No more studies are needed to fix long-term care

The tragic loss of so many Canadians from COVID-19 in our long-term-care facilities must never happen again. On average in our provinces and territories 80 per cent of the deaths have occurred in long-term care.

There is demand for royal commissions, provincial studies and investigations, but is this what is required at the present time? I would argue that the studies are simply a reason for governments to fail to act. The time for change is now and not in three to five years when the studies report.

Specialists and those working in the field have known for decades what is needed. In the interim report on Canada’s aging population in 2007 and the final report in 2009, the Senate identified the need. We were not the first to do so, nor unfortunately, will we be the last.

There are six initiatives that Canada could and should begin immediately.

We must launch the development of a national strategy to establish standards for the size, staff requirements and ratio of staff to clients, training of personnel and safety precautions. There will be a demand on the federal government for additional funding. But new dollars should not flow without clear standards in force across all provinces and territories. If the provinces are more comfortable with the term “provincial standards,” then so be it, as long as they all agree to this standard. Only in this way should federal dollars flow.

All accommodation should be based on the principle of one client per room, with exceptions made for those whose long-term partner is also in care. Alternate accommodation must be made available where there are two in a room when one client needs isolation. This will require infrastructure dollars from the federal government as there are not sufficient beds at the present time. This is the reason so many requiring care fill our acute care hospitals. Renovation budgets for homes will also be required as many of the older residences currently have four clients per room. Data will soon be available for the number of deaths in public, not-for-profit and forprofit homes and funding decisions made accordingly.

The staff-to-client ratio must be increased and take into account that care needs of clients have increased immeasurably in the past 10 years. Keeping seniors and other vulnerable Canadians in their homes as long as possible, although significantly lacking in adequate funding, is a good model.

It has been known for decades that the cost of caring for a person in their home is considerably less than in an institution, but if family cannot or will not provide additional care above home care, then the long-term-care facility is the only choice. The majority of clients now entering long-term care have far greater physical and mental needs than a decade ago.

Greater consideration must recognize that by far the majority of family caregivers are women and compensation must be available for their lost time from employment and the deterioration of their health while they provide care.

Inspections of all facilities must be performed at least once a year and much more frequently when deficiencies are identified. No early warning should be given for such inspections in order for inspectors to learn what the place is really like. Inspections carried out by telephone are clearly inappropriate and unacceptable.

There must be a two-week supply of personal protective equipment in all homes and ready access to a 90-day supply.

Finally, salaries of all staff in longterm-care facilities should be reviewed. It is imperative that staff, particularly personal support workers, health aides, cleaners and food preparation staff be paid adequately. They must not be forced to work in more than one facility in order to earn a decent wage. They are providing care to our vulnerable Canadians. They have a right to expect that we show that we value the work they do by ensuring a good wage.

If we implemented these changes in the next year and then learn that further studies are needed, then conduct them, but do not delay action because governments are studying the problem.