Community leaders needed to fix eldercare
Canadians owe a duty of ca re to our elders. — Bill morris
This summer, hardly a day has gone by without a new report on what went wrong in Canada’s long- term care system ( LTC), or the remedies required to fix it — and rightly so.
More than in any other country, the coronavirus turned Canada’s long- term care facilities into death traps. As of the end of June, LTC residents accounted for 81 per cent of Canada’s fatalities — more than twice as high as the United States and triple the rate in England.
In response, Prime Minister Justin Trudeau very publicly chided the provinces for failing to adequately support seniors and threatened use of federal powers to improve matters. The premiers, however, haven’t pushed back, and for good reason.
Claiming jurisdiction means admitting ownership and fault for the various defects that caused such a horrendous loss of life. They also realize that Canadians are in no mood for squabbles over jurisdiction, legitimate or not. Indeed, everyone seems to appreciate that trust in the system must be restored.
And it’s becoming increasingly clear that billions of government dollars will be required in order to do so. Ontario, for example, recently announced a new pilot program designed to fast- track construction of LTC homes and appointed an independent commission to examine why so many have died in them. Health- care workers have also called for increased staffing and permanent pandemic pay, as well as a “basic care” guarantee.
But the underlying problems that gave rise to the appalling neglect, abuse and gross mismanagement of LTC homes during COVID-19 have been well- documented over many years, and then routinely ignored.
The difference now, as polls indicate, is that Canadians are engaged and want the problems fixed. Given Canada’s rapidly aging population, any meaningful change will likely require both policy innovation and increased investment.
Think tanks, elder- law lawyers, seniors advocates and others have already started suggesting various options. Reflecting their diverse backgrounds, the proposals may seem piecemeal, but a number of common threads are apparent.
Primary among these is that Canadians owe a duty of care to our elders. Some are calling for national standards enshrined in a legal framework, similar to the Canada Health Act.
Serious questions have been raised about the ownership and management of LTC facilities, the quality of care they provide residents and the adequacy of their funding. Many have highlighted the need for better training, pay and job security for front-line staff, as well as improved buildings and a more robust oversight and enforcement regime.
Others envisage a fundamental rebalancing, noting that most of us prefer to age and die at home. Aging- in- place requires suitable community supports to minimize institutional placement. That means flexible and better home- care options, expanded supports for family caregivers and, increasingly, the technology to monitor and respond in an effective manner.
While the stars may appear aligned for change, it would be folly to expect that the innovative solutions we need will arise from within government.
Significant reforms are almost always driven by extraordinary leadership from people outside of government. It was, for example, civic- minded Canadians who took ownership over, and drove policy change on, issues like drunk driving, cigarette smoking and assisted dying.
If transformative change is really going to happen, the necessary next step is for the disparate voices to coalesce under a common umbrella. Leadership will be key in bringing these diverse interests and policy solutions together into a unified vision for eldercare in Canada.
Business and labour leaders, academics, clinical experts, care providers and seniors must band together to reimagine how eldercare can best operate, and unite behind a bold, innovative agenda.
Solving wicked problems is never easy. But groups comprised of strange bedfellows often have the best chance of capturing the public imagination and garnering the non-partisan support required to successfully drive reform.
The lives lost obviously can’t be replaced. As such, capitalizing on the opportunity stemming from this tragedy to significantly improve Canada’s system of eldercare may now be the only and most fitting monument Canadians can collectively offer. Hopefully, we can muster the community leadership needed to ensure this opportunity isn’t squandered.