Senior care homes, COVID-19: death and working conditions

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jerrym
Senior care homes, COVID-19: death and working conditions

Canadian governments are discovering after treating senior care homes as separate from the health care system, allowing minimal staffing, little or no Personal Protective Equipement (PPE), poor wages and benefits that often force workers to be employed in more than one place and thereby assisting in the spread of disease, and little to no government checkup of homes, the terrible toll this has taken on people who live and work there, with almost half the deaths from COVID-19 in Canada occurring in these homes. Belatedly a few measures are being taken to begin to address these problems. 

As Canadians continue to adhere to public health guidelines for COVID-19, one aspect of our country’s response to this crisis has been devastatingly inadequate. Across Canada, many intensive care unit spaces sit empty, while residents of long-term care homes are dying in their beds – sometimes abandoned, filthy with excrement and alone.

Our hospitals are ready. Doctors and nurses have been properly trained and are waiting to be called in for COVID-19 duty. Personal protective equipment is available, and, if not, it’s on its way.

Meanwhile, caregivers in many long-term care homes are underpaid, lack training and don’t have PPE. How could this have happened when we knew from day one that long-term care homes would be centres of COVID-19 infection? How could we have failed our care-home residents so badly? There are hundreds of these facilities dealing with outbreaks across Canada.

When Quebec Premier François Legault referred to negligence in describing the devastation at Montreal’s Résidence Herron, where 31 seniors have died, his words should have caused a serious moment of self-reflection for all politicians and government officials across Canada. The potential for devastation in hundreds of long-term care homes across Canada is a national shame.

That seniors are vulnerable to COVID-19 and that long-term care homes are vulnerable to infection is not part of the emerging science of this virus. It is not unique to COVID-19. We have known that seniors in long-term care homes are vulnerable to infection for years. So how can we have failed so miserably to prepare these homes to protect their residents during this pandemic? What has emerged from the horrors of Résidence Herron, Pinecrest Nursing Home in Bobcaygeon, Ont., and McKenzie Towne Long Term Care Home in Calgary is the stark picture of a lack of protocols, preparedness and resources. ...

We have the chance to do things better. There is still a patchwork of advice and guidance across Canada for long-term care homes. Some provinces are ahead of others and best practices exist, but we need all jurisdictions to move quickly to catch up. We have the knowledge, funding and equipment to bolster infection control in long-term care homes and we need to support them fully. Visitors should not be allowed, unless under extreme circumstances. Masks should be worn by staff at all times when working with residents. Staff in care homes need PPE as much as nurses and doctors in hospitals – they, too, are on the front lines with sick and dying patients. All staff and long-term care-home residents should be tested for COVID-19 – even those without symptoms – in order for isolation protocols to work quickly and more effectively. Care-home staff should be banned from working in more than one facility to limit the exposure of infection between homes. Care-home staff are underpaid and many are casual. We must step up and ensure funding is available to hire more full-time staff if needed. ...

Care homes need clear guidance and hands-on support from health authorities when an outbreak occurs. They cannot be left to manage on their own. Whether they are privately or publicly funded homes, they must be seen as part of our health care system during this pandemic.

Sadly, we have already lost too many residents in care homes to COVID-19 because of a lack of preparedness and focus.

https://www.theglobeandmail.com/opinion/article-seniors-care-home-neglec...

 

jerrym

Basically this can be summed with "There is a failure of leadership at every level of government." that resulted in a patchwork system that is so weak it would never occur in the mainstream healthcare system because voters would toss such a government out of office. 

The surge in COVID-19 illnesses and deaths within Canada's long-term care facilities has left politicians scrambling to react and experts wondering why no one listened to their warnings. 

According to data collected by the federal government, close to half of all COVID-19 deaths — a toll that stood at 832 as of Monday — have occurred in nursing homes.  ...

In Ontario, where 114 long-term care facilities are now dealing with COVID-19 outbreaks, with three of the homes having reported more than 20 deaths each, Premier Doug Ford likened the situation to a "wildfire," promising to dispatch hospital-based teams to tackle the problem.  ...

While in Quebec, where the province is calling the situation in 41 long-term care homes "critical," and 1,250 staff are off work due to illness or potential exposure to the virus, Premier François Legault issued a desperate plea to health care workers. 

"I'm asking everybody available to come forward and help us," he said. "I appeal to your sense of duty to help us protect the most vulnerable."

But those calls to action are being greeted with skepticism by some experts and advocates who say that the country's seniors' residences were obvious COVID-19 danger zones and should have been better protected.

"This wasn't just foreseeable, it was foreseen. We saw it coming in Italy. We saw it coming in Spain, let alone what was happening in Asia. And we knew that people in long-term facilities would be left without the care they need," says Laura Tamblyn Watts, the CEO of CanAge, a national seniors' advocacy organization. 

"There is a failure of leadership at every level of government."

Dr. Nathan Stall, a Toronto geriatrician and fellow at Women's College Research Institute, says the current crisis is revealing all the weaknesses of a senior care system that has suffered from decades of neglect. 

"This is not new," he told CBC News. "It's just taken a global pandemic to unearth the problems that affect almost every aspect of the sector."  ...

One such shortcoming, Stall said, is dated facility designs, where residents often share rooms or are packed into common areas, thereby increasing the probability of virus transmission. Another is the low pay and scant benefits offered to workers.

"There are chronic under-staffing issues," he said. "Many of them work part-time and don't have paid sick leave. And that necessitates them to work at multiple facilities, which contributes to the spread." ...

Governments in British Columbia and Newfoundland and Labrador have already told staff that they can only work at one facility during the crisis. On Tuesday, Ontario announced that it intends to enact a similar emergency rule.

Over the long weekend, the federal government unveiled a slew of new guidelines for long-term care facilities, including enhanced cleaning, mandatory medical screening for staff and physical distancing at meal times. But even that is unlikely to halt the rapid spread of the novel coronavirus, says Dr. Samir Sinha, director of geriatrics at Toronto's Sinai Health and chief researcher at the National Institute on Ageing.  ...

Sinha says the coronavirus outbreak seems to be exposing "unique systemic vulnerabilities" within Canada's long-term care system — an underfunded patchwork of public and private homes, all governed by rules and regulations that differ from province to province.

Testing for the virus among residents and staff remains sporadic, while long-term care workers have limited access to personal protection equipment (PPE), and less training on how to properly use it, he notes. ...

Tamblyn Watts rattles off a list of specific measures that Canadian governments need to immediately take to confront the current crisis and its underlying causes: a vast expansion of testing, more PPE and, above all, a co-ordinated and fully funded national strategy for long-term care.

"The time was about a month ago, but every day matters," she said. "These are not numbers. These are people who are being neglected, people who are dying. They have names. They have families. And so everything that we do matters."

https://www.cbc.ca/news/covid-care-homes-warnings-1.5532312

jerrym

In Ontario the Ford government has had long-term care home owners pushing it to eliminate annual inspections of these homes. CBC National reported tonight that many such Ontario homes have not been inspected since 2017 0r 2018, basically since Ford has been elected. 

Ontario’s long-term care homes are pressing the Ontario government to get rid of mandatory annual inspections as part of its focus on cutting red tape.

Groups that represent the province’s long-term care homes have long asked for an end to annual inspections for all long-term care homes and reducing regulations that they say place an undue burden on an already stressed sector. The head of one of two major organizations says she is optimistic the province is listening to those concerns. ...

It is a possibility that worries Jane Meadus, staff lawyer and the institutional advocate with the Advocacy Centre for the Elderly. Regulations covering long-term care homes are there for a reason — in some cases because of previous harm done to residents — said Meadus.

“Inspecting long term care homes that provide care to vulnerable seniors is not red tape. It is something that is necessary.”

https://ottawacitizen.com/news/local-news/long-term-care-homes-want-end-...

NDPP

Ever since I was a child I knew  that Canada's 'old folks homes' were places the unwanted elderly were sent to die. And it usually worked.  Nothing has changed apparently. Only made obvious.

jerrym

Belatedly, the NDP BC government has begun to address some of the structural issues that have led to such tragic deaths, by taking over as the employer of all long-term careworkers, raising their wages and benefits, making them full-time workers who are employed by only one facility to minimize disease spread. 

The Trudeau government has also belatedly said that at long term care homes it will "help provinces increase worker pay to keep the battle lines well staffed." (https://nationalpost.com/news/politics/covid-19-crisis-trudeau-says-gove...)

The Trudeau government was forced to do this because, sadly, many of the long-term care workers could get more money  because "The government’s emergency benefit program, which pays $2,000 per month to people who have lost their income because of COVID-19 was potentially more attractive to some long-term care home workers, because it provided similar or more money than they can make at the facilities."

