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

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NDPP

'Now it's Happening Again...' (and vid)

https://twitter.com/AndreaHorwath/status/1328443611365707782

"During the first wave, Mr Ford promised an 'iron ring' around ltc homes. Instead he refused to spend the money to hire more PSWs to protect seniors, leaving thousands of families devastated. Now it's happening again and Mr Ford is gambling with people's lives."

And losing heavily.

[email protected]

NDPP

- 109 COVID-19 LTC outbreaks in Ontario

-   700 residents infected

-  11 new deaths

jerrym

Doris Grinspun, CEO of the Registered Nurses' Association of Ontario (RNAO) says the Ontario Ford government is not doing enough to stop the large number of deaths in long term care homes. 

The Ontario government is failing to prevent deaths of vulnerable people in long-term care homes and needs to tighten restrictions in red-control zones now, says the head of a group that represents registered nurses.

Doris Grinspun, CEO of the Registered Nurses' Association of Ontario (RNAO), called on the government to lock down the province immediately in the wake of seven deaths at a long-term care home in Scarborough.

"I have never seen such disregard for the lives of residents and their staff in long-term care, and by extension, the lives of families left in anguish," Grinspun said on Sunday.

Sienna Senior Living reported on Saturday that seven residents at Rockcliffe Care Community have died since a COVID-19 outbreak was declared at the home on Nov. 2. More than half of the residents at the home have become infected with the novel coronavirus.

A total of 136 residents and 66 staff members have tested positive for the virus. One resident case has been marked as resolved. Nineteen staff members have been cleared to return to work. The home, which has 204 beds, currently has 165 residents. ...

Grinspun was particularly critical of Merrilee Fullerton, minister of long-term care, saying Fullerton "ought to have known" that COVID-19 would begin to kill vulnerable people in long-term care homes during its second wave given that restrictions are not strict enough. Fullerton used to be a practising doctor.  "For most people, this is unbelievable. We predicted this scenario. The minister ought to have known that things would be this bad or worse going forward," Grinspun said on Sunday. "No one in government — the public, yes, but in government, no — should be surprised. We will see more outbreaks. We will see more tragedy," she added. ...

Grinspun said the association called on the government on Friday to implement an immediate 28-day lockdown of red-control zones in Ontario, with the exception of essential services and schools. The association also asked the government to make investments in staffing of registered nurses, nurse practitioners, registered practical nurses and personal support workers in all homes across Ontario. And it wants the government to keep "essential care partners" in the homes and to prevent crowding in homes where a number of people share one room.

"We are not acting soon enough," she said. "It's all empty words." Grinspun said if young men were dying, instead of elderly people, there would be protests in the streets — "no one would do that to them" — and the failure to act is clearly discrimination against older people. "It is ageism of major catastrophic proportions," she said.

https://www.cbc.ca/news/canada/toronto/rockcliffe-care-community-reactio...

jerrym

The Ontario NDP released a plan in October to move all long-term care facilities into the public sector following the disastrous performance of private sector LTC homes during Covid-19.

The Ontario New Democratic Party revealed an eight-year plan Friday to create a new long-term care system in the province — including transitioning all facilities to a public model, adding tens of thousands of new spaces for the elderly and eliminating the waiting list for long-term care if the party is elected in 2022. 

"The COVID-19 pandemic revealed a disaster hiding behind the walls of Ontario's long-term care homes," said NDP Leader Andrea Horwath in a news release. 

"We have to take action now to make sure people are safe in nursing homes and during home-care visits throughout the second wave," she said. 

The New Democrats released their plan one day after the office of the provincial Patient Ombudsman published a report that found complaints about long-term care homes increased over 370 per cent from March 1 to June 30 as the pandemic began sweeping through care facilities. As of Wednesday, the province was reporting that 1,952 residents in long-term care have died due to COVID-19, making up 65 per cent of COVID-19 deaths in Ontario. 

Cramped quarters and the neglect of residents, coupled with underpaid staff who sometimes worked at multiple homes were issues exacerbated by the pandemic and led to the death toll in long-term care facilities, experts told CBC News.   ...

The NDP says its plan will cost $750 million in capital investments per year over eight years starting in 2022 if the party comes to power, plus $3 billion in annual operating costs. It includes:

  • Overhauling home care to help people live at home longer.
  • Funding for more and better-paid full-time positions for personal support workers.
  • Funding for "culturally relevant care."
  • The creation of 50,000 new long-term care spaces for the elderly.
  • The eventual conversion of the long-term care sector to public ownership.

On Oct 1., the Ford government announced it would invest $461 million to temporarily raise hourly wages for close to 150,000 personal support workers.

But Horwath has been critical of Ford's decisions around long-term care throughout the pandemic, and the NDP's report claims Ford should have made changes more quickly to protect residents and staff working in the homes. ...

Horwath says an NDP government would build not-for-profit facilities that are "home-like" settings rather than "impersonal, institutional-like" care homes, and implement new standards to ensure new homes are built under the new model, while older homes are phased out. 

Along with those changes, Horwath says the NDP is "committed to creating full-time and well-paid jobs for personal support workers" to increase staff retention and make it a career more people consider.

Horwath is also committing to creating "culturally-responsive" care to make seniors feel "included" in homes regardless of background. 

https://www.cbc.ca/news/canada/toronto/ontario-ndp-plan-changes-to-long-...

jerrym

Another series of disasters in private sector long term care homes in Toronto: 

- Nearly half of all residents at a city-run long-term care home downtown have been infected with COVID-19 since a outbreak was declared at the facility last month.

The city has confirmed to CP24 that there have been 112 positive cases among residents at the 250-bed Fudger House since Oct. 2.

So far 74 of those residents have recovered from the virus and nine have died. The remaining 29 cases are still considered active. ...

The news of the dozens of positive cases at Fudger House comes as officials in Mississauga express concerns about another outbreak at a long-term care home in that facility.

There are now 90 positive cases among residents at the 151-bed Tyndall Nursing Home and another 65 among staff. “While our outbreak response team is working tirelessly with them to address infection control and outbreak interventions to bring this under control this is a dangerous sign,” Peel’s Medical Officer of Health Dr. Lawrence Loh said during a briefing, noting that it is the largest outbreak in any long-term care home in the region since the first wave of the pandemic.

There are currently 96 active outbreaks at Ontario long-term care homes.

The outbreak at Fudger House is among the biggest in Toronto but is not quite on the same scale as one at Rockcliffe Care Community in Scarborough, where 135 residents and 63 staff have tested positive.

https://toronto.ctvnews.ca/nearly-half-of-all-residents-at-toronto-long-...

 

NDPP

Blueprint for fixing our disastrous long-term care system

https://rabble.ca/news/2020/11/blueprint-fixing-our-disastrous-long-term...

"The COVID-19 crisis has exposed catastrophic weakness in Canada's patchwork system for housing and caring for the elderly and disabled. In this country, a huge proportion of the destruction the pandemic has wrought - the disease and death - has occurred in long term care facilities. Canada's record in this regard is one of the worst in the world..."

Time to make a big noise and demand  the lethal ltc system is fixed by the politicians that represent you baby boomers, before you find yourself crushed like so many others before in its deadly grip.

jerrym

The infection and death toll keeps mounting in long term care homes. Some people want to see rapid testing used to identify hot spots and possibly reduce the number of LTC home infections and deaths, but others note that it is not a panacea. 

 COVID-19 continues to devastate care homes in B.C., particularly in the Fraser Health region where there are currently four large outbreaks in seniors’ facilities.

In addition to Tabor Home in Abbotsford, where 16 residents have died and 136 residents and staff have tested positive, there are also large outbreaks at Fellburn Care Centre, Finnish Manor and White Rock Seniors Village.

According to Dr. Elizabeth Brodkin, the chief medical health officer for the region, 83 residents and staff have contracted the virus at Fellburn in Burnaby, and seven people have died. At Finish Manor, there have been 58 cases and seven deaths. White Rock Seniors Village has had three people die and a total of 50 people infected.

“It’s retraumatizing. It’s so sad to hear that so many of my colleagues are going through this. And the severity of some of these outbreaks, it’s heartbreaking, and I know what they’re gong through,” said Debra Hauptman. She runs Langley Lodge, which lost 26 residents to COVID-19 in the deadliest care home outbreak B.C. has seen. Hauptman wants Langley Lodge to be part of a pilot project to bring rapid testing to B.C. care homes. “It’s extremely critical that we have this option. We’re asking please, let us try it,” she said.

The pilot project is being proposed by the BC Care Providers Association, which wants to see how effective testing is at keeping the virus out of care homes.

“That way, not only can we ensure we don’t have these outbreaks affecting residents and staff, but we might be able to reunite families, especially as we approach Christmas. Because it’s been heartbreaking to see the separation of families,” said Terry Lake, CEO of the BCCPA. “I think if we had done more work sooner, we’d be in a better place today,” he added.

His association wants to partner with one of the health authorities for the pilot project, but says his organization will forge ahead on its own if necessary. Proactive testing is already being done in some care facilities in Ontario. Manitoba is also working on a plan. Lake said the testing in a pilot project would likely be done three times a week. ...

