Long-term care reform must be about more than saving elderly from the next virus | #healthcare | #elderly | #seniors
A new report on the Ontario government’s “pandemic readiness and response” in long-term care has highlighted a series of things we already knew.
The province did not protect long-term-care homes from COVID-19. The homes were understaffed and overcrowded. They lacked proper infection control measures and expertise.
Even now — after 14 months of pandemic experience and nearly 4,000 deaths in these homes — residents remain “at risk,” according to Auditor General Bonnie Lysyk’s report, made public on Wednesday.
To sum up its 107 pages: the government was not ready and it did not respond well. It left Ontario’s oldest and most vulnerable to die in these homes to protect hospital capacity for everyone else.
Another report to be released on Friday by Ontario’s long-term care commission will, no doubt, cover much of the same ground. As have the many reports that have come before.
Every time there’s a crisis in long-term care, systemic failures are exposed and the calls to do better ramp up.
So much of these reports focuses on the need for government to ensure residents don’t die in tragic and needless ways that it’s easy to lose sight of the purpose of long-term-care homes.
These are homes, not institutions. They should be places where elderly people can get the help they need to really live their final years, not places to be warehoused while waiting for what’s considered an acceptable death.
That’s why seniors’ advocates have some concerns when the auditor’s report calls for “formal partnership agreements between long-term-care homes, local hospitals and public health units.”
And when the government responds, as it did, that it will “explore opportunities to formalize” such partnerships.
A less siloed and more integrated health-care system would be a good thing all the time, and especially in a pandemic. Ultimately, though, it’s the long-term care sector that needs to get better at caring for the people in their homes. That can’t be fobbed off by having formal connections with hospitals.
And the improvements need to be done in ways that recognize these are homes rather than institutions.
“We do not want long-term care turned into hospital care,” says a seniors’ advocacy organization.
As a geriatrics doctor put it: reform shouldn’t be done in a way that “over-medicalizes or regulates a sector that needs to be supported to deliver better resident and family-centred care.”
Fixing long-term care is decades overdue. But seniors’ advocates have good reason to be concerned at where some of the calls for change may lead.
Provincial governments have a habit of landing on more rules and tighter structures as a fix for complex problems. It seems cheaper and quicker than the real and lasting solutions of more staff, with better training, working in smaller and better-run homes.
The instinctive lurch by government to pile on new rules and requirements so it will be seen to be taking decisive action can make things worse, not better.
If staff don’t have time to properly care for residents now, which they certainly don’t in Ontario, requiring them to tick off yet more boxes doesn’t help a bit.
If Premier Doug Ford really wants to “correct decades of neglect,” as he has promised, that doesn’t just mean protecting residents from the next virus.
It means defining “care” as more than providing the very basics of life — food, shelter and clothing. It means less institutional spaces that warehouse people and more comforting homes, along with the proper programming and staffing levels to help people live full lives, however long they may be.
There will be many recommendations as a result of the pandemic tragedies. Those that contribute to making these homes, where life is worth living, is where true progress lies.