No time to spare as long-term care homes brace for another wave of COVID-19

As a second wave of COVID-19 looms over long-term care homes in Ontario, some in the sector are welcoming the province's latest steps to try to protect residents, but worry the money doesn't come soon enough to address urgent staffing shortages.

Premier Doug Ford announced stricter rules for care homes in the province's COVID-19 hot spots on Tuesday, including Ottawa, Peel and Toronto. As of Oct. 5, visitors to long-term care homes in these areas will be restricted to staff, essential visitors and up to two essential caregivers, such as close family members.

The announcement was made along with a promise of nearly $540 million for infection control and prevention in care homes, including ensuring every home has a two-month supply of personal protective equipment (PPE) and upgrading air quality systems. The money also helps pay for more than 150 new hires in homes across Ontario, the province said.

"We believe it's a critical time right now. We've got to move really really quickly on these initiatives," said Donna Duncan, CEO of the Ontario Long Term Care Association. The group represents operators of all care homes in the province, including for-profit and government-run homes.

Ontario is currently reporting outbreaks in 46 long-term care homes. There were 78 confirmed active cases reported in residents on Tuesday, which marks an increase of about 15 per cent.

Of paramount concern for operators right now is the ongoing staff shortage, Duncan said.

Over the summer, students studying to become medical professionals such as doctors, nurses and personal support workers helped supplement care home staff. Now they're heading back to school, leaving behind regular employees, still battered by the first wave of COVID-19.

"We were at a crisis point in January before this even arrived. We lost thousands of employees over the course of the pandemic for a range of reasons, certainly fear was one of them," Duncan said. "It really was a perfect storm that resulted in the loss of employees."

Caregivers part of the equation

Laura Tamblyn Watts, CEO of CanAge, an advocacy group for seniors in Canada, said she's glad to see Ontario take steps to bolster care homes, but wishes this announcement had come months earlier.

"I had hoped, and our organization CanAge and others had hoped, we would see these movements far before now. Having said that, we're grateful that they are starting to come," she said.

"Our staffing shortages in long-term care are more dire than ever."

While Tamblyn Watts is calling on Ontario to develop innovative new programs to draw more employees to the long-term sector, such as laid-off workers in the hospitality sector who may have transferable skills, she said in the meantime, it's family members that must play a role in helping residents through the pandemic.

Her organization advocated for Ontario to continue to allow two essential caregivers access to care homes, even as community spread surged and the risk they could bring COVID-19 into the homes increased.

"They are our unpaid heroes in long-term care and we have never needed them as much as we do right now," she said.

According to Tamblyn Watts, essential caregivers provide residents with a range of services including help eating, bathing and taking medication.

With staff already stretched thin, Tamblyn Watts said family members are a stopgap.

Get ready for a lockdown now

John Hirdes, a public health professor at the University of Waterloo, wonders how long Ontario will allow that stopgap to go on. With COVID-19 surging in Ontario, he expects more restrictions on care homes "in a week or two."

Ontario is at a "pretty serious turning point," he said on Tuesday, adding now is the time caregivers and care home operators need to ensure supports are there for residents in the event of a full lockdown.

Hirdes and his students have just begun research on the impact lockdowns have on seniors' mental health, and found residents who had access to psycho-social supports such as recreational therapy and communication tools suffered minimal negative effects.

He said anecdotally, some residents with dementia even fared better during the lockdown because with fewer visitors, their environment was calmer.

The conclusions are based on data from New Brunswick, which has experienced few COVID-19 cases but nevertheless saw lockdowns at long-term care facilities.

"So there can be an upside. It's not all negative," he said.

He suggests care homes work to figure out how to increase social time and well-being programming, even with staffing shortages, and family members make sure their loved ones are equipped with a device to communicate with the outside world, before the doors are locked.