The B.C. government is taking over as the employer of all long-term care workers in the province in response to the COVID-19 threat in seniors’ homes.

Provincial health officer Dr. Bonnie Henry said this week that every worker would be hired full-time and paid standardized wages for the next six months.

On Thursday Henry barred employees from working at more than one facility, citing the risk of spreading the virus.

“As we know, many of them work not only across facilities but in acute care and long-term care,” said Henry, noting this was out of financial necessity. ...

“The bottom line is, everyone will be employed by the ministry at a specific rate so they will not be penalized.”

COVID-19 has already been identified in 19 long-term care facilities and resulted in 24 deaths in the province.

All workers will be paid the same wages as those in collective agreements with public health authority-run facilities represented by the Health Employers Association of B.C., health spokesperson Alex Peaker said in an email Wednesday.

This move will result in raises for thousands of workers. The contract for unionized care workers in the public sector sets a starting wage of $24.83 for care workers, nearly $7 an hour more than starting pay in many private and subcontracted care facilities.

The wage disparities are a result of almost two decades of erosion of worker protections and bargaining due to measures introduced by the former BC Liberal government.

Jennifer Whiteside, secretary-business manager at the Hospital Employees’ Union, said the changes should bring permanent reform to a broken system.

Low wages paid by private operators have resulted in staff shortages and forced employees to work in more than one location to earn a living, she said. ...

Whiteside, whose union represents 50,000 health-care workers in B.C., said the government won’t be able to return to the old system.

“How are you going to knock a wage back $5 six months from now? I can’t see how there is any going back.”

In B.C., about one-third of long-term care is delivered by health authorities and two-thirds by contracted private and non-profit care providers. The HEU represents the largest number of unionized workers in the sector, and 20,000 who work directly with seniors. ...

Whiteside said improving conditions for workers would improve care for seniors.

“Advocating for good working conditions and for decent work in this sector, that is also very much about advocating for good quality care,” she said, noting that working multiple low-paying jobs makes it harder for workers to perform at top level. ...

Whiteside said the task of implementing a centralized staffing and payment strategy is bringing to light the “fracturing of labour standards across long-term care.” ...

“Twenty years ago, a health-care worker, was a health-care worker, was a health-care worker,” she said. “We are very quickly going to return to that world, in a very unexpected way.”

https://thetyee.ca/News/2020/04/01/Long-Term-Care-Worker-Pay-Boosted/

 

jerrym

Quebec has been the hardest hit province both in terms of total COVID-19 cases and its problems in longterm care homes. The factors leading to the long term care home resident crisis were laregly predictable. 

It is interesting that Quebec has three times as many private long term care residents (18.4% ) as the Canadian average of 6.1%. The Maison Herron private long-term care facility in Dorval, whose owners are under criminal investigation over the death of 31 residents, had a bitter strike by workers for higher pay last year. In CBC National interview, the family of one of the deceased seniors said the failure to increase the home's low pay left many health care attendants in the home feeling little sense of loyalty to the employer, thereby contributing to their willingness to stop working as the risks to their own health grew. 

It should have been clear long before COVID-19 that the issues in the province’s long-term care homes would leave them poorly equipped to handle a pandemic.

“We already knew there was a lack of personnel, the salary wasn’t attractive, a heavy workload, a lack of manpower,” Philippe Voyer, a professor and researcher whose specialities including nursing and aging, said.

Louis Demers, who studies the health-care system and seniors residences at Quebec’s Ecole nationale d’administration publique, said he believes collective living arrangements for seniors were a governmental “blind spot” when it came to preparation, even though he believes officials reacted well overall. ...

Demers says it’s impossible to make blanket judgments about the long-term care system, since problems crop up on a case-by-case basis.

He says there are times when management may be fingered, such as the high-profile case of a private residence in Dorval, Que., where health authorities found residents lacking food and basic personal care, and eventually called police after learning that 31 people had died within weeks.

However, he noted there have also been major outbreaks at well-regarded public institutions, such as the Montreal Geriatric Institute.

While both Voyer and Demers are reluctant to assign blame, they say there are certainly lessons that need to be learned, especially given an aging population that is likely to need increasing levels of care.

Quebec Premier Francois Legault has promised to address worker shortages in care homes, through both temporary pay hikes and long-term recruitment, which both experts say is essential.

Voyer says badly configured residences, with long corridors and residents sharing rooms, have a harder time isolating sick residents from uninfected ones, compared to residences with house-style layouts, where residents live in smaller wings.

And both he and Demers say there’s an urgent need for more investment in home care, which can help avoid institutional settings altogether.

Statistics show that private seniors residences are a popular option for Quebecers when compared with the rest of Canada.

Some 18.4 per cent of Quebecers occupied such spaces in 2019, compared with just 6.1 per cent on average in other Canadian provinces, according to the Canadian Mortgage and Housing Corporation. It says the discrepancy is explained by a much larger pool of residence spaces in Quebec and the lowest average rents for such spaces in the country.

https://nationalpost.com/pmn/news-pmn/canada-news-pmn/many-factors-behin...

jerrym

Long term care homes in Quebec are in full crisis mode with 142 homes having Coronavirus outbreaks and 42 facing a "critical situation", with 25% of long term care residents testing positive for Coronavirus with up to 120 residents in a single home having the virus. It looks like many more deaths are likely to occur for those in these homes. 

  • Quebec released a list of a list of 142 facilities in the province with outbreaks, as pressure mounted to be more transparent about which long-term care facilities have outbreaks.

Premier François Legault made a desperate plea Wednesday for the most highly trained doctors in the province to bathe and feed elderly residents of long-term care homes, where staffing levels are critically low because of the coronavirus outbreak. ...

Legault estimated the province must find some 2,000 trained health-care workers as soon as possible to make up for staff who can't come to work at public and private CHSLDs — the long-term care homes for those with the highest needs.

The virus has wreaked havoc on residents and staff at those establishments. Infections have swept through dozens of homes in the province, contributing to the deaths of hundreds of elderly Quebecers. ...

Health Minister Danielle McCann called the current situation in Quebec's long-term homes a humanitarian crisis. 

"We want our doctors to come do a humanitarian mission for our seniors, who built Quebec," McCann said.  ...

Quebec and Ottawa have also been discussing the possibility of deploying military medics to help at CHSLDs.

But while those options are being explored, Legault said, the system needs the immediate help from specialist doctors, calling the current situation a "national emergency."

The head of Quebec's federation of medical specialists, Diane Francoeur, responded to Legault pleas on Twitter, saying her members were ready to lend a hand.

Right now there are 42 long-term care facilities deemed to be in what Legault has called a "critical situation," according to a list published by the Quebec Health Ministry Tuesday. 

These include 25 institutions where 25 per cent or more of the residents have been diagnosed with COVID-19. Among them are CHSLD Sainte-Dorothée in Laval, with 120 confirmed cases, and CHSLD Yvon Brunet in Montreal, where there are 99 cases. 

https://www.cbc.ca/news/canada/montreal/covid-19-april-15-quebec-1.5532673

 

Aristotleded24

Hi jerry,

So great to hear from you after all this time. How are you doing?

jerrym

Aristotleded24 wrote:

Hi jerry,

So great to hear from you after all this time. How are you doing?

Thanks Aristotled24. I appear to be over it now. However, it was unlike any other infection that I have had because there were so many up one day and down the next days. 

laine lowe laine lowe's picture

It's good to hear that you have recovered, Jerry.

NDPP

Yes, indeed. Glad to hear it Jerry. And see if you can get tested with one of those mythical serological tests they supposedly now have and which will tell you if in fact it was COVID. If so you are to the best of current knowledge now immune!

NDPP

As Canada's COVID-19 Death Toll Passes 1000, Attention Focuses on Long Term Care Homes

https://nationalpost.com/news/politics/as-canadas-covid-19-death-toll-pa...

"The uncomfortable  and tragic truth is that the very places that care for our elderly are the most vulnerable to COVID-19,' Prime Minister Justin Trudeau said. 'We all need to take leadership for the seniors who built this country.' 'The reality is, despite our best efforts*, we're dealing with a wildfire at our long-term care homes right now,' Ontario Premier Doug Ford said this week. The province's chief medical officer David Williams said Wednesday that Ontario now has outbreaks at 98 homes, and has seen 145 long term care deaths, although this number is likely low..."  *Best efforts? I think not.

