Long-term care changes could be long lasting

The pandemic has brought an outpouring of community support, major employment changes and a whopping pay hike in the longterm-care sector.

It was a focus right from the start because of the impact the virus had on seniors. It’s led to changes that could endure after the pandemic ebbs.

It became apparent early on that COVID-19 had the most serious impact on the elderly. The median age of patients hospitalized with COVID-19 is 68 and the median age of people who died from the virus is 86 in B.C., according to Centre for Disease Control statistics.

Forty-five of B.C.’s 72 fatalities have been in long-term care homes, many in two metro Vancouver facilities that were particularly hard-hit. There have been 289 pandemic cases (20 per cent of the total) associated with 21 longterm-care homes, many in just the two facilities.

That prompted extraordinary emergency measures that are going to have lasting effects.

One of them is the restriction imposed on caregivers that confines them to a single home, by barring them from working shifts at different facilities.

It was such a complicated move that it took three separate orders from provincial health officer Dr. Bonnie Henry to accomplish and is still taking effect.

The first one, on March 26, ordered facilities to provide to her office employment-related data, including employees’ contact information and social insurance numbers . That is now in a database of about 20,000 names that can be used to monitor staffing levels and locate employees.

A day later, Henry ordered facilities to restrict the movement of staff between them by ensuring they work in only one facility.

Last week, a third order was issued that superseded the previous one and refined the measures.

It directed operators to itemize single-site staffing requirements to medical health officers, who would then impose the assignments. Maintaining adequate staffing levels is the main concern, but they are also trying to take into account employee preferences and full- and part-time differences.

The safety measure to limit transmission wouldn’t be possible in normal times. It violates people’s rights to work where they please.

Flowing from that was the announcement from Health Minister Adrian Dix that employee wages will be essentially levelled to curb people moving from lower-paying to higher-paying facilities.

That adds an estimated $10 million a month in costs and gives raises of up to $7 an hour to some employees.

It’s considered unlikely that raise will be rescinded when the health emergency is over.

B.C. seniors advocate Isobel Mackenzie has called for higher wages in privately run facilities, saying it would ease the chronic staff shortages.

She questioned how that wage move could be rolled back. “I don’t know how they’re going to put that genie back in the bottle.” Imagining a post-COVID-19 world, she said the wage parity will be beneficial in easing employees’ need to work multiple sites.

Having a comprehensive database of employees and where they are working will also be a benefit, she said.

B.C. has a low threshold for defining “outbreaks” in such facilities. Even one or two cases can qualify, so they are quite common. There were 185 infectious-disease outbreaks in B.C. care homes last year, Mackenzie said.

But COVID-19 shows the extent to which caregivers are exposed to risks. At last count, the outbreak in care homes breaks down as 165 residents and 124 staff.

Mackenzie said after the emergency, more attention should be paid to monitoring caregivers’ health, as well as residents.

Henry noted last week that visiting was sharply reduced early on, but that can have negative effects and hasten residents’ decline, she said.

Shortages of personal protective equipment several weeks ago made things more challenging, she said, although there are more supplies now.

“As we’re seeing with the continuing tragedies in those care homes, once the virus is introduced … it’s very, very challenging to manage.”

Just So You Know: One happy, hopefully long-lasting after-effect of the pandemic will be expansion of the 211 support phone line for seniors. Support was expanded last month and brought what Mackenzie said was an outpouring of goodwill and volunteer help.