I haven’t been posting during the height of the COVID-19 pandemic because we needed to have a single focus to deal with the virus and rebuild the economy. Now that we are crawling back to health I shall be more active.
During the pandemic closures, one of my real-world friends and colleagues posted on Facebook, “I’ve been thinking furiously of late about the life cycle and how and where we live toward the end of our lives. My generation (approaching 70) will do everything we can NOT to end up in a seniors’ residence, where, as we have learned with this crisis, conditions are often horrific and (this is the most heartbreaking part) many people are dying alone and uncared-for.
“My generation, the boomers, is large in numbers and outspoken. Things must change. I hope fervently that this crisis will provide the impetus, but how tragic that this is what it takes to make society consider how we treat our elders.”
Her post was one of many about the situation in long-term care facilities across Canada. I can’t count the number of people who posted on social media: ‘this is terrible, someone should do something’.
It is terrible. But to those who have paid attention or experienced it prior to this pandemic have long known the problems and issues. It’s part of why I launched this blog.
And now the Canadian Institute for Health Information has used COVID-19 statistics to confirm the poor situation in Canadian long-term care. In Canada 81 percent of COVID deaths were in long-term care facilities, while world-wide the average is 42 percent! In Nova Scotia 97 percent of all COVID deaths were in long-term care! We beat Alberta, Ontario and Quebec, where 70 percent of deaths were in care.
In Nova Scotia, the Advocates for the Care of the Elderly (ACE) have been lobbying for better facilities, more staff and improved care for over 14 years. Conservatives, New Democratic and Liberal governments have heard ACE’s complaints, concerts, predictions and recommendations, and have allowed the problems to continue under the guise of “studying” the issue. Well, when do you have enough study? When do you act?
Former NDP cabinet minister Graham Steele in his book, What I Learned About Politics: Inside the Rise-and-Collapse of Nova Scotia’s NDP Government, told us that politicians and organizations love to say something is being “studied”. Study sounds like something is being done, when the real purpose of any study is to give cover for inaction.
Any premier or health minister who claims to being surprised by the conditions under which our parents, grandparents, older relatives and friends are living is being dishonest. They know what’s happening. However, they have insulated themselves from direct front-line contact to have a layer a deniability built in.
As for the comment that someone should do something, it is uncomfortable to hear, but we need to look in the mirror. We are the someone and the solution. The problems in long-term care exist because of complacency and how many families use these places as warehouses for the elderly.
People claim they would do more, but are so busy. Well, are you too busy to love? Social media is great for launching go-fund-me campaigns for strangers and petitions for all manner of causes, but beyond a few clicks and digital transactions, how involved do people get with the lives of their older family members, former friends or neighbours?
My mother was in a nursing home for eight months. I went to see her every day. A granddaughter who lived nearby went several times a week. My sister went in weekly. We let her know she wasn’t forgotten. And the facility management knew we were involved in her life and care. In those eight months I saw many residents who had no visitors. The only people who touched and talked to them were the staff.
Another family member is currently in care. The facility was on our watch list based on the experiences of others we know. Until the pandemic locked us out, her husband took two meals a day with her. I went in four or five times a week and one of her daughters also visited. (The others live too far away.) Again, we were/are present and involved in her life and had no problem with how she was treated. But again, management knew we were involved. So many of the other residents I see strapped into chairs in front of television sets day-after-day have no one to visit them and no one to pay any interest in them beyond professional obligations.
The problem is equally shared by the public, politicians, and bureaucrats.
The bureaucrats and provincial ministers who have legislative and legal over-sight of these facilities and responsibility for those in care, have turned blind eyes to failures in care and building maintenance. They have hidden behind crown immunity and bogus interpretations of privacy regulations to protect themselves from real responsibility. They receive the pay, perks, privileges and pensions regardless of their performance.
One of the most telling examples of the laissez farie attitude of bureaucrats was the death of Gilles Duceppe’s mother. Duceppe is the former leader of the Bloc Quebecois. You would think his national profile and political connections would assure his mother is well cared for. But in January 2019, the 93-year-old Mrs. Duceppe got up in the middle of the night and accidently wandered outside into -35 degree weather wearing only her nightdress. The door locked behind her. The official cause of her death was listed as hypothermia. In reality it was neglect.
When Mrs. Duceppe went outside an alarm rang. A staff member turned off the alarm and didn’t bother to check why it sounded. No one did a bed check to see all residents were safe. Mrs. Duceppe was outside for six hours in plain view of a security camera that no one monitored. There was no need for her to die. Not then, not that way. Her family are suing the facility.
If that can happen to the mother of a high-profile politician, what hope is there for the rest of us?
There are numerous other problems in long-term care facilities, like acts of violence, which are discounted and covered up. Each act is considered a one-off incident, when in reality there are thousands of acts of violence in Canadian long-term care facilities each year. This is resident-on-resident, resident-on-caregiver and caregiver-on-resident violence. I don’t have the number at my finger tips, but a few years ago I was told the level of violence was over 4,000 acts a year! Much of this is hidden under the cloak of privacy or given a pass on the assumption the offender is of diminished capacity. That’s not acceptable.
So what can we do?
First, visit the person you know in care. If you’re at a distance call them or call the home to discuss their health and care plan, and for regular reports. Then ask someone else to visit.
Secondly, write, email or call your MP, MLA/MNA/MPP to express your concerns about senior care, about a specific home and individual if you know one.
Thirdly, insist on better pay for care givers. The people who work the front lines are only paid $18/$20 per hour for physically and emotionally demanding work. They burn out, which creates high staff turn-over. This turnover is upsetting to residents and is inefficient for facilities which have to spend an inordinate amount of time and money recruiting and training new staff about the residents and procedures.
Fourth: we need real inspections done on a regular basis by inspectors who have the authority to force facilities to act asap to correct their deficiencies.
Fifth: we need more long-term care beds. In Nova Scotia over 700 hospital patients aren’t actual patients. They were, but now they are waiting for a long-term care placement. This volume represents up to 60% of acute care beds in most rural hospitals. Collectively these 700 occupied beds are equal to the largest hospital in Atlantic Canada. If we had more long-term care beds we could save the expense of building a $4 billion new hospital in Halifax. That is a massive, political planning failure.
I suspect government planners have resisted creating more long-term care beds because they figured the problem would die out.
Those planners have overlooked the new demographic in need: millennials. Two 2019 studies in the U.S. found millennials are in worse health than their grandparents and are going into care decades earlier than other generations and will be there for many more decades than their grandparents.
So, in building long-term care beds we need to develop separate facilities to accommodate younger residents. Right now anyone needing long-term care goes to a facility occupied by the elderly. That isn’t fair to teenagers and other younger people who may be paralyzed by an accident, born with a genetic disorder or have another need. It’s also a different type of care, so is unfair to the care giver.
Until we sort out long-term care and do so meaningfully, we should immediately stop talk of replacing the VG in Halifax. If we emptied those 700 acute care beds we might not need a replacement hospital.
Better long-term care, better healthcare, better government starts with us. We are the ‘someone’ to do something.