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Ontario is moving to four hours of hands-on care daily for nursing-home residents by 2025

Posted: November 3, 2020

(November 2, 2020)

By: Rob Ferguson, Queen’s Park Bureau

It has taken 10 years of pressure and more than 2,000 COVID-19 deaths, but Ontario is promising to give nursing home residents an average four hours of daily hands-on care.

Premier Doug Ford made the pledge Monday, warning it will take four years to reach that level because “thousands and thousands” of nurses, personal support workers and others will need to be hired and trained.

“Four hours a day will make a world of difference,” Ford told a news conference, noting the current average is 2.75 hours per day and boasting Ontario is the first province to make the commitment.

“This is the gold standard,” he said.

Critics urged a faster pace, given the staffing crisis in long-term care homes that led to horrific conditions in some, as outlined in a report from the Canadian Armed Forces last spring after military medical teams were deployed to the facilities hardest-hit by the pandemic.

Staff levels in some homes fell as low as 20 per cent because so many workers were sick or absent for fear of catching COVID-19, which to date has infected almost 2,900 employees and more than 6,900 residents.

“The timeline … is so long that it is meaningless for the people who are suffering and dying in long-term care now,” said Natalie Mehra of the Ontario Health Coalition.

The latest government figures released Monday showed 502 nursing home residents and 318 staff have active cases of COVID-19, increases of 22 and 13 respectively from the previous day.

Almost 100 long-term-care residents have died since mid-August, increasing the death toll to 2,016 of the 3,152 Ontarians who have perished from the virus.

Ford’s promise comes just over a week after his government’s commission into the devastating impact of COVID-19 in nursing homes echoed the four-hour recommendation made previously by seniors’ advocates, health groups, the New Democrats and the Green party.

“They’ve been dragged kicking and screaming, even by their own commission,” said NDP Leader Andrea Horwath.

“If it’s a priority … then it can happen quicker than four to five years down the road.”

Green Leader Mike Schreiner said the government should have taken this step over the summer to get more help for the 100,000 people working in Ontario’s 626 long-term-care homes.

The seniors’ group AdvantAge Ontario hailed the pledge as “a bold step on a big issue” given the increasingly higher care needs of nursing home residents, 80 per cent of whom have cognitive impairments.

“They’re much more frail and sicker than they used to be,” said chief executive Lisa Levin.

“This is the one thing to improve quality of life for residents and to help staff because they’re so burned out right now.”

While it’s been estimated the measure would cost $1.6 billion a year, more details will come in the provincial budget to be presented Thursday by Finance Minister Rod Phillips and in a staffing strategy coming in December from Long-Term Care Minister Merrilee Fullerton.

She said there will be targets set in the strategy so that progress can be tracked. A staffing report to the government released in July pointed to problems with high turnover rates of personal support workers in nursing homes, with low wages part of the problem, and said hiring needed to be bolstered immediately in time for the second wave of COVID-19 this fall.

“We recognize that recruiting large numbers of workers is a challenge,” said Candace Rennick, a secretary-treasurer of the Canadian Union of Public Employees (CUPE), which represents 35,000 nursing home workers.

“But there has to be a greater sense of urgency in meeting a basic standard of care.”

Donna Duncan of the Ontario Long-Term Care Association applauded the move and highlighted that the staffing crisis remains a problem with winter coming and COVID-19 infections increasing in nursing homes.

“It will take all of us to make this a reality,” she added in reference to the four-hour standard.

Levin said “there’s no one quick fix” to get more workers and recommended the government have COVID-19 teams ready to move quickly into nursing homes that lose too many staff in outbreaks.

In the longer term, measures could include on-the-job training for care aides and personal support workers, and training laid-off workers from restaurants and hotels to work in nursing home kitchens, in meal delivery to residents, doing laundry and helping with cleaning.

Caregiver advocate Vivian Stamatopoulos and Rennick of CUPE said the four hours of daily care needs to be legislated so it cannot be eroded at “the stroke of a pen” in government regulations.

Stamatopoulous added the 10-year delay in a commitment for four hours of care means the standard is already becoming outdated, meaning the next step would be for the average to increase beyond five hours of care.

“Show me the plan,” she said.

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