 

Staff at Verdun Seniors' Residence Were Locked in to Prevent Them From Leaving

https://twitter.com/JohnOCAP/status/1250774362107641856

 "The failure to protect residents and the abuse of workers in the private long-term care facilities will be the most shocking element of the situation to consider when there is a reckoning after the pandemic."

NDPP

COVID-19 And the Tragic Truth of Failing Our Nations Elderly

https://twitter.com/BigJMcC/status/1250731001422196737

"Regardless of how all this ends, Canadians will have to come to terms with the fact that as a nation, we failed far too many of our oldest and most vulnerable citizens..."

('But China...!')

Pondering

In Quebec, specialists are going to be working as caregivers, for 211.00 dollars an hour.

NDPP

It is almost a truism in Canada that any social or health emergency gaining traction with the public and media will be exploited as an opportunity to further enrich the professional and administrative classes. Those on the bottom are structurally kept there. Public monies mostly flow up not down.

jerrym

Pondering wrote:

In Quebec, specialists are going to be working as caregivers, for 211.00 dollars an hour.

On CBC's the National, Quebec Minister of Health Danielle McCann admits that the provinces long term care homes had a large shortage of workers before COVID-19, saying that "we need thousands and thousands of people, not just a few hundred." indicating that then long-term care problem was severe well before this crisis. For a former Parti Quebecois independentiste Minister and now CAQ Premier, who is extremely jealous of provincial jurisdictions, to ask Trudeau for  help from the Canadian military shows how dire the situation is. 

Legault says long-term care homes are facing a shortfall of about 2,000 staff, but that 2,000 medical specialists have offered to step in since his appeal to them Wednesday.

He's also asked the federal government to send trained military personnel to help but says it is still unclear how many people are available. The premier estimated there may be between 60 and 100 qualified people who may be sent as reinforcements.

https://www.cbc.ca/news/canada/montreal/covid-19-quebec-april-17-1.5535556

Quebec also seems willing to call in the extremely well paid specialists, who although highly trained often have skills to match this situation, even though there are "retired nurses are waiting to be called that are more suited to the work than specialsts", according to the CBC National News. Roberto Bomba from the Quebec Nurses Union said, in referring to the specialists, "They better have a knowledge base and run around and care for the residents. But under no circumstances are they to put in requests for nurses. Our nurses are doing the work. They don't have time to babysit specialists." These quotes can be seen at this url (https://www.cbc.ca/player/play/1725790275768)

I would also say that the extremely poorly paid residential care attendants don't have time to babysit specialists also. It's another example of elites preferring to use other elites even when they are not the best choice. 

jerrym

There are also major questions being raised about the criminal record of the owner, Samir Chowieri, who is the owner of six other long term care homes,, of the Herron long term care home where 31 seniors died since mid March,  and to his family's almost $10,000  in donations to the Quebec Liberal Party.

Furthermore, more questions have been raised as Chowieri has no criminal record after receiving a pardon: "Frédéric Lepage, a spokesperson for Katasa Group Inc. [Chowieri's corporation], sent the Montreal Gazette a copy of a letter from the Parole Board of Canada stating that Chowieri has, since 2014, 'a record suspension under the Criminal Records Act.' " (https://montrealgazette.com/news/herron-scandal-prompts-quebec-to-consid...)

Résidence de l’Île and Résidence Herron are two of seven homes for elderly people owned and managed by Katasa Group Inc., a company that lists Samir Chowieri as its president on Quebec’s business registry.

On June 3, 1994, members of an RCMP Proceeds of Crime unit based in Vanier, Ont. fanned out in Gatineau and Hull and carried out search warrants at three locations, including the offices of the CHO Brothers, a company then run by Samir Chowieri and his brother Elias.

The company began operating in 1987 and was dissolved in 1996, with Samir Chowieri listed as its primary shareholder and president. ...

According to an article published in 1994 by Le Droit, a newspaper based in Ottawa, a Quebec Court judge authorized the search based on an affidavit that alleged the RCMP had reason to believe transactions made by the company between Nov. 3, 1982, and June 1994, involved laundered drug money. That included transactions made to build the Residence de l’Île.

Le Droit reported the RCMP used the date in 1982 as the starting point of the documents they sought to seize because it was the day when Samir Chowieri was released from a penitentiary after having served a two-year sentence he received on June 18, 1981, for being part of a drug trafficking conspiracy that took place in Gatineau, Mirabel, Ottawa and Lebanon. Chowieri’s brother received a six-month sentence in the same case. ...

Less than a year after the RCMP raid, provincial prosecutor Claude Haccoun announced no charges would be filed against Chowieri or his bother. Haccoun told Le Droit there weren’t enough “tangible elements” to file charges in the money laundering investigation.

The same search warrant is referred to in a 2001 Quebec Court judgment in a case where Samir Chowieri, his brother Elias, and their company CHO Brothers Investments were charged in 1997 with having violated Canadian tax laws. While challenging the case, the brothers argued the Canada Revenue Agency investigation was illegal because it was based entirely on documents the RCMP seized in 1994. The judge’s decision notes the Chowieri brothers did “not challenge the validity of the warrant obtained by the RCMP in June of 1994 nor the extent of the seizure done under the authority of that search warrant.” ...

An RCMP investigator named Dave Wilson, a member of the Proceeds of Crime Section, was called to testify as part of the motion filed by Samir Chowieri. According to the 58-page decision rejecting the motion, Wilson testified the “investigation was started by the RCMP against the Chowieris in July 1992. It was a proceed of crime investigation (organized crime involved in fraud) and an attempt to link money to drug trafficking, and to explain how the money had been invested in the company in the first place.”

The decision notes the RCMP seized business records, ledgers and cassette recordings from Samir Chowieri’s office on June 3, 1994. They seized the cassettes based on a tip that Chowieri was illiterate and recorded his business meetings because he was unable to take notes. At least one of the recordings referred to Residence de l’Île. A CRA investigator testified that specific recording steered the tax evasion investigation. ...

The CRA case dragged through the courts for years. Quebec Court Judge Pierre Chevalier rejected Samir Chowieri’s motion in 2001. But in 2002, a judge at the Hull courthouse agreed to place a stay of proceedings on all of the charges filed against the Chowieri brothers and their company.

https://montrealgazette.com/news/local-news/owner-of-residence-herron-wa...

lagatta4

Jerry, so happy you've recovered! Look at this one. Unbelievable! It also means that the Federal government is or was essentially paying rent to the Mafia. https://montrealgazette.com/news/local-news/residence-herron-owner-bough...

I do find it hard to believe that Vito Rizzuto lived in Little Italy anytime in recent history. Yes, my hood is charming with the market and all, and there is increasing upscale condo development here and in adjacent Villeray and "Mile-X", but it remains a neighbourhood of duplexes and triplexes that are very far from spacious or grand. Hardly "Mafia" taste.

Mafia types tend to opt for the more upscale parts of St-Léonard (where there is also great poverty, mostly among more recent immigrants), Anjou, Ahuntsic (near Rivière-des-Prairies) or the RDP part of that eastern borough. Or Laval, across that river, also near it.

jerrym

Thanks Lagatta. 

The Ford government's "enhanced plan to fight COVID-19 in the province's long-term care homes" is completely inadequate. It's restriction that care workers can only work at one facility is only for 14 days, does not cover workers who come from temp agencies and does not come into effect until April 22nd. Furthermore, it does not raise long term care workers pay or benefits or the part-time nature of many of their jobs, which has helped create high turnover rates and poor quality care. It also does not return to the 'resident quality inspections' at care homes that were key to catching 87 per cent of infection control violations, as noted in post #17.

The plan also includes risk and capacity assessments for all homes as well as enhanced training and education for support staff who are working in these facilities. These new measures complement an emergency order issued Tuesday that limits long-term care home staff to working at only one facility in an effort to prevent the spread of the virus.

This was welcome news for the Registered Nurses’ Association of Ontario (RNAO), Ontario Nurses' Association and NDP Leader Andrea Horwath, all three of whom had been calling for staff to be restricted to a single facility. They argued that unless the province ordered employers to keep the same staff, the virus would continue to spread to those most vulnerable.

However, Fullerton clarified that the order is not indefinite, and will expire 14 days after it was issued. “This is a temporary measure to allow for a reduction of the spread of COVID-19.”

Staff members who do work at multiple facilities will be allowed to take a leave absence to accommodate the order, according to Fullerton.

Furthermore, The temporary emergency order will only come into effect on April 22, in order to give long-term care homes enough time to prepare. ...

Horwath said the new measures are not good enough. “We are concerned that there are huge loopholes in that emergency order. It still does not cover, for example, people who work for temp agencies that can be assigned to various homes,” Horwath said.

