Why is the Ford government making LTC homes more like jails?

We should demand any new funding provided by the province to long-term care be used to increase the ratio of staff to residents

Residents of Ontario’s long-term-care homes and their families have been dealing with lockdowns and visitor bans for nearly a year now. Since July 2020, I have conducted over 90 Zoom or phone interviews with relatives of long-term-care residents, as well as registered nurses (RNs), personal support workers (PSWs), and long-term-care administrators. Many of the people with whom I spoke compared the situation of long-term-care residents during the pandemic to being in jail. Now with the government’s allocation of $42 million to hire security guards, ostensibly to do COVID-19 screening, the system will be moving even closer to jail-like conditions.

As taxpayers, we should demand any new funding provided by the province to long-term care be used to increase the ratio of staff to residents and provide the four hours per day per resident of hands-on care that was promised in October 2020. Shockingly, there is no legislation about minimum staff-to-resident ratios in long-term care, beyond requiring one RN to be present in a home at all times. This means that each long-term-care operator can decide on the number of PSWs to hire. Likewise, each operator can set the compensation rate for PSWs, and in most homes, this is only slightly higher than minimum wage.

In 2018, there were 50,000 PSWs in Ontario long-term-care homes sharing the equivalent of 32,700 full-time positions: that means many PSWs need to work multiple part-time jobs to make a full-time income, and they do not receive benefits. Moreover, Ontario PSWs are overwhelmingly women (90 per cent) and almost half of them (41 per cent) are people of colour. Challenging conditions working with long-termcare residents, of whom 90 per cent have some form of cognitive impairment and 86 per cent need extensive assistance with activities of daily living, make burnout almost unavoidable.

We know from last spring’s military report that staff shortages made conditions in some long-term-care homes horrific during the first wave. These are not isolated exceptions. Surveys conducted in November and December 2020 by the Ontario Health Coalition in long-term care homes with outbreaks of more than 10 people found 65 per cent of front-line workers reported insufficient staffing for the provision of adequate care. Personal hygiene was at the top of the list of care that had to be sacrificed. Front-line staff reported struggling to feed and hydrate all residents and to provide medications in a timely manner. Inadequate numbers of cleaning and laundry staff made infection control and the provision of clean linens for residents a challenge.

Why can’t the province spend $42 million to improve wages for PSWs and increase staffing in long-term care? The Ontario Health Coalition calls for recruitment and intensive training of 10,000 to 20,000 new long-term-care staff, to address what Doctors for Justice in LTC are calling “a grave humanitarian crisis.” The rationale for hiring security guards is to free up care staff from COVID screening so they can look after residents. Why not just hire more care staff and pay them the wages they deserve? Instead, the Ford government is funding the hiring of security guards, whose presence will make long-termcare homes look more like jails and provide operators with greater potential to avoid public scrutiny.