In­quiry must ex­am­ine long-term care sys­tem

The Hamilton Spectator - - OPINION - Howard El­liott

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.

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