, too. In her home, Betty was in charge of her own routine. And long before the pandemic revealed the horrors of long-term care, she regarded nursing homes as places where older people were cast away.

Yet Ron’s care was proving insufficient. He bought adult diapers for her, but she disliked wearing them, so she would take them off. He tried using mattress protectors on her bed. But she tossed and turned in her sleep, pulling them into a twisted heap.

Eventually, Ron, who was then living off roughly $7,000 to $12,000 a year from his regular gigs at the Pony Corral, took to buying a new $20 quilt from Giant Tiger every time she soiled one instead of washing them. The quilts were too bulky to fit in the washing machine. And anyway, theirs had stopped working. (Like its inhabitants, the house and its appliances were breaking down.)

When Betty was in a lucid state, she would apologize to Ron for her incontinence. “But she had nothing to apologize to me about, I loved my mom because she was always great to me,” he said.

More troubling to him than her accidents and neglect of personal hygiene were the subsequent episodes when she became “very hyper,” as Ron described it. She would wander around the house, wanting to clean or have something to do. In these restless moods, she didn’t want to sleep or eat or drink, not even the Diet Coke and baloney sandwiches he prepared, which she normally relished. She suffered panic attacks, telling Ron she felt as though she were having a heart attack and was going to die. On four or five occasions, he drove her to the emergency department at Seven Oaks General Hospital. During a couple of those visits, she got up and left before seeing a doctor, unwilling to wait for one. On the other occasions, doctors found nothing wrong.

Eventually, having exhausted herself, Betty would sleep for 15 hours straight, and the house, again, would fall quiet.

Ron played on Fridays and Saturdays with the house band at the Pony Corral in Grant Park, where bandmates came to learn about his troubles caring for Betty.

At the Pony Corral, Ron’s friends could see he was struggling. They knew he had diabetes and his blood sugar was out of control. His legs and feet were so swollen, they were mystified he managed to stand all night through their performances. “You could just sort of see him fading,” his friend and bandmate Karaleigh Vincent said. Ms. Vincent, a former paramedic, used to carry Ron’s guitar and bag out for him after their shows because he would groan in pain. “I mean, his feet looked like balloons.”

Knowing he no longer went out much, Ms. Vincent and others invited him to gatherings, always making sure to send him home with two plates of food – one for him and one for Betty. They pushed him to get medical care, mostly for himself, but also for his mother. They tried helping him get her in to see a gerontologist and to get home care. But Betty wouldn’t hear of their suggestions. “She wouldn’t allow any of this stuff to take place,” Ms. Vincent said.

Trying to help someone who needs help but doesn’t want it presents a quandary with no easy solutions, said Dr. Alison Thompson, an associate professor and bioethicist at the University of Toronto.

This kind of scenario becomes even more complicated when someone has dementia, she explained, as their capacity to make health care decisions may be diminished. In such cases, the next of kin or designated power of attorney is obligated by law to decide for them, based on what the care receiver’s previously expressed competent wishes were. Too often, though, people don’t know what those wishes were because no one likes having those conversations, Dr. Thompson said. So then they’re left to make decisions in the best interest of the person under their care.

Mr. McCrea said he knew Ron had tried taking Betty to see a doctor on several occasions without success, sometimes driving her to the clinic only to have her refuse to get out of the car. He says he believes Ron eventually gave up trying. Whenever he asked how things were at home, his long-time friend said they were all right.

“But they weren’t,” Mr. McCrea said, “and they weren’t for a long time.”

Will we ever take care of the carers?

Caregiving has always been undervalued in this country, even before COVID-19 came along, Elizabeth Renzetti writes. In the postpandemic world, we need to make it better and more equitable.

Caring for a loved one can be a positive experience for many. But according to a 2020 study by the Canadian Institute for Health Information (CIHI), nearly 67,000 – or one in three – unpaid Canadian caregivers, mainly family members, said they felt distress, anger, depression and as though they weren’t able to continue their care activities.

