Long-term-care system marred by basic flaws

Re When will nursing homes be held responsible for deaths?, Letters, July 21

I was my aunt’s power of attorney, on her home’s family advisory council for five years. I learned lots about nursing homes and Ontario’s regulatory environment.

Shelby Shepherd, out of grief in losing his dad, asks about government improvements and penalties for nursing homes. Ending, he notes “those with power and influence to improve conditions” must take action.

In 25 years, conditions have become worse, because our system has basic flaws. More than half Ontario’s 626 nursing homes are owned and operated by for-profit corporations, whose fiscal responsibility is to their shareholders. How can a nursing home ensure profitability, when all get the same funding?

Another significant element is so many homes still have “ward” accommodation (now called “basic”), with three or four residents per room.

These homes must be renovated or replaced. Are we ready to legislate? Bernard Katz, Toronto

Re Publicly funded home care needs boost before winter, July 21

This opinion piece by Tara Kiran hits the nail on the head when it comes to keeping older adults and people with disabilities out of high-risk, long-termcare institutions. No one wants to end up in one, so why have we not, over the years, invested health funding in home care, rather than institutional beds that provide profit for multi-national companies?

Taking the cap off home care hours so that it actually becomes an alternative to institutionalization is a major step the government could take right now to help older adults needing care.

It is a win-win, helping older people stay home and avoiding their placement in what are often more costly, but impersonal, institutions.

For those with dementia who need care around-the-clock and supervision, government should be funding memory care homes — small home-like environments in the community with safe, fenced yards for them to wander, and staff who understand trauma-informed care, which has shown to help them gain functionality. Municipalities and non-profit agencies stand ready to deliver services like that.

Continuing to throw hard-earned taxpayers’ money at long-term-care institutions is the wrong way to go.

Investing much more heavily in home care and in smaller, home-like settings with higher levels of care is the right way. Patricia Spindel, Ajax

As Tara Kiran notes, there is an urgent need to increase and improve publicly funded home-care services.

While the threat of a second wave of COVID-19 has given increased visibility to this need, it is a need that has (as she notes) existed for a very long time.

The absence of a strong and comprehensive home-care system has resulted in many older adults ending up in institutional environments that are large, impersonal, mind-numbing and often dangerous.

Home-care services must be available when needed, must not have arbitrary service caps, and must be flexible enough to provide the kinds of services people need to remain in their homes.

Investing in an enlarged and improved publicly funded home-care system is a good investment that would ensure, to the maximum extent possible, that older adults are provided with the support they need to live, full rich lives within their communities. Judith Sandys, Toronto