Elder-care failures were predictable: researcher
EDMONTON The COVID-19 pandemic’s impact on continuing care facilities was predictable and preventable, says a senior investigator of an Alberta research team on elder care.
Dr. Carole Estabrooks has been researching nursing homes for almost 15 years. Estabrooks and her team at Translating Research in Elder Care (TREC) aim to find solutions to improve the quality of care at nursing homes and to enrich the work life of caregivers.
Estabrooks said there is a care quality problem in nursing homes that stems from how they are built and how they are staffed.
Part of the problem is the under-regulation of staff. In Alberta, care aides working in nursing homes have variable training and work multiple jobs.
“During the pandemic, a lot of them — in Alberta, up to 30 per cent — were working more than one job. We don’t understand totally why, the majority of it is financial but that’s not the only reason,” Estabrooks said.
“There are other reasons they do that, it’s not just they need more money, sometimes they can’t get benefits and full-time employment, and it’s a complex issue. Employers didn’t know the extent of that in any jurisdiction, I don’t think, until the pandemic hit.”
Many of the care aides in urban areas are immigrant woman, who are older and have little education and low seniority in the nursing homes, Estabrooks said. Yet, they complete about 90 per cent of care for the residents.
“It’s not that we’ve taken resources away from the nursing homes in terms of front-line staff, but the residents that are coming to nursing homes are more complicated and more complex than they used to be,” Estabrooks said.
“They have heavier care demands, they’re coming later so that their dementia and other chronic diseases are advanced. So you’ve got a demand that is higher but you haven’t shifted supply to meet it, so you get a net gap. And you just can’t run the system indefinitely without it starting to break apart with inadequate resources.”
Another factor is that some homes were built decades ago. Three or four residents may share one room, which can be an issue if staff members who care for them have been working at different sites.
“In terms of infection control, if you sat down and thought about what it would it mean to have a pandemic with a new virus for which there was no immunity for a couple of years, what would that mean to this population?” Estabrooks said. “You could predict that it was going to be catastrophic.”
Estabrooks said it’s not enough for these things to just be measured. They need to be acted upon through government regulation.
She also believes a review following the pandemic on the country’s continuing care homes is “inevitable.”
“It’s really tragic that it took this to wake the country up and say, ‘Oh my God, is this how we’re looking after older adults? Why are we doing that? How could it be this way?’”