Let’s stop warehousing people in long-term care

This spring, the provincial government continued with plans to increase the number of nursing home beds for seniors who need high levels of care – in response to our aging population and the prospect of running out of places for seniors with complex needs to live.

However, while government is building and expanding facilities, it is ignoring the growing concerns expressed by families about the quality of care, and quality of life, of their loved ones in these institutions.

I am hearing from people around the province who are upset about inadequate staffing levels that compromise the safety, health, and well-being of their loved ones. A group, Advocates for Senior Citizens’ Rights, has formed to pressure government to address the issues of seniors’ rights.

Families of residents in our long term care institutions are telling me about assaults by residents on other residents in dementia units, where staff were not available to prevent the assault or help the victim afterwards. I have heard about preventable falls, about delays in toileting functions, bathing, and other hygiene issues, about people left alone with meals unable to feed themselves, and about excessive use of restraints and psychotropic drugs that have once again put this province on the map for the wrong reasons. Another significant issue is that staff are too busy to spend any time with residents, to treat them with sympathy and respect, to listen. People call this situation “warehousing,” and say they don’t want it for their loved ones.

A core problem, especially in the larger facilities, appears to be insufficient staffing to meet the needs of the residents and some of that seems to be increasing with newer facilities.

For example, the layout and room arrangements at the new Pleasantview Towers in St. John’s make it hard to do the same amount of work in the same time as before. The resulting compromised care will occur in new facilities built on this template which I am told is going to happen.

Compounding the problem is the fact that more of the people needing long-term care have complex conditions such as dementia that require higher staffto-patient ratios.

Government, with its focus on conventional facilities, is neglecting the importance of adequate staffing. It is also ignoring what is going on in long-term care in other places. Instead of evaluating the institutional model, it is missing the opportunity to look at new, creative ways to take care of seniors requiring care. It’s time to move from warehousing to a more humane system.

There are better models of long-term care that are improving the quality of life for residents, and actually reducing their medical costs. Ontario’s Butterfly Program, Dementia Care Matters in the UK, and the Green House Project in the U.S., provide smaller, home-like settings for seniors with dementia, where there is more direct care time, including emotional care, staff are encouraged to form relationships with residents, and residents are able to pursue their interests.

We have made some steps forward in this province with protective care residences in Bonavista, Corner Brook, and Clarenville, for example. These specially designed and staffed homes provide specialized care and accommodation for individuals with mild to moderate dementia. They are equipped with safety features specific to the security needs of persons with dementia in a home-like environment.

A re-direction will take time. In the short term, government urgently needs to re-assess the staffing and other resource needs in long-term care to ensure the rights of seniors are being met.

We also need revamped standards of care, and the assurance that they will be both monitored and enforced.

Lorraine Michael, MHA St. John’s East-quidi Vidi