“We hear from caregivers themselves, they feel invisible,” said Tracy Johnson, director of health systems analytics at CIHI, adding that if they knew what supports were available to them, it might help alleviate their distress.

“Sometimes there are no other options. But sometimes people just don’t even know what their options might be.”

Respite services can provide relief to some, but they’re usually limited to a few hours a week. And a 2019 report by the health policy think tank the Change Foundation and the Ontario Caregiver Organization found some caregivers don’t use respite services because their care recipient isn’t willing, or because the caregivers themselves feel guilty or lack confidence in leaving their loved ones with someone else.

Yet distress doesn’t just hurt caregivers, it may be hazardous to the care recipient, too.

A 2018 review, published in the Journal of the American Geriatrics Society, found individuals with dementia were more likely to wind up in nursing homes, to have worsening behavioural and psychological symptoms, and to experience physical and verbal abuse and neglect when their caregivers were distressed.

Several other notable court cases have highlighted these deleterious consequences.

Margaret Grant of Moncton pleaded guilty in 2009 to failing to provide the necessities of life to her 79-year-old mother, who died after she was left sitting in a chair for at least three months, malnourished, dehydrated, covered in feces and urine, and both legs rotting. Ms. Grant maintained her mother refused to see a doctor.

Mary Nanfo of Bolton, Ont., pleaded guilty in 2008 to failing to provide the necessities of life to her aging mother, whose body paramedics found covered in sores and dried feces. Ms. Nanfo reportedly didn’t seek help because she was too embarrassed to let anyone into their home.

And Patricia Pitre, the owner and operator of a special-care home in Bathurst, N.B., pleaded guilty to criminal negligence in the death of a 74-year-old resident, who had such severe bedsores, some were gangrenous and gave off a strong odour. Even though she administered antibiotics as prescribed and told the court she loved him as family, the judge found she “wilfully and recklessly” failed to call 9-1-1 when it became clear his condition was extremely serious.

Living alone with his mother, Ron had neither the strength nor the will to restrain her if she was agitated.

Betty was having one of her “hyper” spells. She was in a panic to get out of the house, although to Ron, it wasn’t clear why. It might have been March of 2012 because Ron remembers there was still snow on the ground. (While his retention of certain information remains as encyclopedic as ever – he can give clear details of the August day in 1970 when Led Zeppelin was supposed to play at the Winnipeg Stadium, but ended up performing at the Winnipeg Arena because of a rain storm – the endless days of caring for his mother have become hazy in his memory. “I don’t know how my brain decides what it’s going to remember and what it doesn’t,” he says.)

Betty was wearing only a blue, see-through top she liked to wear to bed, with no underwear, and she was talking “a million miles a second.”

In spite of the chilly weather and her lack of clothing, she headed for the back door. It needed a key to open, and Ron quickly removed it.

He was too weak to physically restrain her. But even if he could have, he said, he never would have dreamed of doing so.

Afraid she would still manage to get outside where all the neighbours could see her in her state of undress and agitation, Ron panicked, too, and called 911.

The police arrived first and then the paramedics. Betty refused to go with them. Eventually, they had her sign a release form, acknowledging she declined their help, and drove away.

Some time after that, Ron stopped at the Misericordia Health Centre on his drive home from the Pony Corral, knowing the hospital would not be busy at 3 a.m. There, he inquired about how he could get help for his mom and was given a phone number for a mobile crisis centre. When he called, however, he was told the centre mainly dealt with suicide and mental-health crises, not situations like his own. Instead, they got a specialist to call him back and arrange for a home assessment.

During her visit, the specialist spoke with Betty, testing her ability to recall such things as the date and day of the week. Even when fed the answers, Betty could not remember them several minutes later.

The specialist suggested to Ron that she thought his mother might have early signs of Alzheimer’s disease, and recommended that she come to the geriatric program at Seven Oaks General Hospital on a Thursday for a more complete evaluation.