The chief medical health officer for Fraser Health said rapid testing in care homes is under consideration, but she has reservations. “It is not a perfect answer because it is only a point in time. So if you test someone on Monday and it’s negative, it tells you they don’t have virus on Monday but it doesn’t tell you they won’t have virus on Tuesday or Wednesday,” said Dr. Brodkin. She also said there are concerns that staff could become too reliant on the test. “I know there is some concern if these were introduced in long-term care facilities, they might back off on some of the other things they are doing, which would be a big mistake,” she said.

https://bc.ctvnews.ca/push-for-rapid-testing-as-b-c-care-homes-battle-4-...

NDPP

Exclusive: 96% of Residents at Sunnywood LTC in Whitby have Tested Positive. 19 have died. 67 staff are positive. An inspection done less than 2 weeks ago found 'widespread failures' caused 'actual harm to residents.' No one was screened upon entry, PPE improperly used.

https://twitter.com/acelawyers/status/1336477780507316225

"These numbers are reprehensible, horrific, deplorable and blameworthy..."

[email protected]

NDPP

Ontario LTC Home Logs Zero Cases of COVID-19 in First and Second Wave of Pandemic

https://toronto.ctvnews.ca/ontario-long-term-care-home-logs-zero-cases-o...

"As long term care homes continue to grapple with the second wave of covid-19, The Mariann Home in Richmond Hill, Ont has so far weathered the pandemic without a single case of covid-19, which families and staff attribute to a number of safety measures taken earlier this year..."

Why aren't similar measures taken elsewhere?

NDPP

Two Ontario LTC Operators Got $157 M in COVID-19 Aid. They Also Paid $74 M to Shareholders

https://www.cbc.ca/news/canada/toronto/big-spend-long-term-care-aid-divi...

"Two of the largest long-term care providers in the Toronto area have received more than $157 million in federal and provincial COVID-19 relief while also paying out tens of millions of dollars in dividends to their shareholders. Extendicare Inc and Sienna Senior Living Inc have paid a combined total of $74 million in dividends this year. Meanwhile, more than 480 residents and staff have died of COVID-19 at the companies' care homes in Ontario."

Obviously richly deserved. Think of all the pension money saved. Most Ontarians will tsk tsk a little, avert their eyes and just be glad it's not them inside these for profit death-houses for the aged. As a result, nothing will change. Why would it? This is Canada...

 

NDPP

Former Ontario premier Mike Harris is raking in profits from the long-term [couldn't care less] system he helped create

https://rabble.ca/blogs/bloggers/council-canadians-blog/2020/06/former-o...

"Flash forward 25 years, as successive Conservative and Liberal governments continue this privatization trend...'

No wonder Doug  won't fix it...

[email protected]

NDPP

The Invisible People of Society (radio)

https://www.cbc.ca/radio/ideas/ideas-2021-our-annual-new-year-s-levee-1....

"IDEAS contributor Mary Lynk's documentary focuses on elderly people's place in the common good, as she describes them as often being 'the invisible people of society.' 'A friend of mine said to me when I was telling her I was working on this piece, 'everybody wants to get old but nobody wants to be old. And that what we dread about age is ageism. And ageism is huge in Western culture.' Lynk's documentary was inspired by her 94-year-old father who now lives with her."

Especially in Canada. It's probably why we accept the horrendous conditions in the ltc 'killing fields' with such relative equanimity.

Aristotleded24

Another home being protested:

Quote:

Scores of people protested outside a Scarborough long-term care home on Saturday to draw attention to conditions inside the facility where 60 residents have died of COVID-19.

Tendercare Living Centre, 1020 McNicoll Ave., has lost 60 residents to the novel coronavirus as of Saturday, according to North York General Hospital (NYGH). The provincial government asked NYGH on Dec. 25 to help the home manage its COVID-19 outbreak for 90 days.

Maureen McDermott, a protester whose mother is in River Glen Haven Nursing Home in Sutton, Ont., wondered aloud at the rally how many people have to die before Ontario Premier Doug Ford and Long-Term Care Minister Merrilee Fullerton bring in the Canadian Armed Forces.

"What's that number going to look like tomorrow and the next day? This is disgusting," McDermott told the gathering,

"My mother resides in long-term care and putting her into long-term care was the worst day of my life, handing that over. But I had to have faith. And I did have faith. Then COVID-19 happened," she said.

NDPP

There is no excuse for the suffering and death happening again in Ontario's long-term care

https://www.theglobeandmail.com/opinion/article-there-is-no-excuse-for-t...

"Ontario Premier Doug Ford promised to 'move heaven and earth' to protect seniors in long-term care. It would be too grandiose to say he has failed. More accurately, it seems he didn't even try. Indeed, the same horrifying scenes of disorder and neglect are playing out in residential care homes across Ontario, where the government has undeniably failed to deliver on its promise to protect those most vulnerable to this disease. There is no excuse for this calamity..."

 

'Save our Seniors!': Death Toll at Scarborough LTC Home Climbs to 60 (and vid)

https://twitter.com/CP24/status/1345723462896250880

"...Carrying signs that read 'save our seniors' and 'care over profits', demonstrators said the pandemic has shown that private nursing homes focus on profits instead of providing care to residents. They also want the Ford government to revisit legislation that they say makes it harder to hold private operators liable..."

WTF Ontario?! There are currently 207 Ontario LTC homes in outbreak - the worst since the pandemic began. Doug Ford's promise to build an 'iron ring' of protection around vulnerable seniors in ltc homes has turned out to be the promise of an iron ring of death from which there is no escape. This is a monstrous official dereliction of duty at best and at worst criminal negligence and manslaughter. Why has this unacceptable situation not been rectified? Why no charges? How shameful also that more Ontarians have not demanded immediate necessary corrective action to this ongoing extermination of our ltch elders. Some have been forced to call 911 because they are not  even receiving regular meals. Yet wealthy corporate shareholders have been paid dividends and bonuses.

[email protected]

 

jerrym

Once again the Ford government is facing a crisis in the long-term care homes with the situation so bad that CUPE is pushing the government to send the military back into the long-term care homes. It also called the Ford government's attempts at reforms in LTC 'lethargic and inadequate. 

It’s time for the Ontario government to send the military into long-term-care homes, the Canadian Union of Public Employees says.

With growing COVID-19 outbreaks in the province’s care homes, “We are tragically losing the battle to protect long-term care residents,” CUPE Ontario secretary-treasurer Candace Rennick said in a news release Saturday. “The homes and staff are on the verge of total crisis and collapse.”

The union is joining the Ontario Health Coalition in asking the Ford government to send the military into the hardest hit homes, as it did during the first wave of the virus.

On Wednesday, coalition executive director Natalie Mehra said it was clear the measures the province had taken since the second wave of COVID hit Ontario were insufficient. “What we’re seeing is worse than anything I have ever seen in the homes,” she said.

As of Jan. 1, Public Health Ontario reported 2,814 COVID deaths among residents of long-term-care homes and 11,217 total confirmed cases of the virus.

In its release, CUPE said there were 187 homes in outbreak with 1,186 positive residents and 1,050 positive staff, although those figures are likely a day out of date.

In a statement Wednesday night, the province insisted it is doing all it can to stem the second wave.

CUPE said the PC government’s efforts to reform long-term care were “lethargic and inadequate.” And it also called military intervention “a temporary solution to the worsening crisis caused by the government’s failure to implement immediate and meaningful reforms needed months ago. This kind of crisis cannot continue to be met with half measures by the province.”

https://www.thestar.com/news/ontario/2021/01/02/send-in-the-military-pub...

Aristotleded24

Meanwhile in Regjna:

Quote:

The Saskatchewan government says it's aware of 65 deaths among long-term care or personal care home residents who were infected with COVID-19 since the pandemic arrived in the province last March.

One home run by a private company under a contract with the Saskatchewan Health Authority (SHA) has accounted for nearly two-thirds of those deaths.

In Saskatchewan, special care homes are statistically classified as long-term care homes. In some cases, special care homes are operated by a company that has a contract with the SHA, which inspects and monitors the homes. 

Extendicare's Parkside facility in Regina is one such care home.

As of Monday afternoon, 40 of Parkside's approximately 200 original inhabitants had died after becoming infected with COVID-19, including three who had been moved to a separate Regina seniors complex. The outbreak began in late November and has proved the most deadly in any Saskatchewan nursing home, although no new cases among residents were recorded as of late last week.

jerrym

In an interview on Power and Politics on January 4, 2021, Ontario NDP Opposition Leader Andrea Horwath discussed the utter failure of the Ford government to deal with Covid-19, where cases are skyrocketing, the disaster in LTC homes escalates, and a vaccination program that has the lowest vacination rate in the country is far from working well.

