Pandemic highlights need for national standards for senior care
They are some of our most vulnerable citizens, and the pandemic is claiming the lives of Canada’s seniors at an alarming rate. To date, nearly half of the COVID-19 deaths in this country have occurred in long-term care homes and seniors’ residences. In Quebec alone, almost 850 of the 1,041 deaths occurred in seniors’ residences.
The spread of the virus has exposed systematic vulnerabilities in these homes, from residents living in close proximity to each other, to the lack of protective gear for home-care workers in the early stages of this crisis. And, when evidence from other countries first showed seniors were particularly at risk to the virus, there was an absence of a clear plan to mobilize support to these residences.
“The uncomfortable and tragic truth is that the very places that care for our elderly are the most vulnerable to COVID-19,” Prime Minister Justin Trudeau told the county in a daily briefing last week. “We all need to do better. We all need to take leadership for the seniors who’ve built this country.”
Both federal and provincial governments are doing their best to immediately address shortcomings in these facilities – through essential service designations, the procurement of PPEs for workers, and increasing staffing levels. The Quebec and Ontario governments have gone as far as calling in the military to provide support.
Foundational issues exposed
While these short-term measures are necessary to battle the acute COVID-19 outbreaks in specific homes, as well as flatten the number of cases in all seniors’ residences, many foundational issues still must be examined in the months and years ahead.
The shocking number of virus-related deaths at these homes has prompted an unprecedented collaboration by federal, provincial and territorial governments. But the flaws in Canada’s pandemic response for seniors’ homes and long-term care residences should lead to public and political appetite to act on this front.
This could translate to the federal government stepping in to provide funding to provinces and territories, much in the same way mental health became a focus in 2017’s health accord.
National standards needed
While the federal government may want to take a narrow approach in providing support, such as limiting the scope to pandemic and emergency planning, as well as the implementation of universal national pharmacare, there is a growing need for other factors to be discussed, such as developing a national approach to standards of care.
For years, a variety of stakeholders have raised red flags around the lack of a coordinated approach around standards of care. I recall working for an Ontario Minister of Health and Long-Term Care who made the mistake of musing about testing adult diapers on himself in a media scrum. It made national headlines the next day.
While he was mocked for his remarks, his response was quite sincere and genuine: how could anybody really know if such diapers are effective or not without trying them on themselves? While I am not suggesting governments try on diapers in the coming months, I do believe they need to take more inclusive approaches in developing these standards of care, including involving seniors and patients in the discussions.
Patients first, not profits
There are also other foundational factors that need to be put under the microscope, such as how contracts for long-term care spaces are allocated by provinces and territories throughout the country.
As we’ve seen recently in the Outaouais region of Quebec, there may be a lack of transparency about how these contracts are allocated, as well as who finances and owns long-term care and seniors’ homes. There are a lot of golden handshakes in the sector that are financed, traded and perceived as quasi-monopolies to print money.
The interests of seniors and patients should come first, and while the profitability of various business models is important to attract investment, this has to align with clear standards and conditions for facilities and their employees.
Other key factors that will be examined include adequate screening, increased pay, and training for care-home workers. There is a genuine opportunity for industry associations to obtain support from governments on this front, as the federal government has already expanded the Canada Emergency Benefit Subsidy to top up the salaries of essential workers.
Addressing affordability and models of care
Most crucially, I hope one positive outcome from this crisis will be discussions around the affordability of long-term care homes and seniors’ residences. Many seniors require these supports, but cannot afford to live in these homes, and the costs vary greatly from province-to-province.
At-home models of care also have a role to play in this discussion. For many families, they present numerous benefits, not just in terms of affordability but in ensuring culturally appropriate standards of care. Stress is also drastically reduced when one no longer is forced to transition from their family home.
Media headlines in recent weeks have shown there is genuine public appetite to ensure that our most vulnerable seniors are provided the dignity and care they deserve. And, as evidenced by our current pandemic,these at-home care models seem less vulnerable to the spread of viruses.
It’s now clear that past government efforts to support ‘aging at home’ require a renewed focus.
When our government’s response to the pandemic is examined in the years ahead, one likely conclusion will be that the vulnerability of residents in long-term care facilities and seniors’ homes should not have come as a surprise to anyone. These were long-standing issues that should have been addressed much earlier.
The warning shots have been there for decades – noroviruses and Legionnaires’ disease have long wreaked havoc on vulnerable seniors living in homes throughout the country.
The COVID-19 crisis has exposed this truth for all Canadians, and it will require much focus and resources to address the situation in the months and years ahead.
FHR does work in the senior care space. If your organization needs support or advice in these uncertain times, here’s where you can find the latest news, insights and resources related to COVID-19.
