The COVID-19 pandemic has had a profoundly disproportionate effect on residents of long-term care (LTC) homes in Canada. Although it may be tempting to assert that this was unavoidable in light of the devastating nature of the virus, COVID-19 elucidated existing shortcomings and failings in the LTC system. The report prepared by the Canadian Armed Forces sheds light on deficiencies and shortfalls within LTC homes in Ontario that would have contributed to COVID-related deaths.
On Nov. 23, First Policy Response convened a panel of experts and practitioners to discuss the existing state of LTC as well as its future in the wake of COVID-19. The Video Town Hall was moderated by André Picard, health columnist for The Globe and Mail, and featured Pat Armstrong of York University, registered nurse Sharon Nwamadi and Dr. Samir Sinha of Ryerson University’s National Institute on Ageing. The panellists examined the effects of the first wave of COVID-19 on LTC homes and the potential effects of the second wave, and took a closer look at why the homes are in this state and what changes must be implemented to avoid a repeat occurrence.
The panelists agreed that several key factors contributed to the impact of COVID on LTC homes, including a shortage of staff and a lack of training and specialization. They talked about the undeniable and important intersectionality between labour and the state of the homes – or as Armstrong said, “The conditions of work are the conditions of care.” How can we expect frontline workers, who face the brunt of the pandemic, to be able to function at their best if we fail to support them through proper compensation and safeguards?
The panellists also noted that a key to examining this issue is to view LTC through a gendered lens. Women, and particularly immigrants and women of colour, make up the bulk of the workforce in LTC homes, so it is important to recognize the amplified strain this puts on those sectors of society.
The panel was also aligned on what may be required to learn from the harsh lessons of the first wave of COVID-19. Perhaps what stood out most is the absence of national standards on health care in LTC homes: federal funding is distributed to the provinces, which regulate long-term care. However, the panel also noted the difference between standards and standardization. That is to say, while standards are important, the reality is that care should not be organized or delivered in the same way in different provinces, regions or communities.
When asked about a model of LTC homes that Canada may aspire to, Sinha spoke about Denmark. Crucially, the success of Denmark’s approach to long-term care lies in its emphasis on allowing older people to remain in their homes for as long as possible. This not only saves costs for the state, as fewer members of society require government-funded care, but it also infuses dignity and community into the lives of our oldest members of society. In the wake of COVID-19, where staying home has been one of the best ways to combat community spread, this approach to long-term care has become even more important.
During COVID-19, it has often felt like the world is on fire and we are scrambling to put out the flames. Our most vulnerable members of society have been badly burned as the pandemic unearths our social and economic failings. In contemplating the future of long-term care, it is essential to remember that we all share the common experience of being human which, if we are lucky enough, will involve growing older. While we can learn so much from our elders, who have shown themselves to be resilient in the face of the loneliness and social isolation brought on by the pandemic, we must not interpret their resilience as imperviousness.