During the Power and Politics interview Horwath noted that over 200 long-term care (LTC) homes in Ontario have Covid outbreaks with 2,843 dead there already in these homes. Pointing out that there are reports of LTC residents begging for food and water to survive, in addition to the failure to get support in dealing with Covid, she demanded immediate action. Horwath sees the situation as so desperate that Ford needs to call in the Red Cross and  army to deal with the the long-term care problems. She also pushed for experts to be sent into each of the LTC homes to design Covid-19 containment plans to save as many residents as possible. Despite the enormous problems in the homes she pointed out that Ford has no plans to increase staffing in the homes until 2025. 

Many of the homes where things are completely out-of-hand are run by the private sector. Horwath earlier had called for making the private sector LTCs part of the public sector. "The Ontario New Democratic Party revealed an eight-year plan Friday to create a new long-term care system in the province — including transitioning all facilities to a public sector model". (https://www.cbc.ca/news/canada/toronto/ontario-ndp-plan-changes-to-long-...)  

Despite the Ford government getting 100 billion in funds from the federal government to deal with the problem that it has not utilized $12 billion according to the auditor general. "The Ontario government was sitting on $12 billion in COVID-19 contingency funding around the same time the second wave of COVID-19 began, the province’s financial watchdog said Tuesday." (https://toronto.ctvnews.ca/ontario-sitting-on-12b-in-unspent-covid-19-co...) It looks like the money it is not spending is going to be used to reduce the budget deficit so the Cons can proclaim they are great budget managers. How sick.

The video of Horwath's comments in the Power and Politics interview can be seen at the url below, starting at 19:35 minutes. 

https://gem.cbc.ca/media/power-politics/provincial-ministers-resign-foll...

jerrym

Even within the same senior care home, there is some questionable choices being made about who does and does not get a vaccination. 

Families have learned that where their loved ones live in the Copernicus Lodge seniors' home will determine whether or not they're eligible to receive the COVID-19 vaccine right now.

Residents in one of the home's senior apartment units, Tony Morawski, 101, and his 92-year-old wife, Jean, have lived at the facility for three years and have managed to fend off COVID-19 so far. 

Desperate to keep it that way, their family was holding out hope that they would be vaccinated as soon as possible in the home, located in the Roncesvalles neighbourhood in Toronto's west end.

But now they've learned those living in the home's apartment units will not get the shot at the same time as residents living in the long-term care facilities located in the same building. 

'Sitting ducks'

"We know that those residents are sitting ducks," said Dr. Samir Sinha, director of geriatrics at Mount Sinai Health told CBC News.

Copernicus Lodge, located in Toronto's Roncesvalles neighbourhood, offers a long-term care or nursing home setting along with senior apartments. The nursing-home side is facing an outbreak of the novel coronavirus, with 47 residents infected.

But senior apartments that share the same space as long-term care facilities often share staff as well, Sinha points out. Plus, many residents of those apartments, like Morawski and his wife, are at advanced ages, meaning they face a heightened threat of catching and dying of COVID-19.

"We have enough vaccine to get all these people done. Why we're actually picking and choosing and putting people at risk doesn't make any sense to me," Sinha said, adding it's unacceptable that those living in seniors' apartments are being forced to wait for the vaccine.

https://www.cbc.ca/news/canada/toronto/he-s-101-she-s-92-but-this-couple...

eastnoireast

i wonder how much money flowed out canadian for-profit ltc facilities since this all started,  how much flows out monthly. 

it should be garnesheed, retroactively, directly towards improving conditions.

even if it impacts investor confidence.

jerrym

In Ontario, the situation in long-term care homes is in full crisis as Ford admits his willingness to accept Trudeau's offer of military help and the PC government fails to offer a clear description of what its plan is. 

At a news conference Wednesday, Premier Doug Ford was asked about the "iron ring" the province had said it planned to secure around Ontario's long-term care homes. In response, Ford pleaded with front-line health-care workers to get tested for COVID-19.

"It's not coming in through the walls and the ceiling ... inadvertently though our great health-care workers, it's coming in," Ford said.

The premier also said at the news conference it's possible Canadian Forces soldiers will be called in again to help at some hard-hit homes, although he provided no specifics. 

However, a senior official in the Ford government later told CBC News that the province does not believe that any long-term care homes are currently in need of assistance from the military. The Red Cross is already assisting in homes, and no facilities have such a staffing crisis that military support is warranted at this time, said the official.

https://www.cbc.ca/news/canada/toronto/covid-19-ontario-january-13-2021-...

NDPP

Extendicare now hit with $200 million class-action lawsuit over ltc deaths

https://twitter.com/CP24/status/1349444212459233282

 

Hospital takes over management at Roncesvalles ltc home with COVID-19 outbreak

https://twitter.com/CP24/status/1349453707142979591

 

CBC: Ontario LTC Homes in Crisis

https://youtu.be/3RpdECwpVHg

"Rising LTC outbreaks in Ontario raise questions..."

jerrym

More evidence of the crisis created by private sector long-term care and the need for its removal during the Covid Crisis. 

The long-term care (LTC) home crisis in Ontario is a case study in the perils of treating healthcare as a vehicle for profit.

A recent report from the Canadian Medical Association (CMA) on the risks of COVID-related deaths in Ontario residences found significantly worse outcomes in for-profit and non-profit homes than in publicly run homes – outbreaks were far more likely in both for-profit and non-profit facilities and the death rate was nearly double that of the public sector.

As an overwhelming majority of Ontario’s 623 residences are run by chain companies –  57.7 per cent for profit, 26 per cent non-profit and 16.2 per cent municipal –  the necessity of including long-term care in a truly universal, publicly funded and accessible healthcare system has never been clearer.

Those in power have ignored strong criticisms of the living and labour conditions in Canada’s LTC system for decades. But the research is unambiguous: for-profit facilities offer comparatively substandard care. In fact, the CMA recommended a transition away from private facilities as far back as 1984. It should come as no surprise that LTC homes were woefully unprepared to survive the impact of the virus. ...

The poor living and labour conditions in LTC facilities have made them petri dishes for rapid contagion. Across Canada, 80 per cent of COVID-related fatalities have occurred in LTC facilities – double the average of other OECD countries. Ontario itself is struggling to cope with an embarrassing 70 per cent of its total deaths in LTCs. What’s worse, mismanagement and neglect within Ontario’s long-term residential homes are disturbingly widespread. Reports of LTC misconduct reveal that an alarming number of those who died from COVID-19 were already suffering in environments marred by gross indignity and, in some cases, abuse.

Military intervention during the first wave of the pandemic attracted significant media attention across Canada. The struggles of care workers and residents – long hidden from sight – finally came into public view. The military personnel sent to five homes in the Greater Toronto Area – four run by for-profit firms and one non-profit – were asked to compile an official report based on their observations.

The findings are as heartbreaking as they are horrifying. They include numerous instances of elder abuse, physical violence, forced feeding (“audible choking”) and a liberal use of chemical restraints. Staff were seen ripping out catheters, leaving wounds and infections untreated and using unsterile equipment. Residents often waited for assistance while in soiled diapers. ...

An investigation by the CBC revealed that 85 per cent of LTC homes in Ontario have routinely violated healthcare standards for decades with near-total impunity. One family featured in the investigation grew suspicious after witnessing a significant decline in their mother’s wellbeing shortly after moving into a private nursing home. They decided to hide a camera in her room. The footage has been described as akin to “watching a horror film.” ...

The LTC crisis is a result of decades of welfare-state retrenchment and the general weakness of Canada’s pension-plan model. In 1995, Ottawa dramatically overhauled the system of federal transfer payments to the provinces. These transfer payments had previously funded the bulk of Canadian healthcare, education and social services. Over the course of this transition, governments quietly cut billions of dollars from these essential programs. This downloading of costs from federal to provincial governments was a trend from the late 1980s to mid-90s as all levels of government moved toward fiscal conservatism and privatization.

With far fewer revenue-generating mechanisms for the provinces, the programs now faced significant funding challenges. Partnering with the private sector became an increasingly attractive proposition for cash-strapped local governments.

These revenue constraints contributed to the development of Ontario’s patchwork LTC system. The history of LTC in the province is one of path dependency and neglect. The core of the problem is that the present LTC system, as Richard O’Donnell, former president of the for-profit Ontario Nursing Home Association puts it, “was never planned; it has simply evolved.” ...

Because LTC facilities service an aging population – what’s known as a “guaranteed consumer-base” – they are understood to provide lucrative opportunities for private profiteering. The introduction of debt-financing for private operators has ensured corporate hegemony over LTC provision. And the entry of real-estate investment trusts (REITs) – companies that own or finance income-producing real estate assets – into LTC investment has accelerated the financialization of the sector. This, in turn, has attracted the interest of private equity firms.

Over the past two decades, REITs, international investors and private equity firms have acquired control of 17 per cent of all LTCs and 38 per cent of retirement homes across Canada. ...

Both the privatization and financialization of long-term care are consistent trends across Canada. But Ontario has the highest proportionof for-profit LTC homes in the country. Some scholars estimate that, compared to all other provincial healthcare systems, Ontario’s delivery and management of LTCs is Canada’s most commercialized area of healthcare “with the possible exception of pharmaceutical manufacturing.” Study after study finds that for-profit facilities offer lower quality carelower staffing levels and engage in egregious labour practices.

