Elderly marooned by shipwrecked system

EDITOR’S NOTE:

This is the final article in a five-part series looking at what has been done and what needs to be done to keep our elderly population in long-term care homes safe during COVID-19.

Picture a ship caught on the rocks, relentlessly battered by waves.

It is crammed with elderly passengers, many with dementia or debilitating physical conditions.

The crew, or what’s left of them, are beyond tired. Still, they do their best to patch leaks to hold the vessel together, all while caring for the passengers. At times, the physical and mental strain is unbearable.

The radio operator has been calling for help, seemingly for forever.

The authorities, though outwardly concerned, mostly commission report after report, asking for recommendations on just what should be done. Some of the advice is heard, but much is subsequently ignored.

If that scenario resembled the state of long-term care in this country — including the Atlantic region — before the pandemic, then COVID-19 slammed into the nursing home sector like a tsunami.

This week, SaltWire has run an in-depth series on long-term care and the hard lessons learned from COVID.

• An older, frailer resident population in part due to better home care

• Staffing ratios set decades ago, when LTC residents often drove their own cars, remain in use

• Staff shortages that increase workloads exponentially

• The loss of workers because of high stress and poor pay

• Long-term care ranking well behind hospitals when it comes to funding

• Lack of data on residents, their health conditions, level of care and electronic medication records

• Inconsistent funding for infrastructure which makes planning difficult.

For too long — and despite the best efforts of those inside and outside of the system who’ve cried out for help — governments have treated the needs of our most vulnerable elders as afterthoughts.

Like the bed sore deaths that galvanized action a few years ago in Nova Scotia, it’s taken another crisis — the wave of deaths in LTC facilities across Canada — to refocus governments’ attention on the nursing home sector.

If there’s one bright spot, it’s how, in Atlantic Canada, those in charge of long-term care facilities have mostly done an exemplary job in keeping COVID-19 at bay.

The exception, of course, was at Northwood in Halifax. Thanks to the Nova Scotia government’s glacial pace of response to a longstanding request from the facility to physically expand to provide more private rooms, too many residents (up to four) were still sharing accommodations when the pandemic hit, contributing to the easy spread of the virus.

Nova Scotia just set aside money to make sure those moved out of Northwood to give each resident a room don't have to move back, and to upgrade some other facilities.

That's a start. What else needs to be done?

Governments have to stay committed to real, progressive and effective change. It’s up to all of us, not just those with family members or friends in nursing homes, to demand that they do.

Where required, funding formulas and legislation must be modernized to reflect the reality of long-term care today.

That means, in particular, addressing woefully inadequate staffing levels that are at the heart of the problem. It means better levels of pay where compensation is now too low. It means more registered nursing care, to reflect the challenging medical needs of more of today’s elderly residents.

Yes, it’s great that Nova Scotia recently announced family members and caregivers will be allowed to now do more to help staff. But not everyone in nursing homes is fortunate enough to have that kind of support. It’s not a systemic answer. It’s great that they’re going to allow couples to stay together, but not doing so was always unconscionable.

We learned a few things, the hard way, about infection control and more robust cleaning protocols. Keeping that up costs money. Let's recognize that in the next round of budgeting and the ones after that.

We also need to get serious about data collection. In the modern world, trying to tackle complex problems without sufficiently detailed information is like choosing to operate in the dark.

And we need to learn from best practices around the world.

Here’s a core concept that should not be hard for any politician or bureaucrat to grasp: We should treat our elders as we would hope to be treated if — and when — we found ourselves in a LTC facility.

The people in nursing homes are our mothers and fathers, our grandparents, our sisters and brothers, our aunts, uncles and other relatives. They are our friends and neighbours. Our teachers, firefighters and others who have spent their lives helping others.

And, someday, they could be us.