COVID-19 could change long-term care forever – at the site of Canada’s first outbreak, change is already underway

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VANCOUVER – It was not death that caused the upheaval – by working in long-term care, no matter where you are or whatever the circumstances, death is expected.

When the coronavirus hit the Lynn Valley Care Center in early March, the thing that changed everything was fear.

“When you walk around, fear in people’s eyes, I’ve never seen anything like it,” said Betty Willis, director of care at the center that was the site of Canada’s first coronavirus outbreak in care long-lived, and the country’s first coronavirus death.

Fear permeated the lives of staff in a way that is now familiar to those working on the front lines of the battle against coronaviruses, but at the time, before the virus killed thousands of Canadians and never changes life in the world, they draw a new frontier.

Willis plans an internal review of what happened during the epidemic, based on individual interviews with all workers. Similar examinations may well end up on the agenda in Canadian nursing homes as the industry grapples with the devastating consequences this virus may have taken in its ranks, from Bobcaygeon of Ontario to McKenzie Towne of Alberta to Northwood of Nova Scotia.

One thing Willis and the workers at Lynn Valley know: there is no going back to the old way of doing things.

When an epidemic was declared in Lynn Valley on March 6, workers began looking for temporary rentals to avoid contacting their families. Even though there is a bus stop near the door of the long-term care home, workers got off one stop earlier or one stop later to avoid what they saw as stigmatizing looks from frightened members of the public .

“The human suffering and the price you pay for the loss of human life is enormous,” said Willis. “We weren’t normal. We were in the eye of the storm. “

Now, after 102 infections and 20 deaths, the outbreak in Lynn Valley is officially over, and Willis and his staff have expired cautiously and collectively.

But the threat still hangs over nursing homes across the country, and many face the same challenges as Lynn Valley.

A worker is seen closing the curtains at the Lynn Valley Care Center in Vancouver in this file photo from March 25, 2020. After outbreaks in nursing homes across the country, seniors' advocates and politicians examine the area Canadian long-term care to an unprecedented degree.

Advocates and politicians are examining the long-term care sector to an unprecedented degree, as the vast majority of coronavirus deaths in Canada have taken place in nursing homes. Questions raised about funding models, housing configurations and staffing practices make it impossible for the industry to emerge unchanged on the other side of the pandemic.

Some of the issues raised – including low wages and sporadic caregiver schedules that lead them to multiple jobs in different nursing homes – have been industry hot spots in places like Ontario and British Columbia. long before COVID-19.

BEFORE CHRIST. Senior Counsel Isobel Mackenzie said that with the devastating and particularly devastating coronavirus epidemics in Ontario and Quebec, it is still too early to say with certainty what factors have contributed to more or worse epidemics.

But even before the coronavirus started spreading, Mackenzie was sounding the alarm about how the long-term care sector is pushing operators to cut labor costs – which she says leads to lower standards of care.

“When you think of areas where we can gain” efficiency “, these are the things that directly affect the experiences of residents,” she said. “Better staffing levels, more consistent staffing schedules – linked to compensation and benefits. It’s naive to think otherwise. “

Some nursing homes are saving costs by hiring internally at rates as low as $ 17 an hour. Others are outsourcing – which means they hire companies that employ caregivers to provide staff in their homes, which places degrees of separation between facilities management and their staff.

And in his surveys of long-term care residents, Mackenzie found that relationships with caregivers – who work 70% of the hours in nursing homes – are a top priority for residents.

In British Columbia, the world of work has long opposed the 2001 law that laid the groundwork for the outsourcing of caregiver positions, which they saw as an impetus for low wages, paid sick leave and the precarious nature of the industry.

A similar policy to open long-term care to privatization, promulgated by the Mike Harris government in Ontario, was noted in a previous interview by York University long-term care expert Pat Armstrong, as a likely cause of lower wages and staff. and increased use of casual workers.

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Mackenzie recommended in his February report that provincial funding for staffing long-term care facilities of all stripes be returned to the government if not used specifically for this purpose.

Lynn Valley faced its own challenges with fragmented staff during the epidemic.

The shock and fear that came with being in the “eye of the storm” made Willis wonder how his team members were doing – if they themselves had access to the types of emotional support they should provide to the elderly in their care. .

“With my training in intensive care, I could do well,” said Willis. “But we have fantastic nurses who just got out of school.”

It quickly became apparent to Willis that her biggest challenge as director of care during the epidemic was to make sure that the staff – nurses, caregivers and support workers – were physically and mentally good enough to do their jobs. .

The Lynn Valley Care Center is a private long-term care facility that outsources its nursing support staff, which means that Willis is not their employer, even though she manages the care team at the center. Getting to know each other’s needs took time, as did the team. Willis considered the two important factors to help deal with the crisis.

Mackenzie said contracting out of nursing care has been a long-standing industry problem and that it was greatly relieved by the Lynn Valley outbreak.

“I know it was a challenge in Lynn Valley. The day after the (declared) outbreak was declared, you had three different employers (at the table) – Who orders whom to do what? She talked about the meetings called by the public health authorities that she attended. “I think it would be easier if they employed everyone directly.”

Willis said she will use the report based on individual interviews with all of the workers to guide future changes in the establishment.

“We outsource all of our services – so my next thing is how to build a stronger team,” she said. “For Lynn Valley, it’s time not to relax, but to see what we can learn and share with others. “

She also tries to remember that long term care work is rooted in human relationships. In a pandemic, with a deadly virus spreading quickly, the possibility of connection can sometimes seem fleeting.

Willis remembered a moment after the outbreak began when the family of one of the victims gave him a painting by the resident before her death. This is how she discovered that the resident was a painter.

“I am convinced that we will not lose the human touch of our basic care,” she said.

With files from Star staff

Alex McKeen
Alex McKeen is a Vancouver reporter who covers transportation and manpower for the Star. Follow her on Twitter: @alex_mckeen

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