Despite lower death rates and flattening the curve far more effectively than the for-profit and non-profit sectors, inadequate funding from all levels of government has taken a toll on the public system as well. city-run facility in Ottawa recently made headlines for much the same reasons as private LTC homes: inadequate infection control, repeated medication errors, poor skin and wound care and accounts of abuse. ...

The overwhelming majority of expenditures for LTC homes are labour costs. Keeping these costs low is key if LTC businesses want to maintain their profits. According to the latest available data on staffing in Ontario’s LTCs, personal support workers (PSWs), registered nurses (RNs) and nurse practitioners (NPs) in for-profit homes are paid less than those in public ones. An overwhelming number of staff in private homes –­ 48 per cent of PSWs and 30 per cent of nurses – work part-time across multiple facilities and hold two or more jobs to stay afloat. Workers in public facilities have more job security, higher wages and dramatically higher rates of unionization compared to both the for-profit and non-profit sectors. ...

In its report, the Canadian military noted a “culture of fear” among exhausted and poorly paid workers who are afraid to speak out or question employer practices. ...

The absence of any political will to address long-standing issues of neglect in LTC facilities impacts residents and workers alike. The exploitative labour practices in most LTC facilities have taken a huge toll on a predominantly female and racialized workforce. ...

Ontario Premier Doug Ford has come to the swift defense of the for-profit LTC sector, introducing a bill to extend liability insurance to businesses, workers and non-profits. The government has given assurance that the law will not absolve healthcare providers of responsibility in the face of “gross negligence.” But personal injury lawyers and the New Democratic Party have slammed the bill as dangerous on the grounds that it will make the definition of “negligence” open to debate.

https://healthydebate.ca/opinions/crisis-privatized-care-in-ontario

jerrym

Linda McQuaig has also provided more evidence for the failure of private sector long term care during the Covid crisis, discussing how evidence financialized firms in charge of LTC homes do an even worse job than other private sector firms, which, in turn, do worse than non-profit and public sector LTC homes. 

When it became clear last fall that Ontario's long-term care (LTC) homes were about to be engulfed by the second wave of the pandemic, the Ford government swung into action.

Wasting no time, it promptly introduced legislation -- legislation that gave the corporate owners of long-term care homes extra protection from lawsuits that were accumulating against them.

Tragically, the province has shown no such speed or dedication to the task of providing extra protection -- or much protection at all -- to the elderly people who live in these homes and who, unlike the corporate owners, really are helpless to defend themselves.

It's striking that Premier Doug Ford has given priority to the interests of these corporate owners even as the coronavirus has swept through LTC homes, turning them into gruesome death traps and claiming the lives of almost 3,000 residents.

Investigations, including those done by Toronto Star reporters, have found that the coronavirus death rate has been significantly higher in for-profit homes than in not-for-profit homes.

Dramatic as this finding is, it may only hint at the extent of the problem resulting from allowing the for-profit sector to operate in the long-term care industry.

Indeed, the greatest danger may be posed by the emergence in the industry of "financialized" enterprises -- firms that operate according to a more bare-knuckle type of capitalism, associated with the financial industry, that focuses relentlessly on cost-cutting to drive ever-higher profit margins.

These financialized firms -- which include private equity funds and real estate investment trusts (REIT) -- have become a major presence in the seniors housing industry. They operate large chains and now control just over 30 per cent of government-funded LTC homes in Ontario.

Perhaps not surprisingly, LTC homes controlled by these financialized firms have experienced even higher coronavirus death rates than LTC homes controlled by other for-profit operators, according to Martine August, assistant professor at the University of Waterloo's School of Planning.

So if there are concerns about permitting profit-making in homes caring for the elderly -- and there should be -- these financialized firms should be particularly setting off alarms.

The financialized firms are "like private ownership on steroids," August says.

One concern is the impact on labour, the biggest cost driver in LTC homes. Unions representing LTC workers charge that for-profit homes generally pay very low wages and offer mostly part-time and casual work -- reducing the chance of meaningful relationships developing between staff and residents.

As for financialized LTCs specifically, there's little Canadian research but international studies show they tend to have fewer staff hours and lower-quality care, allowing them to increase shareholder dividends and raise executive pay, says August.

All this cries out for more public ownership and control over long-term care homes.

But, in recent decades, Ontario has gone in the opposite direction, encouraging private ownership in the industry. Roughly 57 per cent of the province's LTCs are now privately owned, with two U.S.-based REITs, Ventas and Welltower, among the biggest players in the industry.

The move toward privatization got started under then-Conservative premier Mike Harris, whose government made long-term care more attractive to private business by removing minimum staffing levels in the homes, making them ripe for profit-making. ...

From his vantage point as premier, with projections showing a coming explosion in the demand for seniors housing, Harris had little trouble spotting the lucrative potential for financialized firms in the industry. After retiring as premier in 2002, he quickly became chairman of a newly formed REIT called Chartwell Retirement Residences, which operates both publicly funded LTC homes and privately paid retirement homes. Over the past decade, Chartwell has distributed $798 million to shareholders and paid its executives $47.3 million, including an annual salary of $229,500 for the former premier's part-time chairmanship, which he still holds.

Mike Harris' involvement in the dubious rise of privatization -- and financialization -- in the long-term care industry makes it all the more outrageous that the Ford government recently awarded him the Order of Ontario, even as the pandemic continues its relentless slaughter of helpless LTC residents.

https://rabble.ca/columnists/2021/01/rise-private-ownership-steroids-fue...

jerrym

The UK Covid strain has hit Roberta Place long term care (LTC) home in Barrie Ontario with devastating consequences as it spread like wildfire through residents and staff. It seems like a warning of what this more contagious mutation could do in other LTCs. Ford dismissed calls to send in the military saying it was unnecessary. 

Public health officials confirm a new, more easily transmissible variant of COVID-19 first identified in the United Kingdom has torn through Roberta Place Long-Term Care in Barrie, sickening all but two of its residents and killing 41 people.

Genome sequencing identified the U.K. B.1.1.7 variant in six swabs taken from the facility. The Simcoe Muskoka District Health Unit all cases at Roberta Place are likely a result of the U.K. variant.

Officials said 127 residents have tested positive for COVID-19. By Sunday afternoon, 40 of those residents had died. One of two infected essential visitors has also died.

Medical Officer of Health Dr. Charles Gardner said Sunday that 86 employees of the home, which is roughly half of the staff, have contracted the virus since Jan. 8. Three external partners and 42 household contacts of primary cases have also tested positive.

Confirmation of the U.K. variant inside Roberta Place profoundly concerns to Gardner.

"What we have here, we probably won't be able to contain. And therefore it becomes a risk to the broader community and other facilities."

He warns the region is "on the edge" of seeing community spread of the variant and is open to the possibility of more specialized testing to detect it.

Roberta Place's first positive case was in a staff member who'd had close contact with someone who recently travelled, though not to the U.K. While officials will not reveal the relationship between the staff member and the traveller, Gardner said the traveller made efforts to isolate within a shared home and that no quarantine rules were broken.

Fifty-five cases of COVID-19 were identified in the first 48 hours of the outbreak.

The rapid rise in cases meant many symptomatic staff members had to stay home. David Jarlette, President of Jarlette Health Services, said that left Roberta Place too short-handed to separate infected and non-infected residents properly.​ ...

The provincial government has dismissed calls to deploy the military, insisting that there isn't the same sort of staffing concern experienced at long-term care homes in the pandemic's first wave.

https://barrie.ctvnews.ca/u-k-variant-confirmed-at-barrie-ont-care-home-...

jerrym

217 doctors in Ontario have signed a letter calling for an end to for-profit long term care homes.

With hundreds of Ontario long-term care residents dead and COVID-19 outbreaks continuing to ravage facilities across the province, a group of health experts is pushing the province to abolish for-profit long-term care facilities. ...

Out of more than 5,900 COVID-19-related deaths in the province, more than 3,400 were in long-term care, according to provincial statistics.

After a lull in cases in the summer, Dosani said long-term care homes are still seeing poor infection-control practices and a delayed response to outbreaks. ...

He also referenced this report from Ontario's COVID-19 Advisory Table, which found that in the first wave of the pandemic, the province saw 78 per cent more deaths in people with COVID-19 in for-profit homes than in their public counterparts.  "It's not a fluke," Dosani said. "This system was actually built this way. It's built to put profits over people. When you think about for-profit homes, they're by design created to have one thing in mind and that's profits for shareholders. It's not care for our seniors," Dr. Naheed Dosani, said Tuesday on CBC Radio's Metro Morning. "This is a humanitarian crisis." Dosani, a palliative care physician for the William Osler Health System, which has hospitals in Brampton and Etobicoke, is one of more than 215 Ontario doctors and researchers who have joined the Doctors for Justice in Long-Term Care campaign.

Despite repeated assertions from Premier Doug Ford, Long-Term Care Minister Merrilee Fullerton and other provincial officials that Ontario was building an "iron ring" around its long-term care facilities to protect residents from a second wave of the virus, deaths have continued to mount. ...

