Canada’s long-term care system failed seniors before and during COVID-19: report

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MONTREAL – Canada has failed to protect vulnerable seniors in long-term care, according to a very critical report examining the issue in light of the COVID-19 crisis. The report released on Friday by the Royal Society of Canada found that the pandemic was a “shock wave” that exposed many long-standing system failures and caused high levels of “physical, mental and emotional suffering” for children. the elderly.

“These unnecessarily lost lives had value,” reads the report of a task force chaired by Dr. Carole Estabrooks of the University of Alberta.

“These elderly people deserved a good phase of closing their lives and a good death. We failed them. ”

The task force, which was created by the Royal Society’s COVID-19 task force of scientists and researchers, said that the causes of the failure are complex but that they are rooted in what they have called “implicit systemic and deeply institutionalized attitudes regarding age and gender”.

It found that 81% of deaths from COVID-19 in Canada occurred in long-term care homes, far more than what is reported in comparable countries, including 31% in the United States, 28% in Australia and 66%. cent in Spain.

Authors say Canadian homes have allowed staff / patient ratios to drop and have increasingly moved to an unregulated workforce in recent years, even though patients are living longer with illnesses that require increasingly complex care, such as dementia.

“(These unregulated workers) receive the lowest wages in the health care sector, receive minimal and variable formal training in (long term care) and are rarely part of decision making regarding resident care” , says the report, which notes that many of these workers report being overworked and suffering from high burnout rates.

On the other hand, the proportion of registered nurses has decreased and many residents do not have access to comprehensive care, including medical and social services and therapy, even though the needs are greater than before.

The report notes that authorities have not listened to the voices of residents of long-term care facilities and those caring for them – the two groups are predominantly female. Women are also more likely to be unpaid caregivers who are increasingly called upon to fill gaps in the system, the authors said.

Long-term care homes were particularly vulnerable to COVID-19, associating an already sick patient base with a new disease to which no one has immunity, the report said. Homes in Canada are often older and have shared bedrooms and bathrooms, which made it difficult to contain COVID-19.

However, the report also notes that basic infection controls and personal protective equipment were often lacking and that many workers worked in multiple establishments, increasing the risk of spreading the virus.

“We have a duty to take care of and resolve this problem – not only to resolve the current communicable disease crisis, but also to repair the sector that allowed this crisis to cause preventable and tragic devastation,” the authors wrote. .

The report makes nine recommendations that he says are aimed at addressing a labor crisis that leaves housing understaffed and employees underpaid and overworked.

The authors asked Ottawa to develop national federal staffing and training standards and to make provincial funding conditional on their compliance.

The federal government should also ensure that data is collected on residents’ quality of life, standards of care and worker satisfaction and that it is analyzed by a third party, the report said. These data should also take into account disparities caused by race, ethnicity, gender identity, poverty and other vulnerabilities.

Provinces must “immediately implement appropriate compensation and benefits, including sick leave, for the large and critical unregulated workforce of direct care aides and personal support workers” and provide them with continuing education and mental health support, according to the report’s authors.

Unregulated staff should be offered full-time work, and provinces should assess single workplace policies that prevent employees from moving from site to site, the report concludes.

This Canadian Press report was first published on July 3, 2020

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