Long-term care in crisis, committee told
Nova Scotia nursing homes will continue to be in crisis while the province refuses to prioritize chronic staffing and bed shortages in the sector, say provincial stakeholders.
Unions representing nursing home workers spoke at Tuesday’s health-care committee and urged the government to finally commit to nearly doubling the minimum level of care for residents to 4.1 hours of care up from 2.45 hours per day.
The two-decade-old funding model translates into our province’s most vulnerable residents not getting the basic care they deserve, said Janet Hazelton, president of Nova Scotia Nurses’ Union. Research has supported using 4.1 as the standard, said Hazelton who’s also calling on the province to make it law in the legislation. She said nursing homes cannot be given discretion to use taxpayer funding other than for patient care.
Jason Maclean, president Nova Scotia Government and General Employees Union, agreed, saying there’s a serious shortage of continuing care assistants throughout the province.
The province's recently introduced bursary program to attract those workers isn't working. He said CCAS are being forced to work overtime while being underpaid at roughly $18. Addressing the shortage starts with increasing wages across the board, hiring more CCAS, improving work conditions and focusing on retention, he said.
Dr. Kevin Orrell, deputy minister of health, gave no indication that the province had any concrete plans of increasing wages or significantly increasing staff levels. He said the province has spent more than $10 million implementing recommendations from the 2018 Expert Advisory Panel on Long Term Care. But not all recommendations have been implemented
Orrell questioned implementing the long-proposed standard 4.1 hours of care per patient, arguing that there's no size fits all. He said some facilities require more or less care depending on the acuity of their condition. He also said imposing it could be unfair to some nursing homes that are managing with the current standard.
But Hazelton didn't buy that explanation. She said every nursing home in the province is stretched thin, particularly with the second wave of COVID-19. She said the province would have to spend an extra $80 million a year to address the staffing deficit.
“We've been talking about this for 10 years; all of the long-term care facilities are overworked," she said. "We need baked in long-term care hours in the legislation so that every resident is getting 4.1 hours of care. God love them if they don't need the 4.1, maybe someone can have a cup of tea with them.”
Orrell touched a nerve with the union reps after lauding the province's ability to prevent COVID in nursing homes during the second wave. He said the province is "basically the envy of the country and probably the world in terms of how we proceeded with this second wave."
Maclean said the deputy minister failed to address the 53 Northwood nursing home residents who died of COVID-19 during the first wave. He said he was also disappointed that the deputy minister didn't appear to be looking to work with the union to address shortcomings in the sector.
"We had tragedies in our nursing homes during the first wave and there's no commitment of needed overhaul and we have less and less people willing to work in long-term care."
Michele Lowe, Nursing Homes of Nova Scotia Association managing director, also spoke at the committe and is also pushing for an increase in minimum patient care. But she was hesitant to limit it to 4.1 hours, saying some nursing homes require more, pointing to more than 80 per cent of long-term care residents having some form of dementia.
She said the government needs to come up with a long-term care strategy that includes a transformation of the sector. She said it must include significantly more funding for recruiting and retaining staff as well as a plan to address aging long-term care infrastructure.
"If we don't have some significant traction in the next six months, we are going to see a repeat of what we predicted five years ago which is happening today. The same thing will happen again five years from now.”