Pandemic lessons on caring for ‘seniors’
It is still too soon to reflect on lessons from the trauma inflicted by a raging pandemic. The entire world remains on a steep learning curve and the end of that “learning” is nowhere in sight.
In fact, there may never be an end as we adapt to the reality of life with COVID-19. But there are a few things we do know for sure.
COVID has shone a spotlight on profound global inequalities. COVID has been equally devastating when it comes to populations within countries. Here at home, older Canadians, racialized groups and marginalized workers have been disproportionately affected by the pandemic.
Right from the get-go, older Canadians were the most vulnerable and hardest hit. Nursing homes, in particular, are the ground zero of this viral war.
The neglect of nursing homes was swiftly and correctly branded as our national shame. Multiple investigations and reports documented the shocking deficiencies and called for better infection control, tighter sanitation procedures and improved care.
Though clearly necessary, these reforms are not sufficient. The “what-to-do-about-seniors” discussion always reverts to a singular and narrow focus on better nursing homes. While there are many good homes in the country, this can’t be the only option.
When it comes to older Canadians, there are three missing parts to the post-COVID equation:
First, the narrative has to change. Let’s stop saying “seniors.” Do we refer to children as “juniors?” We need to talk about older Canadians who now comprise, according to the most recent census, the largest proportion of the Canadian population.
Older Canadians are typically lumped together in one group as though all are sick and frail. This characterization is incomplete — and incorrect. In fact, there are two main cohorts that have evolved: “younger” older Canadians and those over age 85. Their interests and support requirements are quite different.
Second, we should shift the focus from needs to rights. All Canadians — including older individuals — have a right to live in good health and dignity. We should ask what this really means. For most, it does not involve institutional care.
A recent survey by the National Institute on Aging found that almost 100 per cent of Canadians aged 65 and older planned to live in their own home for as long as possible. Yet Canada spends 87 per cent of longterm care dollars on institutionalizing people in nursing homes rather than at-home assistance. Moreover, few options exist for older Canadians between the home alone and institutional care ends of the housing continuum.
There are many successful examples around the world of alternative living arrangements that combine affordability, safety and support. Co-housing, for example, enables small groups to live together in familystyle homes where they share costs and care for each other.
Intergenerational housing matches older adults with students, who get free rent in exchange for free care. Dementia villages provide secure environments that allow residents to avoid institutions and move safely within the village.
These models have never been widely embraced in Canada. If anything, there are barriers to creating these alternatives. In some municipalities, for example, co-housing options have faced outdated prohibitions related to concerns about illegal boarding houses and nursing homes. In 2019, an Ontario MPP introduced the Golden Girls Act (now passed in law) to prevent municipalities from barring unrelated people from cohabiting.
Third, affordable housing arrangements that enable support are important not just for older Canadians. Intergenerational housing options throughout the world have helped students complete their post-secondary education and young families struggling on their own to do it all — make ends meet, maintain relationships and take good care of their children.
Solutions for the future should include intergenerational arrangements. We need each other — emotionally, socially and financially — perhaps more than ever.
If COVID has taught us anything, it is to end our sole fixation on nursing homes. We should instead be nursing better ideas about how to create more caring, supportive and affordable living arrangements for all Canadians.
A recent survey found that almost 100 per cent of Canadians 65 and older planned to live in their own home for as long as possible. Yet Canada spends 87 per cent of long-termcare dollars on putting people in nursing homes