It’s Time to Reimagine Long-Term Care
The pandemic forced all of us into crisis mode, but can it help fast track fundamental change in long-term care (LTC) homes and for the people who live there?
For over 40 years, the Council on Aging of Ottawa (COA) has been a leading community voice for Ottawa’s seniors and has recently focused its efforts on the tragic plight of seniors living in LTC. The Council’s vision for long-term care is that residents should live in safe home-like environments where they are treated with respect and dignity.
Ontario’s current LTC system is based on old institutional models, tired patterns of care, tight regulatory controls, and increasingly, profit-making. Some of the worst things we can do for seniors is to dispatch them off to facilities where they are isolated, inactive, treated as helpless, and forgotten. Required home inspections are often punitive and rarely result in substantial improvements. And, there is a critical shortage of staff working in LTC homes and turnover rates are high.
With lawsuits looming, it is easy to imagine that governments will become more risk-averse resulting in additional controls and penalties in the future. The COA believes we must use this opportunity to fundamentally rethink the kind of care we need in old age.
Canada has the worst death rate (80% of deaths) in LTC due to COVID-19. Imagine instead if the legacy of COVID-19 was world-class long-term care – a source of pride and not a shame for Canadians.
Changes to LTC need to be more than strong infection prevention and control practices. We need fundamental improvements to ensure the quality of life for residents in these homes. We need a shift in focus from clinical care to supporting living for residents. We need to be well prepared for the future increased needs of our aging population.
Let us not lose sight that any of us might someday live in LTC. Will you be grateful or horrified by the conditions in the LTC home where you spend your last years of life? Where is society’s pride, support, and investment in our LTC homes? What if we ignored our schools and hospitals in this way?
Now is the time to reimagine long-term care. Two key issues have emerged as critical for COVID-19 survival in LTC homes – understaffing and overcrowding. We call on the Ontario government to work quickly to permanently address these issues. Good advice abounds – minimum staffing standards, more full-time work, increase pay and benefits for workers, and eliminate shared rooms and bathrooms among others.
We need to transform to person-centred care models in all LTC homes. We need to allow for the diversity of size and design. This means offering residents more choice in how their days are structured and supporting their emotional needs as much as their physical needs. Transformation care models exist around the world and we are fortunate to have many good examples in our own community. There is no single model to achieve success but having this as our vision would guide all our policies, funding, staffing, design standards and would help change our attitudes to growing old and living in LTC. What an excellent legacy to leave!
On July 29th, Premier Ford announced the Independent LTC COVID-19 Commission and said, “We will do whatever it takes to ensure every senior in the province has a safe and comfortable place to call home”. The COA only hopes that these words reflect the actual future of LTC. Let’s speak out now - let’s demand change for all LTC homes.
President, Board of Directors