The plan also did not address the issues of workers being grossly underpaid and workers still doing part-time hours, Horwath said.

“I guess a baby step is better than no step whatsoever. But Mr. Ford’s passion needs to be followed up with action that’s actually going to hit the mark.” Horwath said it is also unacceptable that these measures won’t go into effect until next week. She said the province should have undertaken these measures to protect residents of long-term care homes weeks ago.

“Everybody knew long-term care was in a crisis,” Horwath said. “And so here we are now in the midst of this crisis, and it shouldn’t be another week.”

https://toronto.ctvnews.ca/ontario-launches-plan-to-fight-covid-19-in-be...

 

jerrym

The same sad trail of death's in senior's care homes in Ontario, Quebec and BC, brought on by  minimal staffing, little or no Personal Protective Equipement (PPE), poor wages and benefits that often force workers to be employed in more than one place and thereby assisting in the spread of disease, and little to no government checkup of homes, has also occurred in Alberta.

 The real scandal is that “Everyone knew this could happen,” said Doris Grinspun, president and CEO of the Registered Nurses’ Association of Ontario.  “It’s like somebody sat in a room and said, ‘This is a population we can live without.’ ”

In the Calgary nursing home, Nina Vaughan watches her father survive. ...

Lorne Vaughan has COVID-19. He lives in McKenzie Towne, where 21 fellow residents, including his sister-in-law, Doreen Gauvreau, have died of COVID-related conditions. Another 60 people, the same number that jam inside a TTC bus during rush hour, have tested positive for the virus.

Given the number of deaths at Toronto’s Eatonville Care Centre, reporting 27 as of Tuesday, Bobcaygeon’s Pinecrest with 29, or the 31 at Quebec’s Résidence Herron, odds are that a lot more will die in Vaughan’s home, too. ...

Across Canada, seniors homes have become the epicentres for the COVID-19 pandemic. People who were teachers, soldiers, plumbers, professors are dying en masse. Many are fragile, living in a long-term-care or retirement home system that runs on low-paid, part-time staff who are forced to work in multiple homes to make a full-time salary. That is how a virus can spread.

“Everyone knew this could happen,” said Doris Grinspun, president and CEO of the Registered Nurses’ Association of Ontario. “It’s like somebody sat in a room and said, ‘This is a population we can live without.’” ...

York University professor Pat Armstrong wants long-term care to move from provincial control to the Canada Health Act, the federal legislation for public health care. With national care priorities defined in legislation, Armstrong said federal money for nursing homes could require proof of improvement in a system that has long been underfunded and staffed by part-time workers.

“I think (governments) have got to realize that long-term care needs to be an integral part of the health-care system,” said Armstrong, known for her research into long-term care.

“They need to be doing the same thing (in nursing homes) as they are doing in hospitals. That means we need a new piece of national legislation, a national long-term-care act,” Armstrong said.

In Canada, each province has had a unique response to desperate families and staff.

Late last week, British Columbia moved to limit the spread of infections by mandating that staff who hold multiple part-time jobs work in only one location. The province provided funding to augment lost wages.

Notley, the Alberta NDP leader, asked the government April 2 to implement similar one-site rules. Last week, Alberta confirmed the employment change, saying it is “considering financial supports” for affected workers. Until Ontario announced its one-site rule Tuesday, the province had offered little more than a recommendation that employees work at one location. Some homes, struggling for staff, were still accepting workers juggling multiple jobs.

With the push for one location resolved in some provinces, advocates are still pressing for better reporting of COVID-related deaths. Right now, it’s hit-and-miss.

Quality data is key to prevention, said Dr. Samir Sinha, director of geriatrics for Sinai Health System in Toronto. His staff have been trying to cobble together details of outbreaks and deaths in Ontario’s 630 long-term-care and 775 retirement homes.

“It’s important so we can have an accurate picture on how the situation is unfolding,” Sinha said. “If we don’t understand these things or have the level of knowledge we need, we are likely to repeat mistakes.

https://www.toronto.com/news-story/9952198--everyone-knew-this-could-hap...

jerrym

Almost half the deaths in Canada from Covid-19 have occurred in care homes for seniors. Today Quebec Pemier Legault reported that 80% of the provinces 1,041 Covid-19 deaths were at homes for seniors. 

Long term care standards has to be included in legislation as a central part of the Canadian health care system.

After all when it comes to long term care as you age, sooner or later you will likely need it, unless, of course you've already ...

laine lowe laine lowe's picture

It's a harsh wake-up call but an important one. Problems with long term care were flagged decades ago before the massive explosion of for profit homes became a thing and huge money maker. Conditions are even worse than they were in the 80s.

jerrym

On April 16th Ipolitics reported that in Quebec "70 per cent of the dead lived in CHSLDs or long-term care residences (51 per cent), or other seniors’ residences (19.3 per cent)".  [https://ipolitics.ca/2020/04/16/70-of-quebecs-covid-19-deaths-are-in-lon...

Yesterday, Premier Legault annouced that the number of COVID-19 long term care home deaths had climbed to 80% of Quebec's. Today a chyron (a message scrolling across the bottom of the TV screen) stated the 85% of deaths in Quebec involved those living in long-term care homes. Legault, like Ford in Ontario, has asked for 1,000 more soldiers to aid in the fight against the virus. Beyond the immediate emergency response to this disaster, there has to be an enormous reform of the entire long-term care system that involves better living conditions for residents, as well as better pay, training and working conditions for all workers in the homes. 

 

jerrym

In Ontario, while Ford has looked shaken at his TV presentations because of the impact of COVID-19, especially with regard to the large number of deaths at seniors care homes, his government is a major part of the problem.

This scandal also includes former Premier Mike Harris who privatized a large part of Ontario's care home system and now is the chair of the private sector's Chartwell Retirement Residences.

The private sector care homes are also major contributors to the Progressive Conservatives. 

It took the pandemic to break an already compromised system. In Canada, almost half of the approximately 1,000 deaths from the virus as of April 14 occurred in long-term care homes. In Ontario, where I live, as of April there were 14 COVID-19 infections in 114 of 626 facilities.

At a news conference, Ontario Premier Doug Ford looked shaken. He said, among other things, that he would make it illegal for individuals to work in more than one care home simultaneously, a situation which potentially allows the virus to either enter or leave the premises with those workers.

But Ford has been a big part of the problem. Having people work in multiple locations has become commonplace primarily because the corporations that own for-profit long-term care homes hire workers part-time so that they can pay them poorly and avoid providing benefits. Until now, the Ford government has turned a blind eye to this. As well, the previous Liberal government was set to raise the minimum wage in Ontario, a move that would have helped many long-term care workers. Yet one of Ford's first acts when elected in 2018 was to cancel that planned increase.

Ford has much to answer for. The CBC reported on April 14 that in 2019 only nine of the province's 626 homes received a comprehensive resident quality inspection, or RQI. The CBC reviewed reports from the last five years for all homes in the province. They found that most received RQIs in 2015, 2016 and 2017, but that number dropped to just over half in 2018 and to only nine in 2019. To be blunt, that means that under Kathleen Wynne's government there were a good number of comprehensive inspections, but Ford cancelled almost all of them. ...

Mike Harris, who was Ontario's premier from 1995-2002, responded to growing waiting lists in 1998 by announcing that more than $1 billion would be spent to create 20,000 new spaces. When the contracts were awarded for construction of beds, 68 per cent of them were handed to the private sector. Three giant companies, Extendicare, Leisureworld and Central Park Lodges, received 40 per cent of the contracted spaces. The public was to pay for building facilities to be owned and operated by corporations to enrich their shareholders.

Provincial election finance records showed that between 1995 and 1999 for-profit long-term care companies donated almost $340,000 to the Ontario Conservative party. That did not include thousands of dollars donated to the provincial leadership campaigns of Ernie Eves, Tony Clement and Jim Flaherty.

One of the biggest players in the private sector long-term care field is Chartwell Retirement Residences. Mike Harris now sits comfortably as the chair of Chartwell's board of directors and according to Unifor, another union in the sector, Harris pulls down $237,000 a year for this part-time job. Meanwhile, Unifor, says the company pays only the minimum wage to many of its front-line employees.

The 2006 NUPGE report says that the long-term care model promoted by Harris drains the profits from care into the pockets of owners and shareholders. The public sector model provides better care and keeps people safer than a for-profit system governed by the same market forces that motivate software developers, cable companies and fast food chains. Yet, Harris and some other premiers consistently pushed privatization. But the exploitative practices in the privatized for-profit sector have also had a negative and cascading effect upon the quality of care for clients, not to mention the wages and working conditions of care providers.

https://rabble.ca/blogs/bloggers/pulpit-and-politics/2020/04/covid-19-ex...

jerrym

As of April 20th "There were currently 112 COVID-19 outbreaks at long-term care homes across Ontario, representing the deaths of 240 residents and one staff member.", (https://toronto.ctvnews.ca/woodbridge-long-term-care-home-reports-six-co...) showing how poorly their privatization of long term care has worked out. 

jerrym

Nova Scotia's long term care homes also are facing catastrophic COVID-19 situations. 

