A Tale of Two Institutions

Two unrelated - unconnected facts - except of course, that they are both about the consequences of allowing the COVID-19 virus to spread.

1) nearly 80% of all deaths in Canada attributed to COCID-19 have happened in nursing homes(1).

2) the largest single largest COVID-19 outbreak has occurred in the Cargill meat processing plant in Alberta (2).

I find it fascinating and more than a little bit worrisome that in general Canadians (or at least the Canadian press) are alarmed at the number of cases of COCID-19 and the consequent deaths within our long term care facilities. We are quite right to be concerned that so many people have died within a very short time when we knew how to prevent the virus from spreading. As noted in an earlier blog, any one who has spent any time in a nursing home knows the problems - not enough staff, staff who are underpaid and who have to work in more than one facility to live and environments for the seniors that do not allow for enough private space - are all factors which can facilitate the spread of viruses. Especially for those who had not thought about the problem, it must be more than a little bit troublesome to contemplate their potential future. There are already demands for a national strategy to alleviate the the problem, a demand that Canada takes better care of its "most vulnerable".  While it would be nice if in, fact, such a strategy was developed, I cannot imagine a time when the provinces will allow the federal government to control something that is under provincial jurisdiction nor can I imagine a time when the Canadian taxpayers will tolerate a significant increase in taxes to pay for any such plan.

Canadians, however, seem to have far fewer concerns as to what is happening at the meat processing plant. There are no calls for a national investigation as to how this could have happened or for a national strategy to ensure that it cannot happen again. Perhaps because there is no apparent danger to ourselves and we most of us cannot imagine ever having to work under those conditions, we do not see what is happening in Cargill or the other meatpacking plants as being our concern. But if seniors are being labelled as our "most vulnerable", surely the employees of that and the other meat processing plants, most of who are immigrants must come close to being our second most vulnerable.

For those of us who have read reports or seen documentaries (https://www.nfb.ca/film/24_days_in_brooks/)  about meat processing and immigrants, we are well aware that not only are the working conditions sub-standard but also that the employees are frequently treated poorly because they are immigrants and may feel powerless. We should all be just a little bit angry about the fact that the employees are treated poorly much of the time. We should be offended that this has been allowed to happen for decades. But now we should be bloody mad that at a time when most of us are not supposed to get within six metres of anyone, other than those we live with, employees who are afraid of being sent back to their country are being forced to work in dangerous conditions where it is highly likely some will become infected.

It is well past time that those who profit from the abuse of workers who are immigrant are held accountable. It is equally well past time that all of those who enjoy the products need to speak up. One cannot help but wonder whether or not people's love of cheap meat blinds them from doing what is right.

(1) cbc.ca/news/politics/long-term-care-homes-covid19-1.5556041 

(2)newsinteractives.cbc.ca/longform/cargill-covid19-outbreak

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.