Inquiry must examine long-term care system

Andrea Horwath is right when she says the public inquiry into the tragic circumstances that allowed serial killer Elizabeth Wettlaufer to murder eight helpless nursing home residents needs a broad and deep focus, not just on these heinous crimes.

There are several troubling questions, and an inquiry — while not ideal — appears to be the best way to get at them. How was the host of warning signs missed? She apparently confessed at various points, yet she managed to keep practising — and killing. What role, if any, did regulatory bodies like the College of Nurses play? She had been fired for at least one medication error, and yet Wettlaufer kept getting hired. Did the various agencies do their due diligence in hiring her?

But pressing as these questions are, there is a bigger story the inquiry must address: The state of nursing home and long-term care overall. Wettlaufer was every family’s nightmare, but considering that there are so many stories, and so much anecdotal evidence, it is clear we’re dealing with a bigger problem. There is too much smoke for there not to be systemic fire.

CARP, Canada’s largest group advocating for older Canadians, says abuse in long-term care is “a growing crisis.” VP Wanda Morris says: “… there isn’t a week that goes by where we don’t hear about neglect, abuse or just simply disinterest so that our most frail elderly are left without protections in a facility that is meant to care and protect them.”

The government is still considering terms of reference and scope. Under the circumstances — an election coming — there is a danger it will opt for a narrow and expedient focus. Horwath argues that would be a mistake, and any inquiry must have the scope and power to look at staffing levels, funding, waiting lists and resident-on-resident violence. She is right.

Granted, that is a large canvas. A scope this broad means it will take a long time, and it won’t be cheap. But consider the stakes. Ontario’s aging population is driving unprecedented demand. And that wave of aging citizens hasn’t come close to peaking yet. The hospital system is swamped, in part because it is dealing with patients better handled in a long-term care environment. And those stories continue to pile up: Patients left in soiled diapers, inadequate and poor food and nutrition, patients left alone for extended periods.

This isn’t an indictment of the entire long-term care sector. Many facilities, and staff, deliver quality care under difficult circumstances. But there are too many exceptions. Rather than be skittish about this, the government should call the inquiry and make adopting its recommendations part of their election platform. Given the number of Ontarians with first-hand negative experiences, that commitment would resonate across the province. It could even form a positive legacy from the horror of Wettlaufer’s crimes.