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Groups seek Ontario human rights inquiry into discrimination against elderly in health system

Posted: March 17, 2021

(March 16, 2021)

By: Elizabeth Payne, Ottawa Citizen

The pandemic has highlighted what has long been clear, say groups representing care workers, seniors and their families: Ontario’s health system discriminates against the elderly.

The Advocacy Centre for the Elderly, the Ontario Health Coalition and the Ontario Council of Hospital Unions are asking Ontario’s Human Rights Commission to launch an inquiry into systemic discrimination of the elderly in the province’s health-care system.

“What is happening to the elderly in this province in terms of their access to health care and in particular to hospitals and long-term care reflects discrimination and rationing that effectively either denies them care or makes them wait so long for it that in many cases it is simply no longer important,” said Michael Hurley, president of the Ontario Council of Hospital Unions.

The organizations say they have had long-standing concerns about the way underfunding and the failure to provide adequate health care disproportionately affects the elderly. The pandemic has brought that into tragic light, especially when it comes to long-term care.

“The pandemic hit and everything we have been concerned about was just amplified and shown in stark brutality,“ said Natalie Mehra, executive director of the Ontario Health Coalition.

“It really is a fundamental violation of people’s human rights. We are asking the Ontario Human Rights Commission to use its powers to hold a formal inquiry. We can’t at the end of this pandemic go back to the way things were.”

Canada, in general, has had the highest rate among wealthy nations for COVID-19 deaths in long-term care facilities for older people. In Ontario, 68 per cent of deaths were among people 80 and over. About 55 per cent of total deaths were among residents of long-term care homes, according to provincial data. That number goes up significantly when residents of retirement homes are included.

Many of those long-term care residents died without having been transferred to hospital, even in cases where the family requested it.

The request for a human rights inquiry focuses on a number of systemic issues in health care for the elderly — cuts to the number of hospital beds in the province and the failure to provide adequate care to the elderly in hospital or elsewhere.

“Long-term care is really the tip of the iceberg in terms of systemic discrimination against the elderly in health care,” said Adriel Weaver, an association with Goldblatt Partners, which drafted the letter sent by the groups to the commission.

“Long-term care is in crisis right now, but the underfunding of long-term care is only one aspect of the denial of equitable care to the elderly.”

A human rights commission inquiry — similar to the ongoing Right to Read inquiry that is looking into human rights issues affecting students with learning disabilities —  would take a broader look at health care and the elderly, said Weaver.

“This would ensure all aspects of the health system are looked at. It would also ensure that it is not dealt with solely in crisis mode. What we are seeing now is the product of decades of policy choices. Unless this is addressed in a much more systemic way, it will persist. We are seeing the acute effects, but there are also chronic effects,” said Weaver.

Among other things, the document sent to the human rights commission cites the reduction of complex continuing care (also known as chronic care) beds. Between 1990 and 2014, in a period during which Ontario’s population grew by 32 per cent and the proportion of the population that was elderly increased, more than 6,100 complex continuing care beds were closed down in the province. Ontario has the fewest hospital beds per capita of any province in the country and ranks third last in hospital beds among OECD countries.

As a result, significant numbers of patients were designated by hospitals as needing “alternate levels of care” — meaning they didn’t need to be in an acute hospital bed.

But adequate care was not made available to that large and ever increasing cohort, the advocacy groups argue.

At the same time, long-term care was significantly underfunded.

The impact of “de-hospitalization” was seen during the pandemic when significantly fewer elderly COVID-19 cases from long-term care homes were treated in hospital than people of the same age living in the community, even when there was evidence most homes were unable to cope with caring for sick residents and keeping others safe and cared for.

A report from the Canadian military, which was called into several hard-hit homes in the Toronto area, described shocking scenes of residents left unfed and untended in understaffed, overwhelmed homes.

The organizations argue Ontario’s long-standing de-hospitalization policy has resulted in significant harms to seniors, most recently, during the pandemic.

In their letter to the human rights commission, the organizations argue the long-term care commission and other inquiries into long-term care don’t go far enough to address the systemic discrimination against the elderly in health care.

“While we agree that changes to the long-term and home care systems are urgently required, it is equally essential to critically examine the forces that drive vulnerable patients out of hospital and into those systems.”

Jane Meadus, a lawyer with the Advocacy Centre for the Elderly, said such an inquiry is badly needed.

“We want to ensure that people of any age and specifically the elderly are getting the health care they are entitled to that we pride ourselves on in Canada that is supposed to be provided equitably. We want them to get appropriate care that is funded properly so they are not seen as second-class citizens when it comes to our health system.”

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