generalspeaking

The COVID Pandemic "Shock Wave"

"Those lives lost unnecessarily had value. Those older adults deserved a good closing phase of their lives and a good death. We failed them."
"[Causes of the failure are complex, but rooted in] systemic and deeply institutionalized implicit attitudes about age and gender."
"[Those unregulated workers] receive the lowest wages in the health-care sector, are given variable and minimal formal training in [long-term care], and are rarely part of decision-making about care for residents."
"We have a duty to care and to fix this -- not just to fix the current communicable disease crisis, but to fix the sector that enable that crisis to wreak such avoidable and tragic havoc."
"[Provinces must] immediately implement appropriate pay and benefits, including sick leave, for the large and critical unregulated workforce of direct-care aides and personal support workers [and offer them ongoing training and mental health support]."
Royal Society of Canada report

The report chaired by University of Alberta 's Dr.Carole Estabrooks representing the working group created by the Royal Society COVID-19 task force, comprised of scientists and researchers, concluded that the causes of the failure to protect Canada's most vulnerable, the elderly and health-compromised housed in long-term care institutions, is a damning one, both for the disinterest of the federal government to institute badly needed national guidelines and for the provincial oversight bodies that failed their due diligence in ensuring that best practices reigned at these homes for the elderly.

The pandemic, they emphasize, represented a "shock wave" that had the effect of exposing long-standing deficits in the system, causing high levels of "physical, mental and emotional suffering" for seniors who were  highly dependent and whose plight failed to provoke the interest of authorities until it was too late. An astonishing 81 percent of COVID-19-responsible deaths in Canada occurred in long-term care homes. A rate far in excess of those occurring elsewhere in comparable countries.

In the United States, with its much-higher overall case load and death rate, a much-reduced 31 percent figure relating to deaths in long-term care homes places Canada's figure in stark perspective. Australia suffered a 28 percent death rate in their homes, while Spain, one of the countries of Europe hardest hit by the SARS-CoV-2 virus had a 66 percent rate. Canadian homes, pointed out the report's authors, permitted staff-to-patient ratios to drop, shifting work and responsibility increasingly to an unregulated workplace.

Patients, the report points out, are living longer with diseases requiring increasingly complex care, particularly those patients suffering from dementia. Many of these overworked staff members suffering from high rates of burnout, cope as best they can in the absence of an appropriate representation of registered nurses, where many residents lack access to comprehensive care; medical, health and social services along with therapies to match the needs of patients.

The complaints and wishes of long-term care residents are ignored by authorities, as well as the needs of those  who are tasked with their care. In most instances, both groups are represented overwhelmingly by women. Along with the fact that when family members are called upon increasingly to fill gaps in the system, it is women who respond. Conditions in many of the long-term care homes were such that already-ill patients living in crowded conditions, sharing bedrooms and bathrooms, left them more susceptible to the novel coronavirus.


Canadian long-term care homes tend to be of an older vintage, badly in need of upgrading, with an emphasis on separating residents from close proximity both to protect their health and their dignity. the fact that basic infection controls and personal protective equipment were in short supply and many home workers found employment in multiple facilities to make up a living wage, increased opportunities of virus contagion.

Recommendations for improvement include that the federal government collect data on resident quality of life, the standard of care and worker satisfaction, ensuring such data be analyzed to effect change where needed. Disparities caused by ethnicity, gender, poverty and associated vulnerabilities should all be taken into account. Full-time employment should be offered to unregulated staff and policies preventing employees from multiple home employment must be put in place.

Sick leave, along with appropriate pay rates and benefits must be overseen by provinces on behalf of the unregulated workers and direct-care aides along with personal support workers, offering them opportunities for ongoing training and mental health support. It's long past time for both the federal and provincial governments to commit themselves to ensuring that long-term care residents and those who care for them live and work in conditions favouring overall experiences of quality care and security.

A resident and a worker watch as 150 nursing union members show support at rchard Villa Long-Term Care in Pickering, Ontario on Monday June 1, 2020. (THE CANADIAN PRESS/Frank Gunn)