As of Tuesday, 10 licensed and unlicensed long-term care and seniors’ facilities in the province had confirmed cases of COVID-19, involving 148 residents and 65 staff members.

Most of the cases are at Northwood, which was reporting 112 cases among residents and 40 cases among staff members, on Tuesday.

https://atlantic.ctvnews.ca/nova-scotia-reports-2-more-deaths-at-northwo...

 

Sean in Ottawa

Long term care has been a gaping hole in healthcare in this country for decades. The needs increase as population ages and people can live longer. Employees are at the bottom without respect, support or living wages. The virus is exposing this system tragically.

Misfit Misfit's picture

It takes money and standards that need to be enforced and the government investing in infrastructure to change this. I don't see it happening. In fact, when the government spending from this covid crisis ends, I foresee a strong surge in fiscal conservstive restraint rising in popularity all over, the exact opposite of what needs to be done to properly address these issues.

epaulo13 epaulo13's picture

‘Frontline workers do not have N95s but supervisors are wearing them’: Troubling allegations emerge at care homes hit by COVID-19

Confusion. Exhaustion. Fear. Tragedy.

This is the picture of the “unlawfully inadequate” response to the COVID-19 pandemic at three for-profit long-term care homes — alleged in intimate detail through hundreds of pages of submissions, internal communications, and written declarations from front-line workers.

The documentation filed this week by the Service Employees International Union (SEIU) to the Ontario labour relations board seeks immediate relief to “protect the lives of both employees and residents,” including an order to place the care homes under the direct control of the Ministry of Health and Long-Term Care.

quote:

One written declaration from a worker at Altamont, where 28 residents have died, said employees were not fitted with N95 masks until the day after staff member Christine Mandegarian died from COVID-19.

“The day after Christine died, April 16, 2020, was the first time front-line workers were given N95 masks,” says the written declaration from personal support worker Karen Ellington, who has also since fallen ill with the virus.

“We were told ‘don’t throw it away, we don’t know when you’re getting another one.’ ”

Responsive Group Inc., the company that operates Anson Place and Eatonville, said it was committed to providing a safe environment for its staff and said it has been successful in obtaining additional PPE supplies to combat shortages and meet strict public health requirements.

“It was difficult to hear that some our staff feel we have not done everything possible to protect them throughout this crisis,” the emailed statement said. “We need to do better.”

quote:

SEIU represents some 60,000 front-line health workers, and wants the provincial labour board to order “immediate emergency orders” to protect its members and the residents in their care. The interventions sought by the union include orders directing employers to provide sufficient protective gear for workers, increase staffing, and provide transparent information on outbreaks.

“We are witnessing what happens when hollow words are met with failed action. That is why we are seeking an emergency hearing before the Board for immediate relief to our front-line members,” said the union’s president Sharleen Stewart in a statement.

“We will not stop until every worker is protected and every senior receives the care they deserve.”

Pondering

A woman had a great deal of trouble getting her father out of a care home even though she had everything ready to care for him. Seniors who are lucid surely have the right to decide for themselves. Those who are not should have a family member as guardian not the government or a care home. As soon as there is sufficient PPE people should be permitted to visit dying family members "at their own risk".  After a certain age you know every day could easily be your last so you want to live each day to the fullest. "Risking death" does not have the same meaning when you are 95. For those with dementia seeing family can be the last hold they have on reality.

Keeping family out seems more like keeping witnesses out.

 

jerrym

The following news release from the Ontario Health Coalition outlines the desperate situation in Ontario's long-term care homes, which has been facilitated by the Ford government's actions.

In some ways, long-term care was a COVID-19 storm waiting to happen.

The virus is most deadly to elderly people and those with pre-existing health conditions — the main demographics for long-term-care facilities, which across the country have been ravaged by COVID-19.

But government decisions have made it worse. Combine the pre-existing risk with the chronic understaffing and underfunding that have plagued long-term care in Ontario and across the country, and you have the makings of an accelerating disaster. ...

In a few horrifying cases, medical staff have abandoned their long-term-care jobs, leaving the sick to die and the living to suffer. And even with the best care possible, residents have died alone, their family members not allowed inside to say goodbye.

But the long-term-care outbreaks have been especially bad in Ontario, while some provinces have been weeks ahead in making key moves to address the crisis. ...

The problem struck British Columbia first, as a cascade of cases and deaths at North Vancouver’s Lynn Valley Care Centre caught national attention in March. The province has made several critical moves since then.

B.C. barred long-term-care staffers from working at more than one facility on March 27. Many have part-time hours at multiple workplaces, and must work at several to make ends meet. But the practice, flagged as a problem after the deadly SARS outbreak in 2003, has also allowed for COVID-19 to spread rapidly between care homes.

The Ontario government says it has acted quickly and often to stop the spread of the virus in long-term care. But B.C. acted weeks earlier, and critics say key problems should have been addressed a month ago. #onpoli

Days later, B.C.issued a six-month order requiring care homes to top up those workers’ wages. (Quebec, which has also massively struggled with long-term-care outbreaks, topped up long-term-care staff wages earlier this month as well).

Ontario didn’t issue an order barring long-term-care staff from working at multiple facilities until Wednesday. It doesn’t take effect until April 22, lasts two weeks and leaves a loophole for temp staffers.

“Restrictions much tighter than these should have been put in place weeks ago,” Ontario NDP Leader Andrea Horwath said Wednesday.

And though Premier Doug Ford originally said he’d top up Ontario’s notoriously low wages for such workers, the province has since deferred that to the federal government and encouraged long-term-care homes to give staff full-time hours. ...

The non-profit Ontario Health Coalition said in a statement Friday that the province’s actions fall short of what’s needed.

“We are increasingly frustrated with the disconnect between the statements of the premier and what is actually being put into the regulations, directives and guidance issued by his own government,” executive director Natalie Mehra said in the press release.

“We are inundated with calls and emails from families with loved ones in long-term care and staff in the homes, crying, afraid, furious about the lack of testing, even in homes with outbreaks.”

Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, said the province should have acted a month ago, when her organization first raised concerns. She also said there is much more that remains to be done.

“No one gives us back time,” Grinspun said in an interview Thursday. “We can only do the best we do with the time we have left, until there is a vaccine.”

https://www.ontariohealthcoalition.ca/index.php/long-term-care-is-now-th...

jerrym

The situation in Ontario and Quebec is now so desperate that both the Ford and Legault government have asked the federal government to send Canadian Forces soldiers to fight the desperate situation in their long-term care homes, with Legault asking for 1,000 military in addition to the 125 he already has. 

The Canadian Forces are preparing to deploy medical personnel to Ontario, where COVID-19 has ripped through the province’s long-term care system like “raging wildfire,” leaving staff overworked and desperate as they try to curb a mounting death toll.

During a Wednesday press conference, Premier Doug Ford announced Ontario is formally requesting assistance from the federal government, including Canadian Forces personnel and Public Health Agency of Canada resources. Initially, those personnel will be directed to deploy to five “priority homes,” Ford said. Personnel will provide staffing relief and other support for the day-to-day operations of the homes. ...

“We’re in the thick of a raging battle against COVID-19 in our long-term care homes. And when you’re in a fight like this, you leave nothing on the table,” said Ford.

Planning staff at national defence headquarters in Ottawa had been given an earlier heads-up that Ontario was expected to request assistance similar to that provided to Quebec. The Canadian Forces has already sent about 125 military health-care personnel and support staff to Quebec after the federal government received a request last week for assistance from that provincial government. ...

Quebec Premier Francois Legault also announced Wednesday that he was asking for another 1,000 military personnel to be sent to long-term care facilities in the province.

Ford said that the requested assistance from Canadian Forces personnel and the Public Health Agency of Canada is just one small part of Ontario’s efforts to deal with COVID-19.

“Their support will provide staffing relief so staff can focus on the care of the residents,” he said of the request to send the military personnel to long-term care facilities. “They will assist with operations, co-ordination or medical care, logistics and general assistance to support the day-to-day operations.”

The military teams sent to Quebec long-term care facilities were comprised of nurses, medical technicians and support personnel. Similar teams would be brought together for Ontario’s request.

