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.

Observations From Just Outside the Pandemic #10

It is always interesting to read my "friends" comments on Facebook.  Like most people, I assume, I have a range of friends, some of whom lean to the far left and a few who are in the middle of the political spectrum with a tinge of the right in them. What I am surprised about is how many of them are conspiracy nuts. To be fair, it may be just that those who like to lose themselves in the ever tangled web of "somebody is against us" thread of news are posting more than anyone else.

It is really dangerous stuff. Anti-vaxers, anti-government near anarchists, alternative medicines types and those who are anti-anyone who have lots of money are combining into an unwholesome mess of, at best, useless rhetoric and at worst dangerous rumour mongering designed to disrupt any rational conversation. I am not sure if those who originally envisioned the internet ever foresaw that it would become, instead of a free platform of useful information, a vehicle by which people could distribute so much wrong information.

I find it particularly disturbing to see people who declare themselves to be trained scientists to declare that the whole virus thing is a bit of a hoax, part of a maniacal plot to take over the world, or at the very least take billions of government funds because they will own the vaccine that we will all be compelled to use. Some of these reports and/or videos are well written and produced. They are polished, professionally produced items. It is difficult to know if their degrees are legitimate or if any of their stated work experiences are valid. There are some who have a long history of being opposed to what is referred to as "western medicine" and see the current outbreak as proof as to how wrong we have all been. These people are dangerous not just because what they say may be completely wrong but because they offer easy answers to solve a complex problem. They allow a person to blame someone or an institution for creating the problem which means that if you stop the person - you stop the problem. It is not that simple, we all have some responsibility in stopping the spread of COVID-19.

Yesterday there were a few comments about governments, specifically Ontario's provincial government suggestion that people should not go for a pleasure drive in their car. Others have questioned why provincial parks and even some walking trails have been closed. There are those who are furious that any government would attempt to limit the natural right of a citizen to enjoy the outdoors. All of those decisions, unfortunately, feed into the paranoia of those who are convinced that the government does not have their best interest at heart.

If one reads the government's logic (I admit that sometimes the government's definition of logic and mine are some distance apart), it is not that they are banning all pleasure drives, it is just that they are concerned that people, while on their drive - will stop and visit someone. There is a very real concern that while most of us have been fairly careful about social distancing, it is difficult to maintain such discipline for an extended period. Parks etc are closed because people were unable to self-regulate. It appears as if the government does not trust all of us to always do the right thing all of the time.

Unfortunately, I think the government may be right.