The group of doctors is also calling on the province to take the following measures with respect to long-term care:  

  • hire appropriate levels of staff
  • set a minimum pay standard for front-line workers
  • ensure at least 70 per cent of staff at every facility are working full time
  • let family caregivers have access to facilities 
  • work with hospitals to establish partnerships for care
  • Keep hospital teams on standby
  • Call upon the military if required
  • Accelerate vaccination rollout to LTC homes

"Until we actually delve deeper at the roots — the systemic underpinnings of what is causing this crisis in long-term care — we will not develop that iron ring," Dosani said. "The solutions and conversations thus far have been way too superficial, and have been band-aid approaches." ...

Ontario NDP leader Andrea Horwath backed the group's campaign. "I'm grateful to these doctors and researchers for coming together to advocate for seniors," she said in a statement. "Long-term care residents and their loved ones have endured agony, incredible sorrow, and tragic loss during this pandemic. Ford has "protected for-profit corporations — allowing them to put their bottom line ahead of the care and quality of life of seniors," Horwath said in the statement. "It's time for an overhaul to stop the terrible living conditions and preventable deaths." 

An independent commission — Ontario's Long-Term Care COVID-19 Commission — has been looking into how the province handled the deadly spread of COVID-19 in long-term care homes and has flagged a lack of provincial oversight and uneven management standards. The commission's interim report on the situation late last year pointed to a provincial decision in the fall of 2018 to end comprehensive inspections and a lack of enforcement when issues are found. It also found that fines and prosecutions are rarely applied to home operators, leaving a lack of urgency to address violations. Earlier this month, the commission told the province it needed more time to finish its final report because the government itself wasn't providing enough documentation.

https://www.cbc.ca/news/canada/toronto/ontario-long-term-care-1.5888226

NDPP

re above:

"200+ doctors and researchers @Docs4LTCJustice sign letter calling on Ontario government to urgently address the LTC crisis. We must end for-profit LTC, and the staffing crisis, and legislate family caregiver rights. We demand #LTC justice!"

https://twitter.com/SharkawyMD/status/1354096470115426310

[email protected]

jerrym

In September, Sharleen Stewart, president of SEIU Healthcare, called for an end to for-profit care. She said the province is not holding companies accountable for failures in the system. She said the long-term care homes are in worse shape today than they were before the pandemic. Stewart said for-profit homes have 17 per cent fewer staff, pay their workers less and had worse outcomes in the pandemic than non-profit or municipally run homes. (post #137)

In October, the Ontario NDP released a plan  to move all long-term care facilities into the public sector following the disastrous performance of private sector LTC homes during Covid-19 (post #155). 

Former Ontario premier Mike Harris has been raking in profits from the long-term system he helped create while premier (post #162), driving home the inherent conflict of interest between the PCs, their leadership and their private sector LTC donors.

In January, Linda McQuaig has also provided more evidence for the failure of private sector long term care during the Covid crisis, discussing how evidence financialized firms in charge of LTC homes do an even worse job than other private sector firms, which, in turn, do worse than non-profit and public sector LTC homes (post #174). 

Also in January, more than 2oo doctors in Ontario have signed a letter calling for an end to for-profit long term care homes (post #176).

This month the federal NDP released a plan to eliminate the private sector long term care sector across Canada by 2030, not only because of its failure to deal with Covid, but also because of all the other problems associated with this sector. 

The NDP is calling for the elimination of for-profit long-term care by 2030 in a multibillion-dollar plan presented as a potential election promise.

New Democrat Leader Jagmeet Singh says an NDP government would convene provincial and territorial leaders, experts and workers to set national standards for nursing homes, and tether those benchmarks to $5 billion in federal funding.

The proposal is the latest move in anticipation of a possible election campaign as parties vet candidates and rev up fundraising.

In a release Friday, Singh accuses the minority Liberal government of underfunding health care and protecting the profits of large companies and shareholders.

"Justin Trudeau made a promise to long-term care workers, residents, and their families to better fund long-term care and seniors care before he was prime minister. He broke his promise," Singh said.

The NDP's pre-emptive platform plank would see a national task force charged with crafting a plan to transition all for-profit care to a not-for-profit model in less than 10 years.

It would also follow through on New Democrats' calls to immediately transform Revera from a for-profit long-term care chain owned by a Crown pension fund into a publicly managed entity.

The company runs more than 500 seniors' residences in Canada, the United States and the United Kingdom. It is owned by the Public Sector Pension Investment Board, which bought it out in 2007.

Several studies over the past six months have found that for-profit care homes were likelier to see more extensive COVID-19 outbreaks and more deaths, exposing cracks in care models across the country. ...

​Trudeau has reiterated that he respects provincial jurisdiction while seeking to protect seniors' rights through billions of dollars in extra support funds transferred to the provinces over the past year. ...

Health Canada has referred questions about ending Revera's for-profit model to the provinces, given their constitutional jurisdiction over health care.

Singh's pledge on long-term care builds on past demands to remove the profit element from the health-care system, and fits into a broader progressive push by the NDP since he took the party helm in 2017. Singh has continued to call for a tax on the "ultra-rich," criticize how wage subsidies found their way into shareholder bank accounts and chip away at the Liberals for sluggish progress on national pharmacare and child-care programs. He has also made a renewed push for voters under 35, advocating for cancelled interest payments on federal student loans, now part of the government's fiscal update.

Under the new NDP proposal, funding for provinces and territories would be tied to principles of accessibility and public administration in the Canada Health Act, legislation that currently does not cover long-term care.

Nursing homes, unlike hospitals, are excluded from provincial and territorial public health systems, which critics say leads to under-training of workers, substandard facilities and -- particularly in some for-profit homes -- overcrowding.

More than a quarter of Canada's 2,039 long-term care homes are for-profit, according to the Canadian Institute for Health Information.

Recent outbreaks at several homes have set off alarm bells after the first wave saw more than 80 per cent of COVID-19 deaths occur in long-term care facilities.

As of Thursday, 66 of the 127 residents of the private Roberta Place care home in Barrie, Ont., who were infected with a highly contagious COVID-19 variant have died, according to a spokesperson.

https://www.ctvnews.ca/politics/ndp-calls-for-end-of-for-profit-long-ter...

jerrym

Transcripts from the province's long-term care commission that were just released on Sunday show that Minister Merrilee Fullerton knew about the extreme risks LTC seniors faced in early February 2020, two months before any action was taken to reduce the risks that they faced. Her excuses for not acting are lame. She mentions that while she had considered limiting LTC workers to one home rather than allowing them to continue working in more than one would have faced legal issues, but the NDP BC government did limit workers to one home by adjusting their pay upward and making work full-time, something that a conservative government would tend to oppose. BC has had far fewer LTC deaths per capita than Ontario, not coincidentally.

The Ministry of Long Term Care itself had only been spun off from the Ministry of Health in mid 2019 and still seems to be in set up mode, unsure of itself, and too influenced by private sector LTC homes. 

NDP Leader Andrea Horwath says this costs many LTC resdients their lives. 

 Ontario's Opposition says the province's long-term care minister should have spoken out earlier on the risk COVID-19 posed to the province's nursing homes. NDP Leader Andrea Horwath says Minister Merrilee Fullerton should have made her concerns public when the government said the opposite at the start of the pandemic.

Newly released transcripts show Fulllerton told the province's long-term care commission that she was aware of the dangers the novel coronavirus posed to the sector long before it was declared a global pandemic....

Fullerton's told the commission that she and her ministry advocated for stronger measures than what the government was willing to put in place, earlier than they were willing to act. Fullerton, who is family doctor, says today that she is not a public health specialist and at the time felt it was important to take advice from experts in the field.

Horwath says if Fullerton had spoken up about the situation she could have saved lives.

Fullerton testified before the Long-Term Care COVID-19 Commission last week, with the transcript posted online Sunday night. ...

For instance, Fullerton's notes from the time suggest she was concerned about asymptomatic spread of COVID-19 in long-term care homes as early as Feb. 5, 2020. That possibility wasn't publicly acknowledged by the government until much later. "I recognize that at times people can overstep, so that was -- I needed to listen to the experts and the science and ... I was trying to wear my -- not my doctor or public health hat, because that's not the role I had," she told the commission.

But she noted that her personal history gave her insights into the situation that other politicians may lack.

"I had suspicions early on only -- well, because I'm a family doctor and spent many years dealing with the elderly," she said. "They may not present with typical symptoms, and so you always have to be watching."

In other cases, such as the directive for staffers to only work at one long-term care home rather than toggling between facilities, potentially spreading the virus, it was legal issues and questions about whether there would be enough staff to keep the homes running that delayed government action.

COVID-19 has devastated Ontario's long-term care system, causing the deaths of 3,744 residents and 11 staff members so far. ...

Her notes from the pandemic's first wave, read out during the interview, also show that she advocated for locking down long-term care homes before the province did so, and was concerned about staff not wearing PPE at all times the week before the province made it mandatory. ...

