Canada's Shameful Neglect of the Aged/Infirm During COVID-19 Pandemic

"It is hair-raising. We are expecting a second wave and long-term care homes are not ready."
"Overall, it is a completely unacceptable level and quality of care."
Natalie Mehra, executive director, Ontario Health Coalition

"Historically, the federal government has failed to support this sector [nursing and long-term care homes] ... It is imperative they help the sector by providing access to existing federal infrastructure dollars."
"These are simple and readily available solutions [allowing nursing homes access to funds through the national housing strategy] that could have been and can still be implemented quickly to support provinces and operators in modernizing long-term care homes."
"Seniors and their families do not care about who is, strictly speaking, responsible for what parts of senior-care delivery. The arguments that the federal government distributes funds and provinces provide programs might have been a thoughtful argument in the past, in the '80s and '90s, but the demographics today are completely different."
"The federal government cannot ignore the aging crisis any longer."
Jody Hall, association chair, The Canadian Association for Long Term Care

Lack of  support for long-term care homes contributed to conditions leading to widespread COVID-19 outbreaks and deaths in Canadian nursing homes. It was soon discovered with the onset of the first wave of global infections due to SARS-CoV-2, the extent of the fragility of the system of long-term care which became uniquely vulnerable to COVID. Already-vulnerable patients and a new coronavirus took its deadly toll. That was readily seen when it became clear that overall 81 percent of COVID-19 deaths in Canada occurred in long-term care homes.

In comparison, the United States, a developmentally comparable country, but with an immense case load of COVID, saw 31 percent of total deaths from their long-term care homes. In Australia, 28 percent accounted for their total overall death rate, while Spain suffered a 66 percent loss of life in their long-term care homes; all other countries vastly below the number that Canada realized in senior deaths.

Some of the reasons that Canada had such an overwhelming death rate in long-term homes is that the homes in Canada are frequently older, featuring shared bedrooms, bathrooms and dining rooms. Containing COVID-19 became an insuperable challenge in the pandemic's early days when knowledge of its infection rate was sparse, much less its capacity to spread though asymptomatic people.

The Royal Society of Canada early in July released a report on the state of long-term care in Canada wherein it accused the country of failing to protect vulnerable elders. The pandemic represented a "shock wave", exposing many deficiencies of long standing in the system, so that while causes of the systemic failure may be complex, they are also rooted in a situation the report authors spoke of as "systemic and deeply institutionalized implicit attitudes about age and gender".

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Across Ontario and Quebec and in other provinces, some homes experienced hundreds of infections, resulting in dozens of deaths of residents, along with the deaths of three personal support workers and illness of many more. Workers had been instructed they may only work at one home at a time, a move meant to reduce the opportunistic spread of infections, which has also exacerbated staff shortages. Many workers attended at multiple care homes since few institutions offer full-time hours.

An extreme shortage of staff at long-term care homes has left the situation in a more parlous state than it was before the pandemic, despite governments at every level professing their shock at the health mayhem that occurred in the first wave, pledging to pull out all the stops to make the homes safer for their residents. Front-line workers began receiving a modest pay bump, now reaching a deadline in an industry that pays their workers very poorly and fails to give them sufficient training.

The Ontario Health Coalition released a survey indicating that 95 percent  of long-term care staff who responded, reported the home they worked at was short-staffed and 63 percent that staffing levels had become more serious than before COVID arrived,k while 28 percent indicated staffing levels remained static. Disturbingly staff also reported residents regularly miss baths and showers because of staff shortages. They spoke of non-existent time to provide residents with emotional support.

Describing stress and limited time frames, they spoke of missing brushing teeth for residents, shaving and caring for their nails, along with sufficient time lacking for the critical issues such as feeding and hydrating residents properly; to reposition them to avoid bed sores, or to take them to the bathroom. The result has been more falls among residents. Personal support workers who constitute the bulk of long-term care staff are in a shortage position at many homes.

But the list of negatives don't end quite there. Shortages also exist of nurses, housekeepers, dietitians and those who do the laundry, engage in activities and rehabilitation. "I don't understand how this is allowed to happen", said a shocked long-time personal support worker, reviewing the findings of the Ontario Health Coalition survey; positively "repulsive".

A file photo from an Ontario long-term care home. Brian Thompson / Postmedia