Hello In There – A Note About LTCs

In some cultures, caring for the elders is both an obligation and an honour.

And then there’s us. I’m supposing that the neglect that has caused thousands to die and many more to suffer in our homes for the aged is unintentional, because we’re not that mean. It’s more like we’re …well…you know…kind of busy with other things.

Individually, we care about our aging parents and grandparents. But as a society – and for people we don’t know – not so much.

When the Government of Ontario quietly cancelled proactive inspections of long-term care homes two years ago, it was as if no one was watching. Likewise before that, when the previous government mandated inspections, but didn’t bother to crack down on operators who didn’t meet basic standards.

More than 60 percent of Ontario’s 5700 COVID deaths have been residents of long term care homes. During the pandemic’s first wave, it got so bad in LTC that the army was brought in, just in time to chronicle a shocking lack of health care and horrendous treatment of residents.

That prompted headlines, and those provoked outrage.  Never again, the Premier told us, promising an “iron ring” of protection for our most vulnerable. Now, during the second wave, even more LTC deaths are projected.  And, once again, this is happening most often in for-profit nursing home chains.

Almost 60 percent of Ontario’s long-term care homes are for profit, operated by large companies like Extendicare, Sienna, and Chartwell, whose board is chaired by former premier Mike Harris, a champion of de-regulation.

A study by the Province’s science advisory table, released this week, found that profit-making homes with outbreaks had nearly 78% more resident deaths. This has been partly attributed to more crowded conditions in profit-oriented homes, with many rooms housing several residents. But that condition has been temporarily alleviated, leaving the second major reason: they spend less per resident, focusing on maintaining dividends to shareholders – which can be as high as 7.7 percent.

According to news reports, Ontario’s for-profit homes paid out $171 million in dividends during the first three quarters of 2020 while collecting $138.5 million in provincial and federal pandemic funding. Recently, the Province publicly chastised Chartwell and Extendicare for not passing along government wage subsidies to workers.

As a society far more affluent than most, with much of that wealth created by the generations above us, we have allowed the care of our elderly to become big business. Some industries require a profit motive to succeed; caring for the elderly should not be one of them. Some urgent steps:

  1. Build more high-quality homes, and direct government funding to municipalities, hospitals and other not-for-profit partners who can build and operate them.

  2. Establish national standards for long term care. The federal government has left that exclusively to the provinces. Some, like Ontario, have failed the test.

  3. Restore annual pro-active inspection of LTC in Ontario, with strong penalties and follow up inspections for those not properly looking after those in their care.

  4. Improve staffing in LTC homes by offering more permanent jobs at higher rates of pay, with sick leave provisions which allow staff who are ill to stay home.

  5. Immediately, make vaccinations in long-term care the priority it was supposed to be. Ontario received more than enough vaccines to provide doses to all LTC residents by now. But, unlike other provinces, Ontario decided that the Pfizer vaccine was too difficult to transport to LTC residents, opting to wait for the Moderna vaccine. Because of this and other distribution problems, some vaccines have gone to those at much less risk, such as hospital administrative staff.

Yesterday, Ontario’s science advisory table called for all LTC residents to receive at least one vaccine dose of Jan. 31 rather than the Feb. 15 Provincial timeline. Modelling shows that this one change would prevent 600 cases and 115 deaths.

And while we’re at it, do like British Columbia and vaccinate essential caregivers – family members who help care for LTC residents, providing comfort and helping overburdened staff.

Today’s music video by John Prine was performed in recent years but written by him as a young man, in 1971. He died of COVID in April.

– John