Betty turned to Ron, just as she did the time he called 911. “Ron, why are you trying to make me look like a fool?” he recalled her asking. Ron said he felt horrible, as though he had betrayed his mother.

He never did convince her to go for the evaluation.

For nearly three years, Betty and Ron’s days bled one into the other. Ron said it felt as though he were living in a nightmare. There were only rare breaks, like that unseasonably warm day in October.

It’s only in hindsight that Ron is able to see how dramatically Betty had declined.

He had taken a brief iPhone video of his mother shortly after Carol died. In it, Betty appears pensive as she sits at the kitchen table with a cigarette dangling gingerly between her fingers. Her hair is messy, but voluminous with curls.

The difference between how she looked then and her appearance in a subsequent short video Ron took on her 89th birthday on Aug. 14, 2014, is staggering. Within the span of about 2½ years, Betty appeared to have aged more than a decade.

In the second clip, she looks as though she has shrunk into her body. Her jaw is slack, her curls are gone, and she shakes her head in bewilderment as Ron cheerfully sings her “Happy birthday.”

When he asks how she feels, Betty vacantly repeats the question, “How do I feel?” She looks off into space for a moment. Then she shrugs, shakes her head and answers: “Nothing.”

Like a metaphorical frog being slowly boiled alive, Ron carried on, seemingly numb to their increasingly desperate situation.

Ron was sitting on his bed one afternoon, watching TV, when he heard a noise out in the hall. At least, he says he believes it was the afternoon, since he and his mother, both of whom habitually stayed up till dawn, generally slept past noon. He opened his door to find Betty feeling her way along the wall. She told him she couldn’t see.

The sudden loss of her sight came as a shock to both of them. Not knowing what else to do, he led her back to her bedroom and helped her lie down. If you ask him what he did next, though, he’ll tell you he doesn’t know.

What he can tell you is why he soldiered on, even when it became clear he was in over his head.

“I remember thinking to myself, ‘I’ll do this as long as possible because I want my mom to live as long as possible’ because, ‘cause …” Here, he falters and his voice chokes up again. “’Cause, I didn’t know how I could live without her.”

Ron plays a guitar as a young man. As an adult, he would persist in taking care of his mother even when he knew he was overwhelmed: 'I didn't know how I could live without her.'

It was perhaps an early afternoon in November when Ron went to Betty’s room to check on her and found her on the floor. He did not know how long she had been there. She hadn’t called out for help and was lying on the shag carpet, having rolled off while tossing around in bed.

Ron could see she was struggling to get herself back up. She wasn’t hurt, though; the bed was low to the ground.

He tried lifting her, but he couldn’t manage to get her to her feet, nor back onto the bed.

When Ron informed Betty he was going to call an ambulance, she instructed him not to and said again she wanted to die at home.

As Ron recalls, Betty told him she was hungry or thirsty, so he went and got her some food and something to drink. (While court documents state he gave her water and Boost meal replacement drinks during the intervening period between her fall and her death, Ron said he also prepared other foods, such as noodles and sandwiches – “not just Boost.”)

He also made sure she had blankets. (The furnace had ceased working properly and would only operate at the highest heat setting, so the house was alternately freezing or sweltering.)

Then, he said, he just stayed with her.

Ron never mentioned to his friends that his mother had fallen out of bed.

“I think he was ashamed. I think he was afraid. And I think he was very defeated,” Ms. Vincent said, adding that even if his friends had known what was going on, it’s not entirely clear what steps they should have taken.

Although Ron emphasizes his mother “was the most precious person in my life,” there is evidence to suggest his patience with her, on one occasion, at least, was finite. According to court documents, a furnace company employee told police he had visited the home on Nov. 21 because he needed Betty’s signature to authorize work, and described it as a “hoarder’s house,” smelling of urine and feces. That visit was documented as follows: “Mr. Siwicki said his mother was in and left the room. The employee could hear him say, ‘Mom, you have to sign this’, in an annoyed tone. A raspy and frail voice responded that she was thirsty and cold. Siwicki did not respond to her, but came back and said he could not get his mother’s signature. When he returned to the kitchen, the employee suggested he could stay a while to finish their conversation if he wanted to take his mother some water. Mr. Siwicki did not respond.”