The transcript also paints a portrait of a nascent ministry thrust into a pandemic before it could gather its bearings. The Ministry of Long-Term Care was spun off from the Ministry of Health (formerly known as the Ministry of Health and Long-Term Care) mid-2019, and the commission heard it spent much of that year getting set up. 

But when the pandemic struck, the Ministry of Long-Term Care was still largely dependent on the Ministry of Health, she said, and when it came time to communicate with long-term care homes about the pandemic, the newly formed ministry was being left out.

"Just wondering why Ministry of Health is issuing, reissuing the guidelines without MLTC," Fullerton wrote in an email early in the pandemic, which was read out during the interview. "I understand MOH is the lead, but MLTC must be part of this communication to our own sector."

Her chief of staff echoed the sentiment in a separate email dated March 31. "PPE has been deployed to hospitals and correctional facilities. This was done with LTC partners on the line," he wrote. "We are too often the forgotten partner."

https://toronto.ctvnews.ca/long-term-care-minister-should-have-gone-publ...

NDPP

Today on The Current: Andre Picard *MUST HEAR*

https://www.cbc.ca/radio/thecurrent/the-current-for-march-2-2021-1.5933097

"The Globe and Mail's health columnist, Andre Picard, says he's sick and tired of reading reports on the pandemic's devastating toll on long-term care homes, because 'they all say the same thing and we don't really act on them.'

He talks to Matt Galloway about his new book Neglected No More: The Urgent Need to Improve the Lives of Canada's Elders in the Wake of a Pandemic, and why we need a philosophical change in how we treat the elderly."

If for no other reason than this could be you Canucklheads.

laine lowe laine lowe's picture

This morning's interview with André Picard was excellent, but he has been consistently good in all interviews during the pandemic so it's no surprise - just appointment radio.

NDPP

I very much agree. In a country with abysmal journalism overall, Picard stands head and shoulders above the rest and is a national treasure, especially in such a paper, at such a time and on such a topic. I hope his important book is widely read by Canadians so as to begin to appreciate the awful state of Canada's elderly 'in care'. A truly disgusting state of affairs which must be corrected asap.

NDPP

In face of deadly pandemic, Ontario ltc homes continue breaking COVID-19 safety rules

https://www.cbc.ca/news/health/covid-long-term-care-ontario-violations-1...

"A CBC News investigation has found 1 in 2 ltc facilities in the province were caught breaking COVID-specific government directives between June 20 and Jan 2021. Many infractions occurred during or after outbreaks. 'To have egregious infractions in terms of not following standard operating procedures for things like infection protection and control, these operators desperately need to be held to account,' said Dr Nathan Stall, a geriatrician at Mt Sinai Hospital in Toronto...."

No more 'for-profit' ltc deathbeds for our elderly! Fix it NOW!!!

[email protected]

NDPP

dp

jerrym

The federal NDP has tabled a motion in Parliament calling for the elimination of private sector long term care homes following the disastrous and deadly spread of Covid through these understaffed and poorly maintained facilities that resulted in 80% of Covid deaths occurring in LTC facilities during Covid's first wave. Of course, the Liberal government immediately announced it opposed the motion despite strong evidence that even before Covid the private sector homes were far less safe before Covid and had much higher death rates during Covid. 

New Democrats are seeking the support of the House of Commons in calling on the Liberal government to eliminate for-profit long-term care.

The NDP tabled a motion Monday that calls on the government to take the complex step of transitioning existing for-profit homes to not-for-profit operations by 2030. It also urges the government to work with provinces and territories to stop licensing new for-profit homes.

The NDP unveiled its proposal for the long-term care sector earlier this year, presenting it as a potential election promise as parties prepare for a possible 2021 campaign.

At the time, New Democrat Leader Jagmeet Singh said an NDP government would bring together provincial and territorial leaders, experts and workers to set national standards for nursing homes — benchmarks that would be tied to $5 billion in federal funding.

"We know that for-profit means less care. It means less hours of care. It means less quality food," Singh said at a virtual press conference Monday. "Let us remove profit from long-term care, beginning with Revera."

The motion includes a call to immediately turn Revera — a company that runs more than 500 seniors' homes in Canada, the United States and the United Kingdom — from a for-profit chain owned by a Crown pension fund into a publicly managed entity. ...

Seniors Minister Deb Schulte said she opposes to the motion, citing provincial jurisdiction over health care.

"Even before COVID-19 we have a litany of research that shows that, on the whole, these homes perform worse than non-profit and municipal homes," said Dr. Vivian Stamatopoulos, a long-term-care advocate and professor at Ontario Tech University. She said at the press conference that for-profit residents are more likely to wind up in hospital and to die within six months of admission to a home. "They hire less full-time permanent staff to boot, and they also pay their staff less, which results in a revolving door of
workers," Stamatopoulos said.

During the first wave of the pandemic, more than 80 per cent of Canada's COVID-19 deaths occurred in long-term care facilities. In Ontario, where the second wave has proven even deadlier than the first in nursing homes, an independent commission has been convened to examine the virus's impact on the sector. The commission is slated to deliver its final report at the end of April.

More than a quarter of the country's 2,039 long-term care homes are for-profit, according to the Canadian Institute for Health Information. ...

Ottawa resident Aaron Gruntke said he lost his 59-year-old mother Linda Lee Gruntke less than five months after she entered a for-profit care facility in Toronto. She suffered numerous falls, including one that required 30 stitches and a three-day stay in hospital, he said at Monday's news conference organized by the NDP.

"Sometimes she didn't get medications because there was no nurse available to administer them. Other times she was overmedicated. She once wore the same bandage on her leg for three days straight," Gruntke said, adding that he didn't blame "overworked and underpaid" staff. His mother complained about respiratory issues for three days before staff found her unconscious in her room and sent her to hospital on Sept. 26, he said. She had a heart attack three days later and died on Oct. 3.

"The difference in care between for-profit and not-for-profit is like night and day," Gruntke said, citing the "warmth and kindness" with which staff attend to his 93-year-old grandmother, who lives in a not-for-profit home. "Maybe if my mother had the proper treatment she would still be here today."

https://www.cbc.ca/news/politics/ndp-ltc-motion-eliminate-for-profit-1.5...

jerrym

A new study concludes that Canada had the worst death rate by far among developed nations for people living in long term care. A lot of this has to do with the private sector placing profit over life under all circumstances through understaffing, poorly built facilities etc. It's time to take all long term care homes in Canada into the public sector. Little was learned by governments during the first wave as the death toll was even higher in the second wave, with only Quebec improving its death rate during the second wave, and that primarily because the monstrous death toll there forced the Quebec government to hire 10,000 additional staff for long term care and carry out other measures or face a huge political backlash at the next election. BC, with only 9% of LTC homes having Covid infections, compared to Quebec's 44% and Ontario's 34% infection of LTC care home having infections during the first wave, shows what increasing wages and conditions, making all workers full-time but at a single place to reduce infection spread can do to reduce the risk of Covid infection and death. 

Canada has the worst record for COVID-19 deaths in long-term care homes compared with other wealthy countries, according to a new report released on Tuesday by the Canadian Institute for Health Information (CIHI).

The study found that the proportion of deaths in nursing homes represented 69 per cent of Canada's overall COVID-19 deaths, which is significantly higher than the international average of 41 per cent.

In Canada, between March 2020 and February 2021, more than 80,000 residents and staff members of long-term care homes were infected with the coronavirus. Outbreaks occurred in 2,500 care homes, resulting in the deaths of 14,000 residents, according to the report.

"COVID-19 has exacted a heavy price on Canada's long-term care and retirement homes, resulting in a disproportionate number of outbreaks and deaths," the report's introduction says.

The study, which primarily focused on the first six months of the pandemic, found that across the country, nursing home residents received less medical care. They had fewer visits from doctors, and there were also fewer hospital transfers when compared with other years. ...

Researchers also looked beyond the coronavirus to all deaths in care homes."Resident deaths — for all causes, not just from COVID-19 infection — increased by 19 per cent in British Columbia, Alberta, Manitoba, Ontario and Newfoundland and Labrador," the report said. "There were 2,273 more deaths than the average in the five years prior to COVID-19, with the largest increase occurring in April 2020." ...

"It really tells us that there were things that we could have done to avoid a lot of the deaths that we saw in Canada and that countries, frankly, that were better prepared prior to the pandemic, that had better funded systems, they performed far better than Canada has," said Dr. Samir Sinha, director of health policy research and co-chair at the National Institute on Ageing, a partner in the study with CIHI. "Relative to other nations in the world, Canada has actually the worst record overall." ...

The study's authors found that during the first wave last spring, the total number of resident deaths was higher than in the years prior to the pandemic, even in places with fewer COVID-19 deaths. ...

"The proportion of residents who had no contact with a loved one tripled in the first wave, compared with previous years. Residents who had no contact with family and friends were more likely to be assessed with depression," the report said.

But it appears that lessons learned in the first wave didn't lead to changes in outcomes during the second wave last fall, which was "bigger and broader" in Canada, resulting in "a larger number of outbreaks, infections and deaths." The study found that the number of COVID-19 infections among nursing home residents increased by 62 per cent in the second wave compared with the first. ...

