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‘Pleas from the elderly can no longer fall on deaf ears’ (UPDATED WITH SAH COMMENTS)

Posted: March 24, 2021

(March 22, 2021)

Natalie Mehra, Ontario Health Coalition executive director, says that in Sault Ste. Marie alone, wait times for long-term care homes range from 124 days to 2,088 days. JEFFREY OUGLER/POSTMEDIA

Natalie Mehra, Ontario Health Coalition executive director, says that in Sault Ste. Marie alone, wait times for long-term care homes range from 124 days to 2,088 days. JEFFREY OUGLER/POSTMEDIA

The Ontario Human Rights Commission is being asked to probe “years of systemic ageism” in Ontario’s health system.

The Ontario Health Coalition, Ontario Council of Hospital Unions (OCHU), the hospital division of the Canadian Union of Public Employees and the Advocacy Centre for the Elderly, say such a “landmark” public inquiry on “human rights discrimination” against the elderly in access to, and levels of, care in hospitals and long-term care is necessary following the death of nearly 4,000 nursing home residents from COVID-19 in Ontario in the last year.

However, this “crisis” long precedes COVID-19 and extends far beyond long-term care, said Graham Webb, a lawyer and executive director of the Advocacy Centre for the Elderly.

“Long-term care is just one component of this crisis. COVID-19 has shone a harsh light on Ontario health-care systemic discrimination in treatment of the elderly,” Webb told a Zoom press conference Monday morning, attended by the Sault Star.

Over the last three decades, as the population grew by 4.5 million and aged, Ontario governments have pursued the “most radical” hospital downsizing of any province in Canada, cutting 20,000 hospital beds, these groups argue. At the same time, the province rationed access to long-term care, resulting in a wait list of more than 38,000 mostly elderly Ontarians.

The acuity level of long-term care residents has risen “dramatically” over the years without a corresponding increase in funding for care, Webb said.

“Residents are now more medically frail and complex and a higher proportion than ever before, around 80 per cent, have some kind of cognitive impairment,” he said, adding the challenges of dealing with behavioural issues are compounded by a lack of staffing.

The result is residents being left in soiled diapers, not being taken to the washroom when they ask or they need to and being left in beds “for hours.”

“If this were a day care, and if these were children, these facilities would be shut down in a heartbeat,” Webb said. “Yet, for seniors, little is done to ensure positive change, giving us no wonder people fear long-term care.”

Advocacy Centre for the Elderly receives “a lot of “ calls from Sault Ste. Marie and Algoma District families regarding elderly relatives being, what they believe is, inappropriately discharged from hospital, as well as long-term care concerns.

“The list never ends,” he said. “Thankfully, (the Sault and Algoma) have been spared the worst of COVID-19, but it has not been spared the worst of discrimination for health care against older adults in Ontario.”

In Sault Ste. Marie alone, wait times for long-term care homes range from 124 days to 2,088 days (5.7 years) and an average of 16 people move into long-term each month, says Ontario Health Coalition. There were, as of February, 349 people on the wait-list.

Sault Area Hospital, says OHC director Natalie Mehra, routinely runs at more than 100 per cent capacity. Patients are “crowded” into emergency rooms, creating “enormous pressure” for the elderly to be transferred out to wherever space can be found, “even to inappropriate or unsafe places,” she said.

“These pleas from the elderly can no longer fall on deaf ears,” Mehra said.

Sault Area Hospital says it works on an ongoing basis with its community health-care partners to “ensure” it is able to care for patients in the “most appropriate spaces,” either in hospital or in the community, depending on the needs of the patient.

“We have been incredibly diligent in this work over the past year to ensure the hospital is in readiness to manage a surge in COVID-19 cases while we are continuing to care for patients safely,” SAH manager of communications Brandy Sharp Young told he Sault Star.

Since Labour Day, SAH’s occupancy has been 90 per cent.

At any time, in recent years, greater than 60 per cent of SAH’s inpatients are over the age of 65.

“Supporting older adults to live in the best place possible is a commitment from SAH to our patients and their families,” Sharp Young said, adding SAH collaborates with its patients and community partners to ensure that patients are in the “most appropriate” place for care and “we work together to transition patients when suitable.”

“This work remains a strategic priority for our hospital,” she said.

Mehra urges residents here to send long-term care concerns to the province as well as lobby the Ontario Human Rights Commission to conduct the probe.

“There is responsibility to be seen at the facility level, no question,” Mehra said. “But there is also a systemic ageism in our system that treats the elderly as if their lives are less meaningful and as though their right to care is somehow lesser than others. And that must be challenged, particularly in the face of the horrors we’ve seen over the last year.”

In Ontario, only a small percentage of long-term care residents with COVID-19 were hospitalized prior to their deaths, OHC said, citing a recent study that found only 22.4 per cent LTC residents, who died with COVID-19, were hospitalized. This compares to 81.4 per cent people who lived in the community.

“While individual care needs, no doubt, precluded hospitalization for some, there is no escaping the horrible truth that thousands of long-term care residents were left to die, many of them with woefully inadequate care and many without family until the very end, if even then,” Mehra told the news conference.

Adriel Weaver, a lawyer with Goldblatt Partners, said it is “very strongly” in the public interest that an inquiry be convened, the sooner the better.

“The COVID-19 crisis has made it all too apparent the existing inequity in access to health care for elderly Ontarians,” Weaver told the news conference. “In particular, it’s brought much-needed public attention to the deeply disturbing conditions within long-term care facilities, which Ontario seniors have endured for far too long.”

Weaver said that although Ontario’s Long-Term Care COVID-19 Commission is underway — which, she said, is doing “vital work” — immediate answers to a more “narrow set of questions” are needed now.

“The factors that underlie the deplorable conditions within some long-term care facilities cannot be meaningfully resolved without naming and addressing systemic age-based discrimination in the provision of health care in the province,” Weaver said.

In Ontario, more than 2,200 mostly elderly people deemed alternate level of care (ALC) patients “often derisively referred to as bed blockers,” were offloaded from hospitals into makeshift sites, says Michael Hurley, Ontario Council of Hospital Unions (OCHU/CUPE) president.

These patients, Hurley said, who may have multiple complex chronic medical conditions, are moved to non-hospital sites and, in some cases, hotels, where staffing levels and care are lower.

But elderly patients in Ontario were denied health-care access “long before the pandemic,” Hurley said.

“They were often lied to about services to which they (were) entitled, and taken advantage of at moments of extreme vulnerability,” he told the press conference.

“(Such discrimination) shortens the lifespans of many productive and happy and beloved members of our society.”

Over the last three decades, as the population grew by 4.5 million and aged, Ontario governments have pursued the most “radical” hospital downsizing of any province in Canada, cutting 20,000 hospital beds, the groups say. At the same time, the province rationed access to long-term care, resulting in a wait-list of more than 38,000 mostly elderly Ontarians.

Weaver said it’s not as if the government is passing laws that target the elderly or “overtly” state the lives and well-being of seniors are less worthy.

“But it is comprehensively crafting policy that has a disproportionate, negative impact on elderly Ontarians,” she said. “The policies, in concert, are working in such a way that the elderly bear the brunt of the cuts to hospital care and long-term care.”

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