Volunteer emergency nurses and cleaning staff, infection control specialists and staff from provincial hospitals are also being used to support the more than 100 long-term care homes in Ontario, Ford added. “Every set of boots on the ground will make a difference in this fight,” he said. ...

Military sources say they expect most of the personnel to go to long-term care facilities in the Toronto area. ...

Ford, when asked why he didn’t call on the military earlier for aid, said the situation has been changing every day. “As we see an influx we’ll take all the resources possible,” he explained. “There will be enough people to take care of the five homes.”

The situation with COVID-19 in the long-term care facilities is like a “raging wildfire,” Ford said. Staff in those facilities have been working long hours. “They need a rest and they need support,” he added.

Legault said Wednesday that Quebec’s new request for 1,000 military personnel is centred on staff that can be used in non-medical tasks in the province’s long-term care homes. ...

The Canadian Forces has yet to officially receive that request but military sources say Quebec’s appeal for such a large number of personnel came as a surprise.

The Canadian military has limited numbers of trained medical staff. There are around 2,600 regular force medical professionals, said Department of National Defence spokesman Dan LeBouthillier. That figure includes approximately 460 doctors and nurses.

However, those 2,600 individuals have a primary job of taking care of the 68,000 regular force personnel as well as reservists on operations or full-time service. The number also includes positions such as medical lab technicians, medical technicians, pharmacists, dentists and dental hygienists.

https://ottawacitizen.com/news/national/defence-watch/canadian-military-...

 

 

jerrym

The Globe and Mail is reporting that aproximately 70% of Covid deaths are occurring in long-term care homes while I noted above that CBC reported that the same figure is 85% in Quebec, where there was widespread understaffing well before Covid-19 hit. 

The Ontario Nurses’ Association (ONA) have gone to court, to seek "an order compelling three long-term care homes owned by Rykka Care Centres to comply with provincial infection control and health and safety standards," because the care homes have kept those sick with Covid-19 alongside the healthy. The ONA is also challenging the government's Public Health Ontario statement that "nurses treating residents in long-term care homes with COVID-19 should use surgical masks rather than the N95 version."

In Ontario, almost 70 per cent of all deaths have occurred in long-term care, according to the latest data. Provincial health officials said Wednesday 447 long-term care residents, as well as a staff member, have died of COVID-19. The province has recorded 659 deaths in total, and there have been outbreaks in 127 long-term care homes. ...

Mr. Ford said military personnel will support the “day-to-day operations" of the homes, including co-ordination and medical care. He would not identify the five homes. David Williams, Ontario’s Chief Medical Health Officer, later said the province was looking for about 250 personnel. ...

In Quebec, long-term care homes were understaffed before the pandemic. Illness and absenteeism left them short 2,000 people, out of about 43,500 employees normally working in those facilities. ...

A series of calls for volunteers among medically trained personnel, including retirees, instructors and specialists, only managed to fill half the gap.

“The situation in seniors’ residences is still critical. Today we asked the federal government to send us a thousand soldiers. It will give us more resources to help us with non-medical tasks,” Mr. Legault said Wednesday.

“It’s not ideal but, at the same time, I think this will help." ...

Mr. Ford’s call for military aid came the same day the Ontario Nurses’ Association was in court, seeking an order compelling three long-term care homes owned by Rykka Care Centres to comply with provincial infection control and health and safety standards. The ONA accuses the homes of keeping residents sickened with COVID-19 among the healthy, causing the virus to spread. The association also alleges that the homes “severely limited” staff members’ access to proper personal protective equipment, including N95 respirator masks.

One of the homes, Anson Place Care Centre in Hagersville, west of Toronto, is among the hardest hit in Ontario with 27 deaths. Of the 74 remaining residents, 44 are sick.

Ian Dick, a lawyer for Rykka, told Ontario Superior Court Justice Edward Morgan that Anson Place is exempt from a provision requiring sick residents to be segregated from healthy ones because it is a small home.

The Ontario Ministry of the Attorney-General intervened at the hearing to defend policies governing the appropriate use of N95 masks in long-term care homes.

On March 10, Public Health Ontario said nurses treating residents in long-term care homes with COVID-19 should use surgical masks rather than the N95 version.

The ONA’s chief executive officer, Beverly Mathers, says in an affidavit she was “shocked” by Public Health Ontario’s advisory on masks.

The other two homes owned by Rykka are Eatonville Care Centre, the hardest-hit long-term care residence in Toronto with 36 deaths as of Wednesday, and Hawthorne Place Care Centre in North York.

In Quebec, those still working in long-term care have also complained that they were not issued with enough protective gear and that infected patients were not properly isolated into separate zones.

https://www.theglobeandmail.com/canada/article-ontario-joins-quebec-in-s...

Sean in Ottawa

Pondering wrote:

A woman had a great deal of trouble getting her father out of a care home even though she had everything ready to care for him. Seniors who are lucid surely have the right to decide for themselves. Those who are not should have a family member as guardian not the government or a care home. As soon as there is sufficient PPE people should be permitted to visit dying family members "at their own risk".  After a certain age you know every day could easily be your last so you want to live each day to the fullest. "Risking death" does not have the same meaning when you are 95. For those with dementia seeing family can be the last hold they have on reality.

Keeping family out seems more like keeping witnesses out.

 

Many years ago we went through this in Quebec with my mother who had MS. By going into an institution which they were pushing for in order not to have to provide any home care, you lose the right to get back out. In the end she stayed home and my sister and I took 1 day a week off school to care for her so my father could get into town to do the business he needed and shopping. We were living in a rural area.

Home care was offering a bedridden woman help to get to the washroom at 10 am and 2 pm for 15 minutes. Leaving here alone the rest of the time and requiring her to be able to go in those times. It was not humane and we could not use that level of service. 

This was in the 1980s - not sure what they do now.

jerrym

The CBC National News reported last night reported that 65% of all Covid-19 deaths in Canada occurred in long-term care homes, thereby illustrating that this has been a nationwide problem, thereby illustrating  that treating senior care homes as separate from the health care system, allowing minimal staffing, little or no Personal Protective Equipement (PPE), poor wages and benefits that often force workers to be employed in more than one place and thereby assisting in the spread of disease, and little to no government checkup of homes, has been a recipe for the disaster that is now unfolding. The entire system has to be changed. 

The NDP BC government has begun to address some of the structural issues that have led to such tragic deaths, by taking over as the employer of all long-term careworkers, raising their wages and benefits, making them full-time workers who are employed by only one facility to minimize disease spread, but even there more remains to be done. 

epaulo13 epaulo13's picture

Military and hospital teams won’t stop long-term care nightmare; test, identify and relocate residents’ with COVID-19, union asks

The crisis in congregate living environments, like long-term care, can be solved by following the strategies of nations which are more successful: aggressive testing of all residents and staff and the relocation of those with COVID-19 to specialized facilities, CUPE said today. A limited number of military personnel will bolster hospital staff now deployed in outbreak homes beginning this weekend.

“Once an outbreak takes hold, all the other residents are extremely vulnerable to this virus. The requirements that staff move from room to room wearing the same mask and gown for their entire shift also creates a glaring weakness in the infection control strategy,” says Candace Rennick, secretary-treasurer of CUPE Ontario. “The solution is not to pour in loaned military and hospital staff into long-term care to treat the COVID-19 positive residents, it is to remove residents, so that the virus does not spread within the home.”

CUPE has consistently called for aggressive testing of all residents and staff in long-term care. “This is a key element in turning the dire situation in care homes across Ontario, around,” says Michael Hurley the president of CUPE’s Ontario Council of Hospital Unions (OCHU/CUPE). “We need to test, identify and relocate. Our hospitals have the capacity now to receive these residents and can offer a higher level of infection control, nursing care and access to a wide range of medical specialties. Only a stubborn resistance to providing long-term care residents with access to hospitalization is standing in the way.”

As of April 23: Ontario hospitals are operating at below 70 per cent capacity; 516 Ontario long-term care residents had died of COVID-19 and there were 2,191 cases in 135 homes.

jerrym

On Wednesday the Conseil pour la protection des malades (CPM), which works to protect the rights of patients, filed a complaint with the Quebec Human Rights Commission, alleging "discrimination and exploitation of seniors who live or have lived in a long-term care home (CHSLD) or seniors residence since the beginning of the COVID-19 crisis."

On CBC National News last night, the daughter of a resident of a Quebec long-term care home believes her mother died not from Covid-19 but from starvation and dehydration when many of the staff in the home left the job either sick or afraid for their own lives. 

