Change necessary in long-term care: expert
Professor says pandemic has put spotlight on crisis in assisted-living system
COVID-19 has exacerbated problems that have plagued the long-term care and assisted-living system in B.C. for years.
Lack of capacity, underfunding, a mishmash of contracts between health authorities and facilities, and a shortfall in accountability and monitoring are just some of the problems that were outlined by experts on a panel at the Union of B.C. Municipalities convention Thursday.
“I don't think I'm being hyperbolic in saying we have a crisis in residential care, and seniors' care more broadly, in B.C.,” said Kim McGrail, who is on the faculty of the University of B.C. Centre for Health Services and Policy Research.
“It's a crisis that pandemic put a spotlight on, but it's not one the pandemic created.”
When the first wave of COVID-19 arrived in B.C., long-term care homes were hit hard, particularly in midto-late April.
There have been 56 outbreaks at 52 facilities (47 longterm-care facilities) and of those outbreaks, 32 resulted in no deaths, 24 were contained to a single staff member, seven were contained to a single resident, four involved fewer than five people, nine involved up to 15 people, and 12 had more than 15 cases. As of Wednesday evening, there were eight active outbreaks.
A total of 140 residents have died, which accounts for 62 per cent of the total deaths in B.C., which is lower than the rest of Canada, on average.
There have been 654 COVID-19 cases in these facilities, with 295 of them affecting residents.
Those living in care facilities have had to deal with a lockdown and then limitations on visits, and the government has made changes to how the system works, such as limiting staff to a single site, that are designed to reduce the chance of staff and residents being exposed to the virus.
“Conversations about the sector clearly have a more pointed edge to them now, given what we've seen and experienced during the pandemic, but while it is more pointed, that edge has been there for a long time,” said McGrail. “I would argue we were well-overdue for a broader public conversation about what we owe each other, what kind of society we want to be and how we wish to organize our resources to support aging.”
Pat Armstrong, who is with the department of sociology at York University in Toronto, has been involved in studying nursing homes in six countries for the last decade. She said while there is no single model that provides a magic or universal solution, there are common principles that can act as guidelines for coming up with strategies and standards to deliver the best possible care.
“The pandemic has made the need for such strategies starkly visible and even more urgent,” she said.
The guidelines include making sure there are enough staff, that staff and families are continuously educated about providing care, understanding that care as a relationship requires continuity, ensuring staff have the time, training and autonomy to be flexible and respond to individual needs, and that physical environments are well-designed and maintained.