Ron remembers this event slightly differently. He said his mother called out she was thirsty while he was dealing with the employee and he told her to wait.

“It was very uncharacteristic of me,” he said, adding when he and his mom were alone, he would respond to her requests right away. “So I feel really bad about that. But it is true that happened, where I should have went and taken a drink immediately to my mom instead of telling her to wait.”

Betty and Peter Siwicki in happier times.

Betty Siwicki died at some point in the afternoon on Dec. 17, 2014. The events of that day are a blur, according to Ron.

He remembers receiving a call from the furnace company earlier in the day. That call, recorded to have happened around 11:30 a.m., was described in court documents as a request for a signature to confirm the work on the furnace was completed. The employee told police Ron said his mom was sick, and he might have to call 911.

Ron said he remembers Betty was having trouble breathing. Later, when he checked on her, her breathing had stopped. Ron tried to perform CPR, relying on how he had seen it done on television to the tempo of Stayin’ Alive by the Bee Gees. She remained lifeless.

The one thought Ron remembers forming in his mind was “oh no.” According to the court documents, he pulled off the blanket that covered Betty and was shocked to see the condition her body was in.

He explained he felt she shouldn’t be seen, covered in feces as she was.

“I wanted to get her out of there,” he said.

With all his strength, he moved her body out into the hall and threw away the soiled blankets.

Around 5:30 p.m., the furnace company employee was in the area and stopped by. Ron answered the door and when the employee asked how his mother was, he replied: “She died.” And when she asked whether he had called 911, he didn’t reply but just stared at her. She reportedly told police Ron “creeped her out,” and left immediately.

At some point, he went into the kitchen and sat down. For a long time, he did nothing. Then, he made a few calls, including to his friend David McCrea. Mr. McCrea said he asked whether Ron had called 911, and Ron answered that he had.

The court record says Ron called 911 around 9 p.m. When the first responders arrived, they found Betty’s body on a plastic sheet in the hall with a blanket over top. She was still covered in feces and urine, the smell of which filled the cluttered house. The carpet in her bedroom was soaked through. Betty’s hair was matted. An autopsy found Betty’s brain showed signs of dementia, although the extent of it was undetermined. The pathologist concluded she died of sepsis, a condition caused by her body’s response to her bedsores.

Ron was arrested that night and charged with criminal negligence causing death and failing to provide the necessities of life.

What he remembers clearly of that day is he didn’t cry. The tears would not yet come for some time. Eventually, when they did come, they would not stop.

Michael Gillespie, a long-time acquaintance, snapped into action upon learning of Ron’s arrest. Ron’s lawyer Mike Cook advised him the best thing he could do for Ron was obtain letters of reference for him and get people to show up in court for the bail hearing. Within two days, Mr. Gillespie had gathered around 60 letters of reference and rallied so many of Ron’s friends that there were as many of his supporters outside the courtroom as there were inside.

Asked why he was so determined to help Ron, considering the two knew each other only casually up to that point, Mr. Gillespie’s answer is simple: “I knew in my heart that Ron could not have consciously caused his mother’s death.”

After Ron was released on bail, Mr. Gillespie and a core group of supporters, whom Ron nicknamed “the Committee,” met frequently to handle his affairs. They organized volunteers to clean the family house so they could sell it on Ron’s behalf. It was the first time his friends had been inside for at least 10 years.

It took around two months, an entire team and at least five or six large metal dumpster bins to clear all the clutter. The area where his mother had lain was so badly damaged, they hired a remediation company to remove the carpet and cut into the floor so they could replace it.

