LEVY: Ontario’s long-term care homes an accident waiting to happen
Posted: April 19, 2020
(April 18, 2020)
By: Sue-Ann Levy, Ottawa Sun
As they are forced to play a waiting game isolated from their loved ones, children with elderly parents in Ontario long-term care homes ravaged by a COVID-19 outbreak have vacillated from helplessness and guilt to worry and fear.
They feel guilty they can’t bring their parents home because they have dementia or too many physical needs.
They live in fear the next call or email could be about their own parents — and rightly so.
As of Saturday, 233 long-term care residents had died from COVID-19 and a further 1,322 had tested positive for the virus. There were also 637 confirmed cases among LTC staff.
Experts and advocates for seniors say this was an accident waiting to happen and, tragically, it took the deaths of hundreds of frail seniors to make the Ontario government, health care providers and even the media pay attention.
Natalie Mehra, executive director of the Ontario Health Coalition, said they’ve been pushing for 20 years for improvements in long-term care homes but many are owned by big chains that have had a “disproportionate influence” on successive governments.
The last big expansion of the sector was under the Mike Harris government, she said.
Two years ago, Mehra started getting calls about the shortage of personal support workers.
PSWs were leaving the LTC sector because the needs of the cases in there had increased so much — homes were housing people with a number of aggressive behaviours who often needed to be lifted in addition to their medical conditions, she said.
“It wasn’t worth it to do it anymore,” Mehra said, noting many have felt abused in addition to being poorly paid (most PSWs make from $17-22/hr).
Donna Duncan, chief executive officer of the Ontario Long Term Care Association, which represents 70% of Ontario’s 630 long-term care homes, said even people in the health care sector don’t really know what long-term care is.
“There are those who still think of long-term care as that of the 1980s when they (homes) had lots of tea parties and went on day trips,” she said.
Mehra said by the time the 36,000 on the wait list get a bed, or a room, they are even “more frail,” with 86% needing full care.
“There’s a stigma around it (long-term care homes),” she said.
The OLTCA 2020 budget submission called it a “perfect storm.” That submission talked about 80% of LTCs having trouble filling shifts, new beds not getting built fast enough and the aging demographic — namely that over the next 20 years there will be twice as many seniors over 75.
Mehra said the OHC held two protests in 2018 and 2019 on the front lawn of Queen’s Park, the latter one attended by 8,000 people, to draw attention to the plight of PSWs and staff shortages in long-term care.
They were ignored.
“The issue didn’t get onto the radar until this happened,” Mehra said. “It’s terrible … it’s just hideous.”
“A lot of people who care deeply are in this sector,” she added.
Marissa Lennox, chief policy officer with the Canadian Association of Retired Persons (CARP), said it was “absolutely” an accident waiting to happen and she blames the lack of response, in part, on the assumption that these vulnerable individuals are already “knocking on death’s door.”
She said while many hospitals were prepared due to lessons learned from SARs and other epidemics, it feels like long-term care was an “afterthought.”
Lennox said a “glaring hole” in all of this is that LTCs are not “effectively designed” to isolate those who are affected from those who are not because of a lack of “flexible space.”
“If you’re not properly testing people and not equipping staff with proper PPEs, it’s a nightmare,” she said.
The measures the Ontario government has put in place — such as ensuring a PSW only works in one LTC home — are more than a month too late, she added.
Duncan feels those standing in front of the media still have a lot to learn about the long-term care sector.
Everyone is an armchair critic when what they really need is staff and more personal protective equipment, she said.
“I hope this is the last time we ever see this kind of crisis again, but my fear is that we will revert back to the status quo,” Lennox said. “There was a crisis in long-term care before the pandemic hit.”