The Elderly Health-Vulnerable and COVID-19

"COVID-19 has exposed deep cracks in the long-term care system and it is now up to us to fix these problems."
"This tragedy must serve as a wake-up call to our whole country."
"Until yesterday morning, we didn't know the full extent of what these homes, what these residents, were dealing with,"
"I don't feel our government failed seniors. As a matter of fact, we saved a lot of lives by doing what we did. The system was broken."
"My job is to fix a broken system that has been broken for decades. I'm going to move heaven and earth that we leave no stone unturned."
Ontario Premier Doug Ford

A bench decorated with flowers and signs is pictured outside of Orchard Villa Retirement Residence after several residents died of the coronavirus disease (COVID-19) in Pickering, Ont., on May 26, 2020. (Carlos Osorio/Reuters)

• Eatonville Care Centre, Etobicoke: Resident Deaths: 42 -- COVID-positive residents permitted to wander about exposing everyone at risk; supplies reused despite compromised sterilization; staff burned out; residents frequently sedated with narcotics when depressed or sad.
• Hawthorne Place Care Centre, North York: Resident Deaths 39 -- Nurses and PSWs observed wearing same PPE for hours, moving between patient rooms; 'significant gross fecal contamination' noted in rooms; insect infestation, including ants and cockroaches; residents' calls for help unresponded to for significant lengths of time;
• Orchard Villa, Pickering: Deaths: 69 -- Residents left in soiled diapers, not taken to toilets; PSWs and nurses failed to help residents to seated position prior to meals and medications; 
• Altamont Care Community, Scarborough: Deaths 52 -- Residents bed-bound for several weeks, no evidence they had been moved to wheelchairs for part of the day, bed-repositioned, or properly washed; frequent arguments between staff with the use of derogatory language;
• Holland Christian Home (Grace Manor), Brampton: Deaths: 11 -- PPE problems such as moving from a COVID unit to other units without a change of PPE.

When it was first revealed that long-term care facilities were experiencing outbreaks of COVID-19 among their elderly, health-impaired residents, and deaths began mounting, public attention was turned to the treatment of the elderly in these residences, and new stories began to focus on the plight of the helpless elderly, dependent on care provided by staff which in some instances were improperly trained, exposing their charges to dangerous infectious rates, sometimes impacting on the staff as well. As time wore on, it became obvious that Canada's death rate owed much to the vulnerable elderly.

"These are the kinds of complaints we hear all the time. It took somebody from the outside to show what was going on."
"There wasn't anything in the [military report on the situation in long-term care homes] report that particularly surprised me. We hear it on a daily basis."
Jane Meadus, lawyer, Advocacy Centre for the elderly

"Nothing in that report is going to be any surprise for those of us working on the front lines. [I guess] it takes the military to get some action."
"It would be nice for front-line voices to get heard as well."
Candace Rennick, secretary treasurer, CUPE Ontario, (former PSW)

When it was first discovered, both in Ontario and Quebec, that a runaway infection and death rate was taking place in both provinces' long-term care institutions, each government appealed for help, sending in public health officials, followed by hospital workers, and finally in desperation calling for volunteers and then asking for the military to help solve the problem of inadequate help in the institutions to quell the tide of deaths among the elderly/health-compromised. A day ago, the military produced an intelligence report on the situation they discovered in the homes, while giving assistance.

Residents, they found were left in the beds, unbathed for weeks, fecal matter found in rooms, cockroaches, as well, and residents were despondently crying out for help for hours, their appeals unanswered, medical equipment that was contaminated, and improper use of personal protective equipment, were all found, along with outdated medications. A litany of oversights, inadequate care, tardy responses, and lax regulations along with a failure to comply with government-mandated quality of care.

It isn't as though the provinces had no inspectors to take inspection rounds to ensure compliance with the due care and respect owing people in the care of these institutions at a time in their lives when devastatingly ill health compounded by advanced age made them vulnerable and highly dependent on professional assistance in their daily lives. Ontario alone has 175 long-term care inspectors. And though the five care homes whose failings are listed above are considered the worse-case scenarios, there are countless other such care homes which have seen no COVID outbreaks, much less deaths.

Canadian Armed Forces personnel arrive at the Villa Val des Arbes seniors residence, Monday, April 20, 2020 in Laval, Que. (Ryan Remiorz/Canadian Press)

The situation has been so dire that of the deaths from COVID-19 in Canada as a whole, the elderly have represented a staggering 82% among long-term care facilities. It is as though the elderly health-impaired are the expendable members of society. Staffing levels in the facilities have been inadequate with no minimum standard of care for residents. The facilities have always been understaffed, many of the staff inadequately trained. And poorly compensated for their invaluable work with the elderly health-impaired. Afterthoughts from beginning to end.

An independent investigation is to be called by provincial governments into the situation surrounding these homes and the convergence of the pandemic impacting on the residents. In some instances, with some homes, abuse of residents' trust and care has been detected. And rumblings of charges of criminal abuse are bandied about. Presumably a thorough investigation will reveal much. Just as the military personnel tasked to help in these long-term care facilities have observed and catalogued their own shocking findings of neglect.

Who might ever have imagined that Canada would be struck with a global pandemic, a virus that lays in wait to infect the incautious and unwary, a virus whose impact is deadly for the elderly and the health-impaired? Who could have imagined that the Canadian military would have to be called upon to restore a semblance of order and helpfulness in the care of these vulnerable old people whose families have entrusted their care to a system that has largely failed them?

Canadian Forces personnel return from their break at the Vigi Mont-Royal CHSLD in the Town of Mount Royal on Tuesday. (Ryan Remiorz/The Canadian Press)