They are some of our most vulnerable citizens, and the pandemic is claiming the lives of Canada’s seniors at an alarming rate. To date, nearly half of the COVID-19 deaths in this country have occurred in long-term care homes and seniors’ residences. In Quebec alone, almost 850 of the 1,041 deaths occurred in seniors’ residences.
The spread of the virus has exposed systematic vulnerabilities in these homes, from residents living in close proximity to each other, to the lack of protective gear for home-care workers in the early stages of this crisis. And, when evidence from other countries first showed seniors were particularly at risk to the virus, there was an absence of a clear plan to mobilize support to these residences.
“The uncomfortable and tragic truth is that the very places that care for our elderly are the most vulnerable to COVID-19,” Prime Minister Justin Trudeau told the county in a daily briefing last week. “We all need to do better. We all need to take leadership for the seniors who’ve built this country.”
Both federal and provincial governments are doing their best to immediately address shortcomings in these facilities – through essential service designations, the procurement of PPEs for workers, and increasing staffing levels. The Quebec and Ontario governments have gone as far as calling in the military to provide support.
Foundational issues exposed
While these short-term measures are necessary to battle the acute COVID-19 outbreaks in specific homes, as well as flatten the number of cases in all seniors’ residences, many foundational issues still must be examined in the months and years ahead.
The shocking number of virus-related deaths at these homes has prompted an unprecedented collaboration by federal, provincial and territorial governments. But the flaws in Canada’s pandemic response for seniors’ homes and long-term care residences should lead to public and political appetite to act on this front.
This could translate to the federal government stepping in to provide funding to provinces and territories, much in the same way mental health became a focus in 2017’s health accord.
National standards needed
While the federal government may want to take a narrow approach in providing support, such as limiting the scope to pandemic and emergency planning, as well as the implementation of universal national pharmacare, there is a growing need for other factors to be discussed, such as developing a national approach to standards of care.
For years, a variety of stakeholders have raised red flags around the lack of a coordinated approach around standards of care. I recall working for an Ontario Minister of Health and Long-Term Care who made the mistake of musing about testing adult diapers on himself in a media scrum. It made national headlines the next day.
While he was mocked for his remarks, his response was quite sincere and genuine: how could anybody really know if such diapers are effective or not without trying them on themselves? While I am not suggesting governments try on diapers in the coming months, I do believe they need to take more inclusive approaches in developing these standards of care, including involving seniors and patients in the discussions.
Patients first, not profits
There are also other foundational factors that need to be put under the microscope, such as how contracts for long-term care spaces are allocated by provinces and territories throughout the country.
As we’ve seen recently in the Outaouais region of Quebec, there may be a lack of transparency about how these contracts are allocated, as well as who finances and owns long-term care and seniors’ homes. There are a lot of golden handshakes in the sector that are financed, traded and perceived as quasi-monopolies to print money.
The interests of seniors and patients should come first, and while the profitability of various business models is important to attract investment, this has to align with clear standards and conditions for facilities and their employees.
Other key factors that will be examined include adequate screening, increased pay, and training for care-home workers. There is a genuine opportunity for industry associations to obtain support from governments on this front, as the federal government has already expanded the Canada Emergency Benefit Subsidy to top up the salaries of essential workers.
Addressing affordability and models of care
Most crucially, I hope one positive outcome from this crisis will be discussions around the affordability of long-term care homes and seniors’ residences. Many seniors require these supports, but cannot afford to live in these homes, and the costs vary greatly from province-to-province.
At-home models of care also have a role to play in this discussion. For many families, they present numerous benefits, not just in terms of affordability but in ensuring culturally appropriate standards of care. Stress is also drastically reduced when one no longer is forced to transition from their family home.
Media headlines in recent weeks have shown there is genuine public appetite to ensure that our most vulnerable seniors are provided the dignity and care they deserve. And, as evidenced by our current pandemic,these at-home care models seem less vulnerable to the spread of viruses.
It’s now clear that past government efforts to support ‘aging at home’ require a renewed focus.
When our government’s response to the pandemic is examined in the years ahead, one likely conclusion will be that the vulnerability of residents in long-term care facilities and seniors’ homes should not have come as a surprise to anyone. These were long-standing issues that should have been addressed much earlier.
The warning shots have been there for decades – noroviruses and Legionnaires’ disease have long wreaked havoc on vulnerable seniors living in homes throughout the country.
The COVID-19 crisis has exposed this truth for all Canadians, and it will require much focus and resources to address the situation in the months and years ahead.
FHR does work in the senior care space. If your organization needs support or advice in these uncertain times, here’s where you can find the latest news, insights and resources related to COVID-19.
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