Hamilton Council on Aging endorses a vision that includes more supply and funding
(As printed in the Hamilton Spectator, June 18, 2020)
Margaret Denton, Hamilton Council on Aging
The Hamilton Council on Aging (HCoA) would like to lend their voice to the advocates
who are calling for reform in the long-term care sector in Ontario. We are deeply
concerned about the care being provided to older adults in some long-term care homes.
Although much has been said about the poor conditions in long-term care, the shocking
number of incidence of COVID-19, and resulting deaths, in combination with the recent
military report about the horrific working and living conditions of staff and residents at
five long-term care homes in Ontario and the Westtlaufer nursing home murders has
catapulted the issue into the forefront.
This “broken” long-term care system is rooted in ageist attitudes and values toward
older adults as well as systemic problems in the way long-term care is organized and
funded in Ontario. First, the acuity level of older adults entering long-term care has
increased dramatically over the years. The average resident today is age 85 or older
and faces many challenges, including multiple chronic diseases and problems with
memory, mobility and incontinence. Home care in Ontario is limited in scope and
funding forcing many older adults, particularly those without care givers or those with
low incomes, to seek long-term care. There are many wonderful and caring people who
work in long-term care homes, but the problem is that there is just not enough of them.
The long-term care sector is underfunded in Canada. Canada spends on average, 30
per cent less of its gross domestic product on long-term care than other developed
countries. As a result, long-term care homes are understaffed, the workers are
underpaid and many of their jobs are part-time occasional. As a result, long-term care
homes have problems recruiting and retaining staff. Further 60% of long-term care
homes in Ontario are for-profit; where non-profit homes are able to apply any surpluses
to direct care for residents, for-profit homes must show a profit for owners and
shareholders to the detriment of the care provided. Most residents are housed in semi-
private rooms, with shared bathrooms, and some homes still have ward rooms with 4
residents to a room, making hygiene and infection control problematic. Long-term care
in Ontario is regulated by the Long-Term Care Homes Act, 2007. Under this Act, the
intention was that each of the 626 long-term care homes in Ontario would receive a full
Resident Quality Inspection but according to a CBC only half were done in 2018 and 9
were done in 2019. This cut in the number of inspections limits accountability and
transparency.
To his credit Premier Ford has announced his intention to establish a commission: to
examine the long-term care sector and make recommendations for reform. The Ontario
Ombudsmen and the Patient Ombudsmen are both doing investigations. Others call
for a formal independent public inquiry.
The Ottawa Council on Aging’s report “Long Term Care in Ottawa: We Need Change
Now”. (coaottawa.ca/committees/health/long-term-care-in-ottawa/) argues that long-term care should be “a place where residents live in a safe, home-like environment and are
treated with respect and dignity”. The Hamilton Council on Aging endorses this vision
for long-term care and agrees with their priorities for change in long-term care:
1. Provide more care: Fund more direct care staff-RN, RPN, PSW and other health
workers – in LTC with a regulated minimum number of care hours/resident
appropriate to the complexity of care needed.
2. Plan for beds. Ensure that enough LTC beds are available to meet current and
future needs and that all beds meet Ministry standard.
3. Pay attention to at-risk seniors. Monitor all barriers that reduce or delay access to
LTC and while seniors wait for care
4. Promote innovation and quality. Regulate and mange LTC in a manner that
promotes innovation and continuous quality improvement for residents and staff.
The Canadian Institute for Health Information provides an interactive report card of eight
indicators designed to measure the quality of care in long-term care homes in Canada.
The report card details several areas, including physical function, safety and quality of
life, where care needs to be addressed if we are to improve the quality of life of
residents. The report card shows that some homes do better than others on selected
indicators, but in every home there is room for improvement. Long-term care homes
may benefit by comparing their results to others and taking action in areas where they
fall behind. Persons seeking information to assist with choosing a long-term care home
may benefit by comparing and contrasting long-term care homes on their quality of care
indicators. The website may be visited at https://www.cihi.ca
Margaret Denton is the Vice President, Hamilton Council on Aging. For more
information or to make a donation please see www.coahamilton.ca