Handle With Care

This morning, as we looked in the mirror, there appeared someone who may someday live in a nursing home.  And, self-interest aside, is there anybody who doesn’t believe that the elderly deserve to live their final years in a safe, caring, and dignified environment?

So what are we to make of the lack of widespread extreme outrage at how these homes have been managed in Ontario, especially during the pandemic?

Of our province’s deaths recorded in the pandemic’s first wave, almost two-thirds were in long-term care homes. Quebec’s numbers were also bad, but other provinces such as British Columbia showed how it didn’t need to be that way.

Perhaps nothing points to the Ontario failure more than the need to bring in the Canadian Armed Forces – and the horror show the military witnessed once they got there. In a scathing report they exposed major health care breaches, such as using the same equipment on infected and non-infected residents without sterilizing it, along with appalling eye-witness accounts of horrendous treatment: rotten food, cockroach infestations, residents left in soiled diapers for extended periods of time.

Many of the worst homes had a history of awful conditions observed during Provincial inspections. But there were few consequences, especially after the provincial government eliminated annual surprise visits shortly after taking office in 2018. A CBC investigation detailed the drastic drop in inspections and perhaps the unseen hand of former premier Mike Harris, now Chair of Chartwell Nursing Homes.

Why does Ontario have such a frightening record? Several studies point to likely answers. For starters, most LTC homes in BC, with slightly more than 150 LTC deaths, are not for profit; in Ontario, with almost 1900 deaths, it’s the opposite.

A recent study published in the Canadian Medical Association Journal found that both categories of homes were equally likely to have COVID outbreaks, but profit homes were more likely to have worse outbreaks and more deaths. Their death rate was 23.4 per thousand, compared with 18.2 in non-profit and 5.8 in municipally run homes.

Other studies have found that for-profit homes had 17% fewer workers and, in general, spent less per resident.

In September, an “independent commission” began looking into why Ontario’s long-term care homes were so badly hit during the pandemic’s first wave. A report is not expected until April.

Meanwhile, there is widespread concern about rising cases in nursing homes now, as COVID numbers increase in the community. This week, there are about 160 residents and 200 staff members in Ontario’s long-term homes with active COVID 19. Those are similar numbers to what we saw in early April.  Since September 1, the number of homes with outbreaks has risen from 13 to 71.

Some obvious solutions include much more stringent regulations and inspections, an expansion of not-for-profit homes, and greatly improved home care so that more of us can live out our later years at home. More on these subjects in future newsletters.