Over the next few years, the Committee helped Ron find an apartment and furnished it for him while he waited to appear in court. Friends organized performances to raise funds for him. Meanwhile, Ron was interviewed by a psychiatrist, who found he bore no evidence of mental illness. The psychiatrist’s report to the court, however, said he struggled with decision making, having financially and emotionally depended on his parents most of his life.

In 2018, Ron pleaded guilty to criminal negligence causing death and was sentenced to three months in prison by Justice Colleen Suche, who said while he demonstrated genuine remorse, he’d exhibited a serious abdication of his responsibilities as his mother’s sole caregiver. The Crown later challenged the sentence and the Manitoba Court of Appeal increased it to two years.

If there is a legal lesson to be learned from Ron’s case, it’s this, his lawyer Mr. Cook said: “If you have anybody in your care, be it a child, a contemporary or an [older] adult, you should not have a moment of hesitation if urgency arises,” he said. “Get proper medical attention.”

Mike Cook, then acting as Ron's lawyer, outside the Winnipeg courthouse in early 2018.

It’s tempting to imagine how differently things could have turned out for Ron and Betty. If only Ron had known what to do. If only Betty had not been so averse to medical help. If only the right people had intervened.

Typically, caregivers, particularly of individuals with dementia, are connected with the public-health system, usually through a family doctor, and they would have a case manager or home-care nurse regularly check in on them, said Dr. Stajduhar, the professor at University of Victoria’s Institute on Aging and Lifelong Health.

But having worked in home care herself, Dr. Stajduhar said she has encountered people who have not let her into their homes. And unless home-care nurses see clear signs of neglect or abuse, they have no authority to enter. “There’s lots that can be done, but families have to take it up,” Dr. Stajduhar said. “And we can’t force people.”

Nevertheless, she said, caregivers can benefit from speaking with other caregivers. She pointed to the non-profit Family Caregivers of British Columbia as an organization that offers peer-to-peer support. The Ontario Caregiver Organization does this as well, offering a 24-hour help line, webinars and virtual mentoring programs. Similar organizations exist in Alberta and Nova Scotia, but not every province has one.

Amy Coupal, chief executive officer of the Ontario Caregiver Organization, suggested Canada might look to Britain as a model. Britain has an internationally recognized national organization, Carers UK, which provides a wide range of resources including financial help and practical support.

Dr. Stajduhar also pointed to the Dutch Buurtzorg, or “neighbourhood care” model, in which a designated team of nurses takes care of residents within a geographic area. In this way, the nurses really get to know people and understand their needs. And people who would otherwise refuse care might be more willing to trust them, Dr. Stajduhar said, and perhaps extreme cases, like Ron and Betty’s, might be prevented.

Ron is eager to move on now that his sentence is complete, but declining health has left him worried about what will happen to him as he gets older.

On Jan. 11, 2021, Ron left the halfway house, where he served the remainder of his sentence, a free man. Free, but hampered by health problems that have grown with age. He underwent a quadruple heart bypass surgery in 2017. Although he’s learned to better manage his diabetes, his kidney function is poor and he needs to stay vigilant after suffering a mini-stroke in 2020. And through all of this, he also met a girlfriend through Facebook, a retired nurse – the nurse Ron says he believes his mom would have wanted him to spend the rest of his life with.

Over several interviews and text messages, Ron expressed his desire to move on.

“I would like to finish this off and put it behind me. Been going on too long,” he wrote.

But when asked what he’ll do if he can no longer take care of himself one day, Ron is vague. “Yeah,” he sighs. “I mean, that’s the dilemma.”

Ron has been reading the news about how the pandemic has played out in long-term care, where residents have died not only from COVID-19, but have suffered from neglect, dehydration, malnutrition and loneliness. On Facebook, he recently shared a video of two U.S. doctors decrying the inhumanity of not allowing loved ones to visit dying patients during the pandemic.

“Think about those people with parents in care homes where they were dying away from family,” Ron wrote. “Horrible.”

Betty did not die that way. She died where she wanted, in her own home, Ron said. She died with him, who loved her more than anyone.

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