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Time to make a national strategy for long-term care

The COVID-19 pandemic is showing that we must change how we care for our seniors – and we need to act quickly with a coordinated national response.

The Council of Canadians recently launched a petition, which has already garnered thousands of signatures, calling on the federal government to work with provinces to bring all long-term care homes into public hands under the same principles of the Canada Health Act. We are also calling on the federal government to work with provinces to create a coordinated seniors’ care strategy that puts protections and standards of care in place for seniors and workers in these homes.

Several people have written to the Council to ask why we have included the federal government at all since long-term care homes fall under the jurisdiction of provincial governments.

Here’s why.

On Tuesday, in his daily address, Prime Minister Justin Trudeau stated that, “COVID-19 has exposed some uncomfortable truths about our society, including how we care for seniors in Canada.”

Sadly, this is true.

“Right across the country long-term care homes and seniors’ homes have been the most hard hit by the pandemic, exposing the failures of a system that must be strengthened,” he said.

This is also correct – but one of the “uncomfortable truths” is that this situation didn’t just happen recently – it has been there for decades, allowed to grow in varying proportions in different provinces and entrench so deeply that the COVID-19 pandemic has caused nothing short of a national tragedy for many vulnerable seniors, their families and their caregivers.

Simply put, it’s a national tragedy that requires – and deserves – national attention and action.

Who pays for it trap

For decades, caring for seniors has fallen into the “who pays for it?” trap. Provinces provide the oversight and some funding, which is supplemented by co-payments from seniors and their families in these long-term care homes. But when provincial budgets are squeezed by other priorities, seniors have often been left behind.

By tying federal funding transfers to specific and coordinated standards, we can ensure seniors in long-term care homes are getting the care they need.

Most provinces have turned to for-profit providers, many of them large corporations that are in the business of running seniors’ homes. According to the CBC, just under 40 per cent of long-term care homes in Canada are run by for-profit businesses. The rest are public, non-profit or a mix. This ratio changes depending on where you live. For example, in Ontario, the province with the highest number of long-term care homes, 57 per cent of them are for-profit.

Who administers the homes is important. History continues to show that for-profit delivery of services means worse care. A recent Toronto Star article reported that seniors in for-profit long-term care homes in Ontario are far more likely to be infected with COVID-19 and die than those who live in non-profit and municipally-run homes.

Aging facilities

When you look at the facilities themselves, many are aging and designed in a way that made it harder to contain the spread of COVID-19. The Canadian Long-Term Care Association, an organization representing long-term care homes across Canada, has lobbied for years for federal infrastructure funding to improve and update homes across the country, making them safer for seniors. When you have two and four seniors sharing a room, often with only a curtain to separate them, as well as shared bathrooms and common areas, keeping those who are sick isolated is difficult. When you factor in that a high percentage of the seniors in the homes have cognitive impairments such as Alzheimer’s or dementia and would have difficulty following hygiene protocols such as regular hand-washing, ensuring infection control is nearly impossible.

In a recent press release the association said, “containing the spread of infection is proving difficult due to the chronic underfunding of long-term care infrastructure by successive federal governments.” Even now, as the federal government considers infrastructure projects as a way to help rebuild the economy, seniors’ homes are still not a priority, the group added.

Family members barred from long-term homes

It has been widely reported that staffing shortages in homes have been in crisis proportions for years before the pandemic hit. Funding cuts meant fewer staff having less time to provide care. We have heard from many seniors’ family members who would go to the homes to supplement the care provided to their loved one. Now, with visitors barred from entering long-term care homes to help stop the spread of COVID-19, seniors have been left isolated and alone without their family supports and with even less care.

Provincial governments are scrambling to provide the short-term responses needed to curb the COVID-19 outbreaks. Under-staffed homes are being helped by military personnel – even education support staff are being asked to help. Some provinces have given frontline workers in the homes wage increases or one-time “risk payments,” and calls are escalating to ensure everyone working in the homes has access to personal protective equipment.

To date, more than 4,600 seniors have died in 279 different long-term care homes across the country, according to research being done by freelance journalist Nora Loreto. Eighty-five per cent of all COVID-19 deaths in Canada have happened in residential care.

This is a national tragedy that requires national attention and action. Every senior and worker who has died, their families and those still living and working in long-term care homes deserve no less.