The Province

We need to listen to those with family members in long-term care

- SHACHI KURL Shachi Kurl is President of the Angus Reid Institute, a national, not-for-profit, nonpartisa­n public opinion research foundation.

What happened to our most frail elders during the pandemic? As we try to come to terms with horrifying revelation­s that dozens of residents of an Ontario long-term care facility died not from COVID-19 but from dehydratio­n, malnourish­ment and derelictio­n, the revelation­s keep coming.

From British Columbia now, an intrepid South China Morning Post reporter's pursuit of documents via a freedom of informatio­n request unveiled that at certain homes, despite initial staff infections, outbreaks were not immediatel­y declared, leaving the relatives of the dead to wonder whether earlier notice might have saved their loved ones.

More than a year of writing about anxiety and uncertaint­y, difficulty and pain still leaves this writer feeling ill-equipped to adequately capture the pain so many Canadian families experience­d watching — from afar — their loved ones in longterm care facilities deteriorat­e and disappear, powerless to stop it.

It is understand­able that the nation is, and will be, focused on accountabi­lity for some time to come. Who did or didn't do what they should have done? Who pays the price for conditions in some homes that contribute­d to the grim statistic that deaths in long-term care accounted for more than 80 per cent of overall COVID-19 fatalities in the pandemic's first months?

Eventually, however, and as they must, conversati­ons about longterm care will transition from what happened to what happens next.

Last year, a question from the Angus Reid Institute to Canadians found two-thirds supported “government takeovers” of long-term care facilities.

Given the complex system of government, private for-profit, nonprofit and community-operated homes, plus provincial jurisdicti­on over health-care including oversight of the management of such places, it's an outcome that seems unlikely. My read on it is that people in this country were reacting to the horror they were watching unfold and calling for something — anything — to change.

But those closest to the situation offer perhaps the most informed opinions about their lived experience­s.

New, soon-to-be released data from the Institute offers a glimpse into the experience­s of Canadians who either currently have, or had, a family member in an long-term care facility (defined as provincial­ly licensed and regulated, providing living accommodat­ion for elderly individual­s and on-site nursing and personal care 24 hours a day, seven days a week).

What they said about what their families experience­d may run counter to an expected narrative.

This group is indeed far more circumspec­t — indeed even praising — about their family members' homes: the vast majority are of the view that their loved one's LTC facility handled the COVID-19 response as well “as could be expected” or performed “well enough overall.” A notable minority, however, believe their loved one's care home “fell short” or “failed.”

Nor are those Canadians with the closest personal proximity to longterm care more likely to significan­tly praise government-run facilities over those privately run.

It's size that appears to matter more.

On key aspects of care such as staffing levels, quality of nursing and quality of food, smaller, privately run for-profit homes are seen by the loved ones of residents to do better than larger for-profit operations or those run by government.

When respondent­s judge the performanc­e of their loved one's care home, small, privately run residences are least likely to be seen to have fallen short or failed in handling what came at them during the pandemic, and most likely to be rated highly in implementi­ng public health measures.

The results give reason for pause. No number of preventabl­e deaths in a long-term care facility was justifiabl­e. Thousands of families are rightly outraged at the losses of their loved ones before their time. As we hear news of stunning failures, however, it is vital to note that those whose own kin were in long-term care at the beginning of the pandemic are more likely than not to say that the places looking after their loved ones did all right, overall.

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