The CPM complaint is calling for an end to the suffering of the elderly. It is also demanding that financial compensation be paid to residents whose right to receive dignified and safe care has allegedly been violated since the beginning of March. ...

The complaint alleges that at the beginning of March, the Quebec government and health authorities should have known that the majority of deaths caused by COVID-19 would involve the elderly based on information available in other countries.

The CPM also contends that the authorities should have known that CHSLDs were most at risk for outbreaks and transmission of the novel coronavirus that causes COVID-19. ...

The organization claims Premier François Legault and the Quebec government only declared that long-term care facilities were their priority in the fight against COVID-19 on April 2. The complaint alleges that the province therefore delayed authorizing and ordering exceptional measures to protect residents.

Paul Brunet, president of the CPM, wrote in the complaint that “thousands of elderly people (…) have been mistreated, neglected, several have died while the government, health authorities, CHSLDs and residences for the elderly have exploited and violated their fundamental rights to the dignity, integrity and security of their person.” ...

The CPM is asking anyone who believes they have suffered from a lack of care and services in a CHSLD since March to contact the organization so that they can be included in the complaint.

https://globalnews.ca/news/6857103/quebec-long-term-care-centres-coronav...

 

 

 

jerrym

The bankruptcy of Premier Legault's proposal to seek to overcome Covid-19 by fostering the development of herd immunity illustrates how ethically bankrupt this regime is. This is a province with the highest Covid death toll in the country, the greatest number of infections, as well as the greatest number and percentage of deaths in senior care homes, but he still proposes to begin openning up the Quebec economy under these circumstances, putting everyone, but especially seniors and those with underlying health conditions, such as diabetes at risk.  

Premier Francois Legault pushed the concept of "herd immunity" on Thursday as he prepared to lay the groundwork next week for a plan to gradually restart the economy and get children back to schools.

The approach would involve exposing a large proportion of Quebecers to the novel coronavirus in a measured, gradual way, to help them develop a natural immunity.

The idea of reopening schools has garnered an unfavourable response among some parents, teachers and unions, who worry about kids returning to class just weeks after physical distancing and stay-at-home measures were enacted to slow the spread of COVID-19.

But Legault argued Thursday that less than 10 per cent of the province is currently naturally immune to COVID-19 — perhaps a bit more in hard-hit Montreal — and that number won't change unless the province starts resuming certain activities.

"The idea is to go very gradually so that people who are less at risk can develop antibodies to be able to become immune," Legault said. 

Quebec reported an 109 additional COVID-19 linked deaths Thursday, bringing the provincewide death toll to 1,243. The province also confirmed 873 new cases, bringing the overall tally to 21,838.

Legault stressed that the situation in long-term care homes — which accounted for 93 of the additional deaths Thursday — is much different than the rest of the province, which has had more stable figures. ...

Health experts have questioned the strategy, saying there are larger ethical questions that need to be considered.

Alison Thompson, a professor at University of Toronto’s faculty of pharmacy, said letting children be exposed in schools to COVID-19 is a far cry from a mandatory vaccination program. "It’s not just a matter of building immunity — they have to get sick first," she said in a recent interview, calling the proposal a "sickness strategy."

Legault has revealed little about the province's plan, but said parents won't be obliged to send their kids to school. ...

Quebec's association of pediatricians came out in favour of the plan in a two-page letter published Thursday, noting that one thing scientists agree upon is that COVID-19 isn't dangerous for most kids, who are confined largely to protect their grandparents. ...

Quebec reports 9,500 health care workers are missing — 4,000 are recovering or infected with novel coronavirus while 5,500 simply haven't returned to the job.

"We need you," Legault said, reassuring them they would have the protective equipment they need. "The network cannot function with 9,500 people absent." 

The federal government announced 1,000 Canadian Forces members would help shore up staffing at long-term care homes.

A patients' rights group has filed a human rights complaint on behalf of long-term care residents in Quebec.

The Quebec Council for the Protection of Patients' complaint describes alleged discrimination and exploitation of those who live or have lived in long-term care or seniors homes since the beginning of the COVID-19 crisis and seeks financial compensation from the Quebec tribunal.

The province's seniors homes have been the epicentre of the fight against the novel coronavirus, accounting for nearly 80 per cent of deaths — something the council argues the province should have known given what had happened elsewhere.

https://www.toronto.com/news-story/9960228-legault-pushes-herd-immunity-...

epaulo13 epaulo13's picture

Ontario nurses win court battle to secure access to PPE in long-term care homes

The Ontario Nurses’ Association says it has won a legal battle that will force four long-term care homes to immediately fix alleged safety issues for health-care workers.

According to court documents, filed by the ONA in mid-April, four Ontario long-term care homes have been allegedly restricting or denying the use of PPE in their facilities.

The homes named in the application include three owned by Rykka Care Centres Group—Eatonville Care Centre in Toronto, where at least 37 residents have died, Anson Place Centre in Haggersville, Ont., where at least 27 deaths have been attributed to the virus, and Hawthorne Place Care Centre in North York, where at least six residents have contracted COVID-19. 

A separate application was filed against Henley Place, operated by Primacare Living Solutions, located in London, Ont.

In the documents, the ONA says that its members have “not been provided with readily available access to N95 respirators when providing care to residents with confirmed, suspected or presumed COVID-19.”

On Thursday, the ONA said they are relieved a ruling, by the Superior Ontario Court, ordered the homes to immediately rectify the safety concerns. 

“It is truly a huge relief to know that after exhausting all other avenues, the Ontario Superior Court has agreed with ONA that these employers must follow health and safety practices to prevent the spread of infection among long-term care residents and the registered nurses and health professionals who care for them,” ONA President Vicki McKenna said in a written statement.....

 

NDPP

An important thread on an awful failure of governmental fiduciary care over too long a period. We must not allow the abuse and elder-cide to continue. Hopefully averting the eyes has ended.

kropotkin1951

The sad reality is that for twenty years our elder care has been going from marginal to life threatening. During the time one of Canadians favorite jokes was the about the kids getting to pick the retirement home. The punchline of the joke assumed that many of our senior care homes were substandard. Canadians are some of the nicest people on the planet, just ask us.

jerrym

Dr. Amit Arya,  a palliative care specialist who works in nursing homes, discusses the systemic problems faced by these homes below. 

None of us can imagine a beloved parent or grandparent in one of the nursing homes we are reading about without an involuntary shudder. Human beings dehydrated, starving, and left sitting in their own feces and urine in one Quebec institutionMilitary personnel deployed to homes desperate for staff. More than 1,000 people dead in long-term care homes across the country, and many more cowering in fear, sealed off from their loved ones as COVID-19 stalks the hallways of the nursing homes they live in.

Some of this is particular to this pandemic. No one could have been completely prepared for it.

However, COVID-19 has also ripped the bandage off an open wound, revealing what was previously there. It has exposed the inadequacy of the existing system.

Most nursing home residents have advanced incurable conditions — often dementia, but also heart, lung or kidney disease. People like me who work in nursing homes already know that care is driven by efficiency, rather than giving seniors with declining function the life they deserve. COVID-19 is showing us all why many of us would not choose these places for ourselves.

So what can we do? ...

The crowded conditions in which we warehouse our frail elderly aren't just an issue of personal privacy, they contribute to the spread of disease. Even in normal times, seasonal flu can be a killer in these homes. And with COVID-19, everyone is now discovering what those of us working in the system always knew: many nursing homes simply do not have the space to isolate patients in order to keep people safe during an outbreak. We need to create the space to provide the privacy seniors want for their dignity and autonomy – space which also serves to combat the spread of viral illness. ...

What about staff? These are the people our elderly are so dependent upon. They dress many of the residents and brush their teeth. They take them to the bathroom, clean them afterwards, and give them baths. To stop the spread of COVID-19, some provinces are now saying support workers may work in only one home, rather than different institutions from day to day or week to week. This will reduce the spread of the virus, but it will also build better relationships between workers and their patients.

Obviously, also mandating that nursing homes provide workers with proper protective gear as well as sick leave is as important to the patients as it is to the staff.

However, support workers need to be paid a decent wage, and receive full-time work and benefits. Earlier this year the Ontario government capped the wages of personal support workers at many nursing homes, for example, but the truth is that few of these workers make much more than minimum wage.

And we need more of them — not just to protect against illness, but also to relieve the regimentation of daily routine for the residents. ...

Few people realize how thinly nurses are stretched in these homes. There is usually only one nurse for about 30 often very ill residents in the daytime, one for about 60 at night. Usually there is no doctor on-site — residents typically see a doctor once every week or two. There aren't enough doctors and nurses to look after the routine needs of these patients, including palliative care in many cases, much less address the COVID-19 crisis. ...

