The COVID pandemic revealed the horror of the many illnesses and deaths in some Canadian long-term care (LTC) homes. COVID revealed chronic under-staffing, inadequate infection control, and inadequate government inspection with enforcement.
The Ontario Health Coalition reported the for-profit LTC facilities had death rates five times those of the publicly-owned homes, and double those of the non-profit homes. The Ryerson National Institute on Aging reported 85% of Canadians of all ages and 96% of Canadians aged 65 years and older, will do everything they can to avoid moving into an LTC home.
LTC is part of the publicly funded health care continuum. Funding has not kept pace with the aging demographic and the increasingly complex health needs of LTC residents.
Providing More Care, Protecting Seniors and Building More Beds Act attempted to address some of the issues by reinstating comprehensive inspections with enforcement commencing in October 2022. The lack of staffing was addressed with increased funding to support educational programs for nurses and personal support workers. In addition, increasing the daily personal support hours from 2.75 hours per resident to an average of 4 hours per resident across the industry by 2025.
The following issues remain to be addressed:
- Reduce new LTC home construction costs by developing and funding an innovative, flexible, publicly funded home care system that will allow residents to age at home and out of LTC
- Implement unscheduled (in addition to scheduled) inspections with compliance enforcement. Even prior to 2019 unscheduled inspections revealed neglect of care.
- Provide adequate government support to all publicly funded health care to ensure staff retention with equalized staff grid, full time positions and wages and benefits commensurate with skills and training required for the job. The pandemic exacerbated the history of 20-25% annual turnover of staff in LTC and nurses leaving health care. Legislation may be required to standardise a grid for compensation of health care workers, based on education and experience.
- Reinstate the requirement that license agreement renewals to LTC providers be contingent on a history of HIGH-quality care. In 2021, a number of LTC providers with the highest COVID death and illness received new 30-year licensing agreements and funding for additional beds
- Utilize evidence-informed, resident-centred care practices that provide a meaningful quality of life as stated in the January 2022 National Long-Term Care Services Standards draft
- Prioritize funding of new LTC construction to not-for-profit homes. Municipal and not-for-profit homes provide more care hours because they do not pay dividends to investors.
Long Term Care is a critical issue in the upcoming election