Standards have to be set higher
Why did it take so long to request the commission of the Canadian Armed Forces (CAF) to long-term care residences In Ontario and Quebec? The military entered these facilities to confirm patterns of abuse and neglect taking place in plain view, after reports of abuse and neglect became too numerous and patterned to avoid.
We now know the problem was systemic and chronic, taking place over decades. This in itself is a startling revelation which has national significance. We know the problems are more widespread than in five Ontario long-term facilities. Every province will have to review practices in long-term facilities and Nova Scotia should start examining its 130 facilities.
The Ontario Health Coalition, the Service Employees Internal Union and the Personal Support Workers Association representing thousands of workers have all made serious allegations about the condition of residents. The military was seen as an impartial institutional witness that could report with some credibility. Quebec and Ontario are two provincial systems among all the others that became overwhelmed by conditions created by the coronavirus.
But they also were aware of numerous complaints from residents and members of the public. Some 1,700 military personnel entered the residences and did work normally done by employees. The military interviewed residents and family members about their experiences and became the front-line witnesses to the goings on every day.
The first military report contained alarming details, reporting that residents were being bullied, drugged, improperly fed and left unattended. The report stated that neglect may have led to the death of some residents.
The history of institutional abuse is filled with horrific stories that are overlooked, covered-up and left to review by some future accountable authority. Some managers manufactured facts about specific events, then proceeded to conduct business as usual.
But because most clients in longterm residences are elderly or sick, there is the ugly underbelly of ageism that distorts the truth about what is really happening. Ageism comprises the prejudice and discrimination against people on the basis of age, particularly when they are older people.
It's a widespread phenomenon that is rarely confronted and challenged by the public. Not surprisingly, ageism takes place everywhere in Canada, and is experienced by both young and old.
In a nursing home setting where it festers, older people are viewed as cranky, sickly, egocentric and especially lacking in social value. Their complaints are often not taken seriously and ignored. That is now an insidious reality which explains how abuse is sustained.
Ageism is rooted in the thoughtless assumptions that older people gradually become unintelligent, asexual, unemployable, mentally incompetent and unattractive. As an ideology, ageism is found throughout the economy where untested beliefs and prejudices spin their way through conversations and interactions.
The biases are subtle but convincing to those who express them. And so it is not inconceivable that longterm care institutions everywhere in Canada should nurture ageist views among staff, some of whom might regularly use abusive and neglectful behaviour to maintain control over residents.
The military observed that poorlytrained support workers had trained new workers, creating a dangerous chain of incompetence within each institution. In this circumstance new workers act out what they see others do or neglect to do. It is a dangerous learning dynamic in any organization.
The for-profit business model employed in most residences enables a cost-cutting management mentality. Cuts are made to laundry services, food, supplies, dietary services and qualified personnel. Eventually cuts take their toll on the efficient operation of the organization. It's the law of diminishing returns as an operational principle. The net results are that the elderly die alone, often terrified and without the presence of a loved one.
For the general public, it's out of sight, out of mind. It takes the explosive revelations by the military to shell shock the public and the powers that be.
Unfortunately, it's a vivid portrayal of us as a society: take a hard look at what might happen to you. We should get concerned. The future is now.
We should know that most workers are not knowingly abusive and usually engage in countless acts of instinctive kindness. I saw that with my mother who spent the last two years of her life in a Montreal nursing home. Fortunately, friends and family were always close by and provided almost worry-free care in my absence some thousand miles away. But it was concerning how casual neglect would occur without accountability unless those outside the system stepped in.
We think of ourselves as a compassionate and caring society. But compared with countries like China and South Korea, where older people are respected as a deep cultural value, Canada falls far short. Japan has a national holiday called Respect for the Aged Day. It's the law to honour your parents in Singapore.
First Nations in Canada, such as the Metis, Inuit and Mik'maq, respect older people in their communities as "elders" and consult with them on many matters. It is one of the reasons why it is offensive for our communities to fail to consult with the.
It is going to take oversight by an Ombuds or ministries for seniors to keep a close watch on residences that serve older people. Or the insidious behaviour reported by the military will reappear.