The truth is that there would be fewer residents in these institutions if families had more help at home. Increased funding is needed for geriatric and palliative home care, to support not just the patient but also their family.

COVID-19 has made everyone think about what it means to be isolated and alone. For people in nursing homes, loneliness may be the most powerful condition of their everyday lives. When the pandemic is over, each one of us – whether we have a loved one in one of these homes or not – needs to consider whether there is something we can do to improve the living conditions and relieve the monotony and loneliness of our sickest seniors.

Many of our parents and grandparents will live their last months and years in these places. Many of us will end our days there, too. ...

Now and after the pandemic, let's make sure that nursing homes are not a feared destination in which to live or die.

https://www.cbc.ca/news/opinion/opinion-nursing-homes-conditions-1.5541155

NDPP

'Absolutely Could Have Been Avoided': How One Nursing Home Director's Fast Actions May Have Saved Lives

https://www.cbc.ca/news/canada/toronto/long-term-care-covid-19-eatonvill...

"This care home has no COVID-19 deaths. Another one nearby has 39 deaths. Why?"

jerrym

The numbers for deaths in long term care homes just keep getting worse.

Canada is closing in on 50,000 known cases, of which more than 2,700 have been fatal. Deaths in senior and long-term care facilities make up 79 per cent of COVID-19 fatalities, according to government data — particularly in Quebec, Ontario and Nova Scotia.

https://nationalpost.com/news/canada/covid-19-trudeau-says-in-many-parts...

jerrym

The situation is not improving in long term care facilities in Ontario. 

Ontario has recorded a significant spike in the number of new COVID-19 cases as the death toll in the province surpassed 1,500.

The province confirmed 477 new cases of the virus on Friday, the biggest single-day spike since May 2, bringing the total number of patients in Ontario to 19,598. Ontario also recorded 63 new COVID-19-related deaths, bringing the total to 1,540. ...

According to Friday's epidemiological summary, of all deceased patients in Ontario, seven were between the ages of 20 and 39, 66 people were between the ages of 40 and 59 and 388 people were between the ages of 60 and 79.

People, who are over the age of 80, continue to be the hardest hit group. So far, at least 1,079 people in this age group of have died.

There are currently 234 COVID-19 outbreaks at long-term care homes, according to the province. 

https://toronto.ctvnews.ca/ontario-records-significant-spike-in-covid-19...

jerrym

The flood of lawsuits in Canada over failing to deal adequately with the Covid-19 crisis has already started, with many of them invovling long-term care homes. 

Nursing homes, insurance companies, airlines among the targets of legal action already underway

Legal experts say to expect a slew of lawsuits to be filed in the coming months.

"Will there be a big bubble? Yes, absolutely,"  said Erik Knutsen, a Queen's University law professor and co-author of Canadian Tort Law and The Civil Litigation Process. "Is that a bad thing? No, because that's how we sort these things out. That's the mechanism. Do I expect there will be a large explosion of COVID-19 related litigation? 100 per cent." ...

According to research conducted by the law firm DLA Piper, there were just under 700 COVID-19 related individual legal actions and 176 ‎class actions filed in the U.S. as of April 28. 

In Canada, a total of 17 COVID-19-related class actions were filed across Canada with many more under investigation as of the same date. There have also ‎been a number of high profile, non-class action claims commenced, the law firm said. ...

Because Canadian class action plaintiff lawyers closely monitor U.S. court filings, the law firm said it anticipates a "host of 'copycat' class proceedings in Canada."

In the U.S.:

  • Nursing homes, where the virus has been most deadly, are expected to be hit by an onslaught of litigation.
  • Companies including Amazon and Costco are facing lawsuits, accused of price gouging.
  • Insurance companies are being taken to court for denying claims.
  • Airlines are being sued for not refunding tickets.
  • Cruise lines are being sued for negligence in their response to the COVID-19 outbreak.
  • Schools are facing lawsuits from students who are demanding partial refunds on tuition and campus fees, arguing they're not getting the calibre of education they were promised.

Experts say Canada may follow a similar path and in a few cases already has.

For instance, a $50-million class action lawsuit has been launched against Revera Retirement Living on behalf of the families of COVID-19 victims at the company's long-term care facilities in Ontario. ...

If it's a case of negligence, like those pertaining to nursing homes or cruise lines, the defence will likely be that none of it was foreseeable, that they couldn't predict or prevent all infections and that they complied with government regulations, Kalajdzic said. ...

But even though places like nursing homes may have met the minimum standards set out by the government, that doesn't mean they met the negligence standard, Knutsen said. Even if a statute of standards has been passed by the government, those standards may not meet the reasonableness test, he said.

"You may have to do more. The catch is it has to be obvious to a layperson, not a lawyer, a non-expert, that the standard itself was deficient." ...

However, in the U.S., at least, there's already a lot of pressure on governments to pass statutes that immunize various companies against liability, Kalajdzic said.

Nursing homes are pushing back against potential lawsuits with a lobbying effort to get states to grant them emergency protection from claims of inadequate care.

"There may be a solid case in law, but if the government passes a statute that provides statutory protection against liability, then there's very little litigants can do," Kalajdzic said.

And there's precedent, she said. In the wake of 9/11, Congress passed a statute that immunized airlines from any civil liability.

https://www.cbc.ca/news/coronavirus-lawsuits-insurance-nursing-homes-1.5...

 

northwestern_lad

As an aside, I can't help but notice that while Conrad Black, they threw away his Canadian citizenship when it suited him, is now printing crap saying that trying to fight Covid-19 is an overreaction, we're seeing asylum seekers, who have been attacked in the past by the likes of Black, are now in long-term care homes in Quebec, working in hot spots and serving Canadians in front line roles. Good on those folks for stepping up when so many others haven't, despite their residency situation. While those asylum seekers are actually helping things, Black and his ilk are doing the total opposite. When thinking of the state of our long-term care homes this week, that contrast really struck me and it's something I can't ignore:

https://magpiebrule.ca/2020/05/09/the-good-the-bad-and-the-connie/

lagatta4

Obviously we need a major overhaul of long-term care, but let's be frank, we also need straight talk about advance directives and the right to die under circumstances where we do NOT want to be kept alive. I'd say absolutely not dementia; please kill me (kindly). I think many people don't realise how horrific and dehumanising such a condition is.

jerrym

The % of deaths from Covid-19 occurring in long-term homes keeps climbing to now hit 82% of all Covid-19 deaths. This is the highest percentage by far of such deaths occurring in any of the 14 nations examined, telling us how horrid our system of senior care is. 

New data reveals the overwhelming toll on elderly Canadians in long-term care during the COVID-19 outbreak, showing they make up 82 per cent of all deaths.

The National Institute on Aging says that as of May 6, 3,436 residents and six staff members of long term care settings had died of COVID-19, representing 82 per cent of the 4,167 deaths reported as of Wednesday.

Dr. Samir Sinha, research director at the institute, says it is a staggering figure, given the roughly 400,000 residents living in care homes represent just one per cent of Canada’s population.

And it is a much higher figure than was indicated in a study released days ago by the International Long-Term Care Policy Network.

It said people in long-term care accounted for 62 per cent of Canada’s COVID-19 deaths. It also found Canada has the highest proportion of deaths from COVID-19 in long term care settings among 14.

https://www.thestar.com/politics/federal/2020/05/07/82-of-canadas-covid-...

jerrym

During Sunday's CBC The National, the broadcast showed the wretched living and working conditions found at many long term cares starting at 28:25 on the url below. It shows long term care worker staffing be changed from 4 residents to worker to 10 residents to worker in private homes, with workers begging inspectors to increase the staffing so that patient needs can be met and inspectors in Ontario saying there is nothing they can do as there are no regulations requiring this. 

https://www.youtube.com/watch?v=Cb5C25jjoOk

 

jerrym

Considering the wretched conditions for workers and residents vividly described in the CBC broadcast discussed in the previous post the Toronto Star's findings during an investigation of long-term care homes are hardly surprising. 

An analysis of long-term care home deaths by the Toronto Star concluded that "For-profit nursing homes have four times as many COVID-19 deaths as city-run homes".

Residents of for-profit nursing homes in Ontario are far more likely to be infected with COVID-19 and die than those who live in non-profit and municipally-run homes, the Star has found.

A Star analysis of public data on long-term-care homes shows the facilities have been hit by outbreaks at approximately the same rate, regardless of ownership. But once COVID-19 makes it into a nursing home, the outcomes have been far worse for residents of for-profit homes.

https://www.thestar.com/business/2020/05/08/for-profit-nursing-homes-hav...

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