Improving Long Term Care

For this 2020 provincial election, we need your help keeping candidates committed to improving long term care which has been in crisis even before the pandemic. Below are some key questions you can ask candidates during the election:

1. Is your party willing to work with the federal government to implement national standards for long term care that: a) ensure a good quality of life for residents and b) properly compensate, train, provide full-time work and protect the health and safety of all staff working in long term care?
2. Is your party prepared to phase out public funding for privately-owned, for-profit long term care residences?
3. Will your party commit to regular, rigorous and unexpected inspections of long term care residencies?
4. Will you party commit to ensuring that a designated relative or close friend is able to be tested for COVID and to access all necessary protective equipment in order to support in person their relative or friend in long term care during a COVID-19 lockdown for as long as is necessary?

 


Background: Long term care in crisis

 

BCHC believes that BC and other provinces and territories should work collaboratively with the federal government to develop and implement national standards for long term care immediately. The next step needs to to bring long-term care under the Canada Health Act.

Accountability to Canadian citizens for any new funding transfers for LTC to provinces and territories to improve standards in long term care needs to be embedded in a funding agreement that will ensure accountability and transparency.

It has taken the many deaths of seniors in LTC from COVID-19, 81 percent of all deaths from COVID in Canada (CIHI, May 2020), and a shocking report from the Canadian Army (after it was called for emergency help in LTC facilities in Ontario and Quebec), to finally expose our collective failure to protect and safeguard the final days of the most vulnerable citizens in this country. And, although definitions of long term care vary internationally, the Canadian death rate from COVID is much higher than the average of 38 per cent deaths of seniors' 65 years and older in long term care from COVID of 16 other OECD countries.

Canada also has a higher than OECD average of seniors over age 80 living in LTC and retirement homes but at the same time has fewer health care workers (nurses and personal support workers in LTC homes with a rate half as high as the rates in Netherlands and Norway. (CIHI: 2020) Canada also spends much less as a per cent of GDP on LTC than most other OECD countries.

Now, politicians across Canada saying rather disingenuously that people have known for years that the conditions for residents and staff in long-term care (LTC) are very bad. Previous governments are always to blame. When the Ontario government called a Commission of Inquiry into COVID-19 related deaths in LTC in mid 2020 the CEO of the Registered Nurses of Ontario commented (in a July 2020 article in the Globe and Mail) that Ontario had completed 35 reports in the last 21 years about long-term care with little to show for it.

What politicians and many health researchers and care providers have long known is that LTC is chronically underfunded, poorly regulated, and infrequently inspected. The care aides who work in long term care are often poorly-paid casual workers. The result is that for some 3-4 per cent of seniors who end their lives in LTC in BC today, it's a sad and miserable ending to a lifetime of work for their families, communities, and country.

Nationally, there are no federal regulations or national standards for LTC. It does not come under the five principles of the Canada Health Act which guarantee public administration, accessibility, comprehensive services, universality, and portability of health care services which could help to guarantee some quality of life an protection for seniors in LTC. Though Canadian Health Commissions in the last few decades have recommended that LTC be designated an essential health service under the Canada Health Act, they have been ignored.

One result is that long term care is differently regulated and funded by provincial and territorial governments across Canada. In BC, LTC is publicly-funded but it can be provided by for-profit, not-for- profit, and government bodies.
Publicly-funded privately-operated LTC in BC has continued to grow unimpeded and is a source of reliable income for investors internationally. In the last two decades BC governments have actively supported the private provision of long term care with public dollars despite the evidence that for-profit long term care results in inferior care for the residents.

A recent study by the BC Seniors Advocate, A Billion Reasons to Care, shows that a significant amount of the public funding for people in privately owned long term care is more likely to go into the pockets of investors than to improvements in the quality of care.

LTC residents are mostly women, mostly in very fragile health and on average 85 years old. The care aides on the front lines are also mostly women, they are poorly paid, get only part-time casual work, and have little access to training for a demanding and skilled job.

Often the care of residents has depended on family members or volunteers to assist in caring for LTC residents. This assistance has often been critical for ensuring residents' basic needs are met. Families also provide essential emotional support. In the absence of rigorous evaluation of the quality of care and residents quality of life, families have also provided a watchful eye in preventing neglect and abuse. Those residents who don't have family support are dependent on the over-worked part-time care aides to provide both physical care and emotional support.

From April 2020 COVID-19 BC public health directives banned all family members from visiting residents for several months. Communication was by phone or tablet. Residents were confined to their rooms and not allowed to go outside. They could not get the essential physical and emotional support they had received from family members in the past. In these months of lock-down, some relatives of residents noted a fast deterioration in the mental and physical health of the residents. Media reports have documented the trauma experienced by family members when a resident's health has declined very fast or their family member died alone. Its still unclear why all family members were banned from visiting or helping residents when employees could go home at the end of their working day.

The visiting restrictions have eased slightly but a new wave of COVID-19 seems imminent.

You can download a PDF to print containing the questions and information above by clicking HERE.

 

Were you able to ask a candidate a question?

 

Please let us know about it! We can help amplify your work by holding candidates accountable for statements they’ve made while campaigning. Fill out our quick and easy report back form

Other ways you can share the information:

  • Distribute the information below and questions above to each candidate in your riding. Share their responses in local newspapers, on your website, through social media sites, and/or in a mailing to your organization’s membership.
  • Most ridings will be holding virtual Town Halls and Public Forums where candidates can be provided with information and asked questions on the issues. Because participants are usually limited to the number of questions they can ask, it may be necessary to identify in advance which issues are your priorities.
  • Provide the information to your contact list (members, supporters, friends) and encourage them to get in touch with their candidates by email, by telephone, or in person