Viruses and Long Term Care

The Globe and Mail (amongst other Canadian new outlets) have reported that almost 50% of the just over 1000 deaths (as of April 16) reported as being caused by COVID-19 were seniors. That in itself should not be too surprising as it is far more likely that people over a certain age are more likely to have multiple health concerns that make them more vulnerable to infectious diseases. What has surprised many people including apparently,  politicians, is that a significant number of the seniors who have died were residents of nursing homes or long term care facilities. It strikes me that politicians are demonstrating the worst form of hypocrisy. There cannot be a single person in Canada who has visited a loved one or a friend in a nursing home for more than a couple of times who is not aware of the long-standing issues in such institutions. Provincial politicians have been aware of the variety of issues that have impacted the quality of care. And they have been aware for decades.

Staffing has always been a problem. The pay is generally abysmal. Because most long term care facilities only hire part-time staff (it means that they do not have to pay benefits), it is not surprising that many of the front line workers work in more than one home. There are never enough workers for even the basic level of assistance and frequently trying to find a nurse is impossible. It is a well-accepted fact that residents who have active family support, are far more likely to get better care. Those residents who can be ignored, are. Not because the staff do not care but because there is just not enough time. The hallways are full of people in wheelchairs, sometimes partially restrained, just sitting there, waiting for someone to spend time with them.

This is not a new problem. There is a general perception, although the word fantasy might be better applied that we use to do better at taking care of our elders, that we did not put them in institutions.  If that is partially true it is only because the majority of our elders did not live so long or need so much care. My grandmother was in a good, clean long term care facility over 40 years ago. My mother was in the same home 25 years later. It was still a clean place with nice staff who tried. My mother, who was a competent, articulate woman, especially as her needs increased, frequently felt abandoned by staff.  For staff to spend ten minutes with her just chatting, meant that some other resident was not getting any support at all.  

It is no surprise to me that people, both the residents and the staff in such homes are at an increased risk from this virus. The only way to stop the spread of a virus would be to have everyone in a private room, with meals delivered to their rooms. Under the present systems that it is just not possible. The consequences of such social isolation might be worse than the virus.

It needs to be clearly understood that staffing levels are mandated by the province. Facilities, of course, can hire more staff, but they will not be funded by the province. I suspect that the taxpayers are not prepared to pay for the cost of supporting our elders in an appropriate manner.

I do not have any suggestions as to how to fix the problems. Helping seniors live longer in their own homes is great, but that strategy in many cases only postpones the inevitable. The solution, for me, is shoot me when I become so ill or frail that I need long term care. I do not want to be there - ever.