The report singled out Ontario and Quebec, noting that they "had the largest proportion of homes with outbreaks involving resident cases." It also said that during the pandemic's first wave, "more than one-third (34 per cent) of all Ontario LTC homes and 44 per cent of all Quebec LTC homes experienced an outbreak with at least one resident case." Those numbers compare with just eight per cent of long-term care homes in B.C. and 17 per cent in Alberta. "Did we have a number of avoidable deaths? Absolutely. Could they have been prevented? Absolutely," said Sinha, who is also director of geriatrics at Toronto's Mount Sinai Hospital.

https://www.cbc.ca/news/canada/ottawa/canada-record-covid-19-deaths-weal...

kropotkin1951

Help keep as many of the next wave of eighty year olds as possible out of these homes. Sign the petition and give seniors a chance to make better arrangements for ones final decade or two.

https://petitions.ourcommons.ca/en/Petition/Details?Petition=e-3291

laine lowe laine lowe's picture

I've been researching best practices for long term care facilities on First Nation reserves and it's been a struggle to find any examples but one paper I cam across made my blood boil. It was written by a consultancy (maybe law) firm that was advocating for introducing for profit health care and long term care on First Nation reserves.

jerrym

In Ontario senior care home residents are demanding that they be allowed to go outside because they feel like they have been in solitary confinement for a year. 

Residents of Ontario's long-term care homes begged on Tuesday to be allowed outside, saying anti-pandemic restrictions that have confined them indoors for more than a year make no sense given almost all have now been vaccinated.

Some compared their situations to solitary confinement, and urged the provincial government to act on what they called a gross violation of their basic human rights.

Chuck Ferkranus, a resident of a home in Newmarket, Ont., said no one in the building has COVID-19 and yet residents are stuck in their rooms. Ferkranus, who challenged those in authority to live as he does for even a week, said residents are being treated worse than criminals.

"We did nothing wrong; we're not guilty of any crime," he said. "If vaccinations don't end the rules, if no one having COVID doesn't end the restrictions, then what does it take before this comes to an end?"

Many of an estimated 150,000 nursing home residents have been confined to their rooms or floors for as long as 15 months now, cut off from most relatives as well as the outdoors. Activists blame extreme staffing shortages and operators who prioritize corporate needs ahead of the welfare of residents.

Advocates also say the restrictions make no sense. Scientific evidence, they note, indicates COVID-19 is far less likely to spread outdoors than indoors. They also point to evidence that extreme isolation is physically and mentally damaging, especially to residents of nursing homes, many of whom suffer cognitive difficulties and need familiar faces and touch.

"It just cannot go on like this; people are really suffering," said Natalie Mehra, executive director of the Ontario Health Coalition. "We're furious and we're heartbroken."

Alfred Borg, another resident in Newmarket, said he hasn't been allowed outside for more than a year or even had a shower for five or six months. Instead, he said, residents only get in-room sponge baths when even the law guarantees twice a week baths or showers.

"All day long we just sit in our room," Borg said. "Why are we being treated so much differently from everyone else? It is not enough just being alive. We need a better quality of life." ...

Jane Meadus, a lawyer, called the restrictions a violation of human rights. While anti-pandemic measures loosen in the rest of society, she said, seniors continue to suffer. "All along, these detentions have been illegal," Meadus said. Premier Doug Ford and his ministers have not responded to letters Meadus wrote last month calling for a ban on such confinement, she said. At a news conference on Tuesday, Ford expressed some sympathy but gave no indication he would act on the concerns. "I fully understand -- my mother-in-law's in there," Ford said. "But we have to be super cautious."

https://toronto.ctvnews.ca/it-s-beyond-appalling-long-term-care-resident...

NDPP

Re Above WTF!?

I have long observed Canadian society is rather bloodless and barbaric when it comes to the institutional treatement of the elderly. That is the main reason conditions are as bad as they are here, and have been for a long, long time.  The above is unconscionable. Please take a minute to demand Doug Ford or his appropriate minion immediately cease the torture of these people and facilitate some freedom and fresh air. This is outrageous and should be unacceptable to all here.

[email protected]

 

Fear Ageism not Aging (radio)

https://www.cbc.ca/radio/ideas/fear-ageism-not-aging-how-an-ageist-socie...

"Despite our denial, we are all old people in training. And to become old often means to become 'the other' in Western society. It's a reality that experts and senior advocates can attest to. For the most part ageism continues to be a socially acceptable prejudice to the point of being murderous..."  

'We did nothing wrong. We're not guilty of any crime. If vaccination doesn't end the rules, if no one having COVID doesn't end the restrictions then what does it take before this comes to an end?'  - Ontario elder see #189

jerrym

The 322-page report from Ontario's Long-Term Care Commission released on Friday concluded the Ford government "had no comprehensive plans to protect long-term care homes that have been neglected for years, leaving residents and staff 'easy targets' for COVID-19". The report notes that the problem extends back into the provincial Liberals and previous PC governments' time in office .

The report stated that the long-term care sector was insufficiently prepared for a pandemic, and it was made worse by the province's slow and reactive response when the virus arrived....

"Critical decisions came too late and the government's emergency response system proved inadequate to protect staff and residents from COVID-19," the report found. "Staff, long-term care residents suffered terribly during this pandemic. Residents and long-term care staff who lost their lives to COVID-19 paid the ultimate price."

Long-term care homes in the province have been hit hard by the COVID-19 pandemic, with more than 3,700 resident deaths. Of those, 1,937 occurred during the first wave.

The report looked into the state of long-term care before COVID-19, the deficiencies in Ontario's pandemic response, the devastating impacts of the COVID-19 crisis in long-term care, and best practices and promising ideas that can be adopted and expanded to improve long-term care. ...

"The province's lack of pandemic preparedness and the poor state of the long-term care sector were apparent for many years to policymakers, advocates and anyone else who wished to see. Ontario's policymakers and leaders failed during those years to take sufficient action, despite repeated calls for reform," the report stated. "Rather, the commitment and resources needed to prepare for a pandemic and address long-neglected problems with long-term care were shunted in favour of more pressing policies and fiscal priorities."

The commission found that the government failed to follow through with the recommendations that came out of reports after the SARS outbreak in 2003. While Ontario paid attention to them for a time, it "lost the will to make pandemic preparedness a priority." This resulted in the stockpile of emergency supplies acquired following SARS expiring and later ordered to be destroyed.

Many of the issues highlighted by the report are not new, but previous governments all failed to address them. The report stated that long-term care experts and advocates have repeatedly been calling for an overhaul of the sector even before the pandemic struck. Many homes had outdated and not up to standards infrastructure. Staffing issues have also been a problem prior to the pandemic. ...

The commission also looked into the government's second wave response. The report stated that despite the preparations by the province during the summer when "there was a lull in the storm," it did not protect residents from a deadlier second wave.​ ...

The commission laid out 85 recommendations, which build on the two interim guidance released last year. They include preparing for future pandemics and developing plans to deal with infectious disease outbreaks. The province should maintain a pandemic stockpile, including personal protective equipment.

“Pandemic preparedness must be a constant priority. The lives of those most at risk depend on it. When COVID-19 slammed into an already vulnerable long-term care sector, the cost of that lack of preparedness was on full display. As it should have done following the SARS outbreak in 2003, the province must now accept that there will be another pandemic. ...

Counselling services should be offered to residents and staff whose emotional and psychological well-being were affected by COVID-19. The commission is also recommending standardizing and prioritizing infection protection and control practices in long-term care homes. Health care system integration should also be strengthened. The commission found that the long-term care sector did not have established relationships with the health care system, particularly hospitals. Resident-focused care and quality of life must improve. ...

The government should also address human resources challenges by accelerating the staffing plan, increasing the number of skilled staff, supporting enhanced education and development and improving working conditions and compensation. The commission also recommended regulating personal support workers. To meet the care demands of long-term care residents, the province must increase and reorient long-term care funding. ...

The province must also improve its compliance enforcement efforts to protect the residents’ safety and well-being and strengthen investigations under the Health Protection and Promotion Act. That includes enhancing whistleblower protections.

https://toronto.ctvnews.ca/ontario-had-no-plan-to-protect-long-term-resi...

jerrym

The evidence on the failure of the Ford government to deal even marginally effectively with the Covid crisis in long-term care homes keeps piling up, like the dead bodies. 

Documents obtained by Global News and interviews with more than 20 health experts, including physicians and senior’s advocates, reveal how the Ford government received repeated and pointed warnings about the looming dangers lurking in long-term care homes, and how it failed to deliver what was desperately needed in a sector already devastated by a deadly first wave of COVID-19.

“It was all just too slow, too late,” said Dr. Kevin Katz, medical director of infection prevention and control at North York General Hospital in Toronto.

