Long-term care needs national oversight: paper
Countries with strong regulation and centralized oversight of their long-term care have fared better overall in dealing with COVID-19, according to veteran, Canadian seniors care researchers.
Fuelled by this, co-authors Pat Armstrong and Marcy Cohen are making recommendations to Ottawa in a discussion paper today by Vancouver-based Canadian Centre for Policy Alternatives, a left-leaning think-tank.
“It’s exactly two months from (the throne speech on September 23, which indicated there would be national standards for long-term care) and nothing has happened,” said Cohen.
It comes as several provinces report record high number of daily COVID-19 cases as well as more and larger outbreaks in seniors care homes.
“We’re now in our second wave (of COVID-19). It’s time to talk about what the system should look like and for the federal government to use its spending power.”
Cohen sees the debate between the role of provincial and federal jurisdictions as “dysfunctional jockeying and political posturing” between the two.
“The setting of clear standards in health care as a condition of federal funding is not an attack on provincial jurisdiction — it is the only path forward to a universal public system of long-term and continuing care; the same path Canada took to universal hospital and physician care.”
Australia, Austria, Hungary and Slovenia are places with overarching standards and approaches to long-term care that have generally had lower numbers of COVID-19 cases and deaths.
There needs to be a federal plan for reducing a “dependence on for-profit facilities,” said Armstrong, a professor at York University.
She added it needs to ensure “that all public money for elderly care goes to public or non-profit organizations, including subcontracted services.”
Their other goals for Ottawa include “ensuring everyone has access to care based on need, without financial barriers, and with minimum waiting times for admission.”
They also call for national rules on staffing levels at facilities with a minimum of 70 per cent being full-time at a single site.
Infection plans should include adequate PPE as well as measuring effective laundry treatment, room size and air ventilation standards, backed by public reporting with consistent, verified data, plus enforcement of penalties for failing to comply.
Cohen said some provinces like B.C. and Quebec have taken early action and already implemented parts of these recommendations such as restricting movement of staff and training many more of them.
According to the B.C. Centre for Disease Control’s latest available situation report, adults over the age of 70 comprised nine per cent of COVID-19 cases, which is in proportion to their 13 per cent share of the general population. However, they are greatly overrepresented when it comes to accounting for 42 per cent of COVID-19 related hospitalizations and 84 per cent of deaths.
Another challenge that is pressuring long-term care is rising housing instability.
Isobel Mackenzie, the B.C. seniors’ advocate, recently said issues such as rising rent, renovictions and landlord issues are pushing some of the 20 per cent of B.C. seniors who don’t own their own homes into the long-term care system as a way of avoiding homelessness.