Senior care homes, the private sector ripoff, death, working and living conditions,

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-...

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...

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-...

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 care, lower 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. A 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

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-...

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...

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...

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...

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...

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...

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-...

A new Angus Reid poll finds that the thousands of deaths and poor conditions existing in long term care (LTC) homes has led to three out of five Canadians want private LTC phased out, 72% want more invested in LTC, want more homecare and greater enforcement of standards. Only 1% want no change. This should be a major issue in the upcoming election. However, most are skeptical that anything will change.

Indeed, the future of Canada’s long-term care industry is an issue that will continue to dominate conversations among policy makers, and family members, for months and years to come.

New data from the non-profit Angus Reid Institute finds four-in-five Canadians saying the pandemic fundamentally altered the way they view the industry.

Further, half of Canadians (47%) now say they will do everything in their power to avoid entering LTC themselves, and to keep close family members out. One-in-five (22%) say they’ll start saving for such a plan, while more than twice that number say they “dread” the thought of living in long-term care (44%).

If the industry is to be improved, three-quarters of Canadians say either significant changes (45%) or a total overhaul (31%) is necessary. For some, this means more federal government involvement. At least three-in-five residents in British Columbia, Manitoba, Ontario, and Atlantic Canada say that the federal government should be directly involved in creating standards for the industry. That said, in Alberta, Saskatchewan and Quebec, the same number disagree, and say it should be solely up to the provinces.

More Key Findings: 

• Three-in-five say private care should be minimized or phased out, rising to two-thirds among those 55 years of age and older. That said, two-in-five say that private care can still be a part of the solution to the problems facing the industry

• Seven-in-ten (72%) say Canada should invest more in homecare, and a full majority (55%) say they would be willing to pay more in taxes to accomplish it in their own province

• B.C. and Ontario residents are most willing to pay extra to fund long-term care. In each case, three-in-five say they would be amenable to paying two per cent more in personal taxes. The rest of the country is divided nearly fifty-fifty on that proposal

• In terms of top priorities for the industry, two-in-five say more enforcement of standards is needed (43%). Further, a similar number would increase the minimum number of staff per facility (39%) and raise their pay (38%) in order to recruit and retain quality employees

https://angusreid.org/canada-long-term-care-policy/