Some of the documents included:

  • An April 20, 2020 letter from infection prevention and control leaders at Toronto-area hospitals warned about the dire need to train and hire more infection prevention experts.
  • An Ontario Health review Insights and Recommendations for Long-Term Care from July 24, 2020 warned that “LTC and public health are significantly under-resourced to meet IPAC standards to protect the basic needs of residents”
  • A “lessons learned” list from the Ministry of Long-Term Care dated July 15, 2020 warned that the province knew it needed “1000s” of PSWs.

The Ontario Long-Term Care COVID-19 Commission’s final report as well as a damning new auditor general’s report underscored a months-long Global News investigation that found the Ontario government failed to provide homes with adequate infection prevention and control (IPAC) measures, didn’t hire staff fast enough and failed to take action on de-crowding older homes. ...

Deaths in long-term care and retirement homes increased to 2,265 from 2,072 in Ontario during the second wave, Alberta saw its first wave numbers catapult from 153 to more than 1,000 in the second wave, and Manitoba’s jumped from just three deaths in the first wave to 480 in the second wave.

Over the course of the pandemic, nearly 15,000 residents in long-term care and retirement homes died across Canada.

“If you want to talk about high yield things that could have been done, it would have been to secure staffing, shore up infection prevention and control, and it would have been to de-crowd homes,” said Dr. Nathan Stall, a geriatrician and researcher at Mount Sinai Hospital in Toronto. “We failed to act meaningfully on either of those three issues.”

“Why was this sector so neglected and why did nobody act on what was learned in the first wave to prevent it from happening in the second wave?”...

In April 2020, as long-term care homes were still reeling from the devastating first months of the pandemic, a group of physicians warned the Ontario government that it needed to rapidly build IPAC inside nursing homes.

“The majority of [long-term care home facilities] had significant deficiencies in IPAC practices and lacked IPAC expertise and accountability,” reads a copy of the draft proposal to hire IPAC specialists.

Infectious disease experts called for the government to hire IPAC specialists for nursing homes at a ratio of one full-time specialist per 200 beds;  one per 250 beds in retirement homes. ...

Known as a “hub and spoke model” these workers would be trained and managed by the specialized doctors based at nearby hospitals.

The proposal written up for Toronto — which could be expanded across the province — said the cost would be between around $5.5-million and $7.2-million a year.

“The dividends in resident and staff safety as well as future cost savings to the overall healthcare system will be substantial and will be felt immediately,” the document read.

However, it wasn’t until November – as homes began reporting more COVID-19 outbreaks – when the Ministry of Long-Term Care formally outlined specific recommendations related to the “hub and spoke model,” which was first adopted in September. ...

The funding letters for this life-saving IPAC measure didn’t arrive until January 2021, nine months after the first proposal was issued. The province didn’t respond to questions about why the funding took months to arrive after it was announced. Long-term care minister Merrilee Fullerton declined several requests for an interview. ...

Dr. Susy Hota, medical director of infection prevention and control at Toronto’s University Health Network, said the province needs to move faster to close the “gap” in the need for these experts in long-term care. “It’s not like there are infection prevention and control practitioners waiting in the wings through this pandemic,” Hota said. “They’re all employed and they’re all very much in shortage.”

https://globalnews.ca/news/7826134/ford-government-ignored-covid-warnings/

jerrym

In addition to the  Ontario's Long-Term Care Commission's report released on Friday on the Covid crisis in long-term care homes discussed in post # 191, another just released report, this one by Ontario auditor general Lysyk, describes the epic crisis in these homes. Lysyk's report focuses on the Ford government failure to regularly inspect LTC homes despite a backlog of 3,000 complaints. Ford pointed to thirty years of failure to invest in long-term care by, in his words "government after government, Liberal and Conservative," which is true, while failing to acknowledge his own gross failures on this issue, that has led to the deaths of thousands in these facilities.

Once again, the coronavirus pandemic has thrown a spotlight on Ontario’s long-term care homes. Two reports criticize the lack of action by the government, as well as existing problems in the homes, which left hundreds of residents and staff easy targets for the pandemic -- and they paid the ultimate price. 

A scathing report from the government watchdog outlined neglect and said the nursing homes were badly prepared for COVID-19. A second report from a provincial COVID-19 commission, that was given to the government on Friday night, said there also was no plan to protect long-term care residents from the pandemic.

Some 3,700 residents of long-term care homes in Ontario died because of COVID-19, more than half of them during the first wave last year.

Ontario’s auditor general Bonnie Lysyk said the provincial government’s decision to delay implementing measures to control the spread of the coronavirus in nursing homes might have contributed to the devastating toll on residents and staff during the first wave of the pandemic. Lysyk said Ontario didn’t appear to learn any lessons from the SARS outbreak almost two decades ago.

"Ultimately, senior management in the long-term care homes are the ones that are responsible for protecting the people inside their homes. So there needs to be some accountability on that front,” she said.

Lysyk also said the government was not prepared and that it had canceled surprise and comprehensive inspections of long-term care homes in 2018.

"Instead of doing comprehensive inspections, they would catch up on the backlog of complaints," Lysyk said. "I think there were outstanding ones of about 3,000. So in that sense, they then did that instead of continuing and doing comprehensive inspections."

Lysyk said in February 2020, the medical officer of health issued a guidance on infection prevention and control, but that left it up to the home operators to decide what action to take. By the time an emergency order was made two months later mandating staff and essential visitors to wear masks, there were more than 800 confirmed cases of COVID-19 among residents and staff. ...

Premier Doug Ford did some buck-passing of his own, but also promised action, saying that what happened in the long-term care homes can never be allowed to happen again.

"I could point to 30 years of underinvestment from government after government, Liberal and Conservative, but none of that matters because I’m your premier today," he said. "I will stand here and tell you that I’m doing everything in my power as premier and I’m sparing no expense to fix the system."

However, Dr. Vivian Stamatopolous, a long-term care researcher, said the government didn’t implement the recommendations of experts to safeguard long-term care homes ahead of the second wave.

"You can build as many fancy facilities as you want, but if you don’t address the root problems within these homes -- the working conditions and the absent standard of care in addition to the laughable penalties for noncompliance -- nothing is gonna change," she said.

https://news.wbfo.org/post/2-scathing-reports-criticize-ontarios-covid-r...

NDPP

Dr Vivian Stamatopoulos: #FireFullerton (and vid)

https://twitter.com/DrVivianS/status/1387536643641552897

"The worst collective catastrophe in our ltc history while everyone around you documents all the evidence of your flagrant failure..."

 

'There Was No Plan to Protect Residents in LT Care!' (and vid)

https://twitter.com/AndreaHorwath/1389951126062125059

"Andrea Horwath calls on the Ford gov't to accept responsibility for the failure to protect seniors in LTC and for Minister Fullerton's resignation."

There should be a criminal investigation and charges laid. For a start Ford must #FireFullerton.

[email protected]

jerrym

A third report, this one by the military, in less than a week details the horrors that the Ford government allowed to occur in senior's long term care homes in Ontario. This follows the Ontario's Long-Term Care Commission's report on Friday (see post # 192) and the Ontario auditor general (see post #193). "Dozens of residents in two Ontario nursing homes hit hard by the coronavirus died not from COVID-19 but from dehydration and neglect, the Canadian military says". Those responsible, including owners of private LTC homes, should be prosecuted for their actions. 

Dozens of residents in two Ontario nursing homes hit hard by the coronavirus died not from COVID-19 but from dehydration and neglect, the Canadian military says in reports obtained by The Globe and Mail.

The documents contain new details about the deplorable conditions in two Toronto homes before the Forces stepped in last year, revealing for the first time that causes other than COVID-19 hastened the deaths of residents as outbreaks spiralled out of control and staffing collapsed.

At Downsview Long Term Care Centre, where one in four residents succumbed to the virus, another 26 died from dehydration before a military team arrived last June to provide humanitarian and medical support.

At Hawthorne Place Care Centre, 51 residents died of COVID-19 in the 269-bed facility. The military says it suspects those fatalities pale in comparison to deaths from other causes. “Residents are dying from non-COVID-19 causes more than they should be.”

The allegation of deaths because of dehydration is “not only troubling but potentially criminal,” Amber Irwin, a spokeswoman for Long-Term Care Minister Merrilee Fullerton, said in an e-mail on Sunday.

According to figures published by the provincial government, 3,762 long-term care residents in Ontario have died of COVID-19. But no one is tracking the number of fatalities from other causes during the pandemic.

The reports on Downsview and Hawthorne were submitted to the independent commission that examined the devastating impact of the coronavirus on residents in long-term care homes but have not been made public. ...

Sixty-five residents of Downsview died of COVID-19 last spring, ranking the home the third-hardest hit in Ontario.

“We will always grieve for those who died last year,” said Mr. Balcom, adding that the home now has a new senior management team. “We never want anyone – residents, family members and staff – to experience what happened at Downsview and across the province last year.”

At Hawthorne Place, residents have died because of dehydration and malnourishment, the military says. When members of the Armed Forces arrived at the home, the report says, they found “feces and vomit” on the floors and walls, two residents with dried feces under their fingernails and management that was “non-existent.”

https://www.theglobeandmail.com/canada/article-canadian-military-report-...

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