Ontario’s long-term care is overdue for change. So what needs to happen?

·6 min read

Since COVID-19 first arrived in Ontario and began spreading in long-term-care homes, it shed light on an area of the health-care system that has laid broken for decades. In 2003, the Star spent a year investigating the cracks in the long-term-care system, and in years since, has kept tabs on issues of neglect, understaffing, poor wages and more. We asked residents’ family members, health-care workers, lobbyists and thought leaders what one thing is that they would like to see happen in order to bring change to long-term care.

Kimberly Lyn, digital editor, daughter of long-term-care home resident

My mom went into long-term care a few days before the global pandemic was declared. In the summertime, the facility had an outbreak. Unfortunately, my mom contracted COVID, but luckily only dealt with a cough and fatigue.

I think there needs to be more resources dedicated to more strategic communications. Long-term-care homes definitely need more resources and more help, but now you’re also asking them to do an extra job of mass communications to residents’ families. There’s a lot of information overload; there’s often miscommunication to family members.

It’s very disappointing that you try your best to stay on top of all the information they send out, but then you miss one thing and it kind of ruins the ability to spend time with your loved one.

Maureen Halushak, editor-in-chief of Chatelaine, daughter of long-term-care resident

My mom has been in a long-term-care home for almost two years. My family has not been in her home for 50 days since an outbreak started in November.

The outbreak has been a horrible and eye-opening experience in terms of how long-term care is handled by the ministry of health and long-term care.

Regular, unannounced inspections of every home every year are important. I’d also like to see more transparency with inspection findings, like when restaurants post their inspection results on their windows. Residents and loved ones need to know about the immediate status of the homes.

Celina Caesar-Chavannes, former Member of Parliament and author

Many personal support workers are women from marginalized or racialized communities. We keep putting them on the front lines — first to get the vaccine, but yet they’re the last to receive the benefits they need, the access to adequate health care, the access to pay equity.

(And) I think it’s more than just increasing the pay. We need to make sure they have adequate sick days and benefits. Access to child care is a long-term goal — it should be affordable and accessible to people.

Nathan Stall, geriatrician at Mount Sinai Hospital and a research fellow at the University of Toronto

What is happening in our long-term-care homes is a humanitarian catastrophe. Many hospital systems are being pushed to the brink. So there are things that need to be urgently done.

First, we must absolutely get community spread under control. We cannot rely on the vaccine as the get out of jail free card. Harder, stricter and blunter public health intervention is needed.

Things like paid sick leaves and eviction moratoriums will help people in the hardest hit communities to better comply with prevention measures.

In long-term-care homes, we need more infection prevention and control support on the ground, better medical management and support. We need to be getting vaccines into the hands of all long-term-care residents immediately. If we can protect them as a population, then we could take a huge load off our health-care system and reduce the death toll substantially.

Naheed Dosani, palliative care physician

I would like to see the end of the for-profit long-term-care industry as we know it, and ultimately, see long-term care become a part of our public health-care system, that we as Canadians are so proud of.

I dream of a society that recognizes our elders for who they are: our mothers and fathers, our siblings, our friends and our neighbours, and gives them the system that they deserve. Not a system that is designed to protect corporations over human life or places profits over people.

This includes improving staffing, disrupting the system that exploits front-line workers, often racialized women, addressing design standards, creating transparency and accountability.

Sharleen Stewart, president of SEIU Healthcare

The truth about eldercare is it cannot be done without hands-on care from health-care workers — it’s about people.

Decision-makers in government and owners of nursing home chains refuse to confront this truth because it would require supporting workers they’ve made a practice of exploiting.

As the pandemic raged, we watched those chains pay millions in cash to shareholders, while seniors died under their supervision.

We can only recruit and retain the people we need to provide safe, quality, hands-on care if we pay them what they’re worth. That must include full-time jobs and a living wage.

Miranda Ferrier, co-founder and president of Ontario Personal Support Workers Association and Canadian Support Workers Association

Conditions in long-term care will remain dire and get worse until the people of this province professionally recognize the role of the personal support worker in providing the bulk of patient care.

Patients and residents of long-term-care facilities deserve to be under the care of professional PSWs who are regulated and professionally accountable to the people of this province.

Donna Duncan, CEO of Ontario Long Term Care Association

We must work together and take immediate action to protect long-term-care residents from COVID-19, while responding to issues that arise with urgency. That starts with stabilizing and growing our workforce by creating the conditions that will make our staff feel safe and supported.

We can do that by vaccinating our residents, staff and essential visitors as quickly as possible, expanding on-site rapid testing, further enhancing infection prevention and control measures, ensuring homes can quarantine new admissions and supplying homes with adequate personal protective equipment.

While the vaccines offer hope, we need to take these actions now to avoid further tragedies. One life lost is too many.

Jean Kuehl, retired long-term-care home registered nurse

I worked in for-profit long-term-care homes for 28 years, retiring a year ago. The number one way to improve long-term care is to immediately hire more nurses.

Skilled, regulated staff — RNs, RPNs and nurse practitioners — would make an enormous difference to the care our vulnerable residents receive. We need more staff in general, including hands-on PSWs and nurses.

To attract nurses, new positions must be full-time, not casual or part-time. The clinical judgment of nurses must be respected, ensuring that they have full access to the range of equipment (for example, personal protective equipment such as N95s), supplies and resources they require.

More RNs in long-term-care homes would make an enormous difference to residents. Residents are living longer, but with multiple, complex medical conditions that cry out for the skilled care of nurses.

With files from Karon Liu, Gilbert Ngabo and Jenna Moon

Angelyn Francis is a Toronto-based reporter for the Star covering equity and inequality. Her reporting is funded by the Canadian government through its Local Journalism Initiative. Reach her via email: afrancis@thestar.ca

Angelyn Francis, Local Journalism Initiative Reporter, Toronto Star