long term care

Saturday August 27, 2022

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Saturday August 27, 2022

Not the new and improved Doug Ford …

August 19, 2022

At minimum, the provincial government has a massive optics and communication problem around its new initiative to try and free up badly needed acute care beds.

By now we all know the health-care crisis is real. And a significant part of the situation is a result of people who need alternate levels of care occupying acute care beds. Give Doug Ford and friends credit for finally trying to do something about it.

But is what they’re doing the right thing?

January 27, 2021

New legislation would allow hospital patients to be transferred to a temporary long-term care home without their consent while they await a bed in their preferred facility. The interim LTC facility would not necessarily be in their community. The law will not physically force patients to move, but it’s not at all clear what will happen if they don’t.

LTC Minister Paul Calandra says people should “absolutely” be charged a fee if they won’t move, but he won’t say how much. It could be $62 per day, or it could be much more. How much more? How far away might people be moved? The government either doesn’t know or isn’t saying, and it is not allowing debate or public input into the new law. This is not the new and consultation-friendly Doug Ford people thought they were voting for. (Hamilton Spectator editorial) 

 

Tuesday May 4, 2021

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Tuesday May 4, 2021

Ontario government needs to wake up and make nursing homes a top priority

May 16, 2020

The people of Ontario didn’t need two new reports to tell them Doug Ford’s government was missing in action when COVID-19 hit the province’s nursing homes last year.

The deaths of nearly 4,000 long-term-care residents and 11 employees during the pandemic had already spoken for themselves. And that grim message amounted to a scathing indictment of governmental ineptitude at the highest levels. 

Yet for all this, Ontarians really did need Friday’s report from the Long-Term Care COVID-19 Commission along with the one from Auditor-General Bonnie Lysyk two days earlier. They’re essential for telling us what we should — make that must — do for the sake of the 115,000 of the province’s most vulnerable citizens who live in nursing homes today.

According to the commission, the Ford government was completely without a comprehensive plan to protect nursing homes when the pandemic hit. Then, not only was its response “slow, unco-ordinated and lacking in urgency,” it failed to heed the lessons of the first wave. As a result, more residents died in the second wave than the initial one.

November 19, 2020

For its part, the auditor-general’s report denounced not only the current provincial government but governments stretching back over a decade. Not one of them followed up on the recommendations made by an expert panel after the 2003 SARS outbreak to prepare long-term-care facilities for a future health-care crisis. 

Not one of them addressed the concerns about the litany of long-standing weaknesses that had been identified in the nursing-home system. And so the province’s nursing homes, which consume seven per cent of the health-care budget, became pandemic disaster zones.

For some Ontarians, this may all sound painfully familiar, something they’d just as soon forget after they condemn the current government. 

But these two reports are important for more than putting on the record a precise diagnosis of what went so badly wrong in the province’s nursing homes over the past year. Their greatest, and hopefully most lasting, value will be in the prescription they offer for what should be done now.

May 27, 2020

The best way forward will demand more funding, more and better-paid staff, an end to overcrowded wards, better coordination with the rest of the health-care system and — for goodness sake — a pandemic plan. Ontario also needs a new model for building and managing new nursing homes, and the Long-Term Care COVID-19 Commission came up with a promising proposal for one. 

It recommends constructing new homes that are paid for upfront by private investors who receive a return on their capital with profit over time. However the homes will be operated and the residents cared for by a mission-driven organization. It could be public, not-for-profit or for-profit. But the sole focus of those running the homes must be the care of the residents and certainly not returns for investors.

January 27, 2021

What matters now is what the Ford government and the people of this province commit to doing with this and all the other ideas in these reports. Ontario Long-Term Care Minister Merrilee Fullerton promised Monday to adopt many of the recommendations from the commission’s 332-page report. But what else could she say?

Governments and the public have notoriously short memories. Premier Ford will face many expensive demands for all kinds of changes coming out of this pandemic.

The only way to ensure Ontario’s nursing homes never experience another catastrophe like COVID-19 is to make the homes an absolute, non-negotiable priority. The government will say they are. But only the people of Ontario, the people who vote and pay taxes, can guarantee the government acts. (Hamilton Spectator Editorial) 

 

Wednesday January 27, 2021

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Wednesday January 27, 2021

Ontario health experts demand province abolish for-profit long-term care

With hundreds of Ontario long-term care residents dead and COVID-19 outbreaks continuing to ravage facilities across the province, a group of health experts is pushing the province to abolish for-profit long-term care facilities.

November 19, 2020

“When you think about for-profit homes, they’re by design created to have one thing in mind and that’s profits for shareholders. It’s not care for our seniors,” Dr. Naheed Dosani, said Tuesday on CBC Radio’s Metro Morning.

“This is a humanitarian crisis.” 

Dosani, a palliative care physician for the William Osler Health System, which has hospitals in Brampton and Etobicoke, is one of more than 215 Ontario doctors and researchers who have joined the Doctors for Justice in Long-Term Care campaign.

Despite repeated assertions from Premier Doug Ford, Long-Term Care Minister Merrilee Fullerton and other provincial officials that Ontario was building an “iron ring” around its long-term care facilities to protect residents from a second wave of the virus, deaths have continued to mount.

Out of more than 5,900 COVID-19-related deaths in the province, more than 3,400 were in long-term care, according to provincial statistics.

Most recent is the outbreak at Roberta Place Long Term Care Home in Barrie, Ont., where almost every single resident has contracted COVID-19. Genome sequencing has also confirmed that a highly transmissible variant of the virus first detected in the United Kingdom has been found at the home, according to the local public health unit.

The facility was reporting 44 resident deaths as of Monday. (CBC) https://www.cbc.ca/news/canada/toronto/ontario-long-term-care-1.5888226

 

Thursday November 19, 2020

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Thursday November 19, 2020

The province is dodging the truth on COVID-19 in long-term care

On Monday, Ontario’s long-term-care minister, Merrilee Fullerton, assured Ontarians that in spite of COVID-19 spreading through long-term-care homes, they’re actually doing better than they did in the first wave of this pandemic.

June 17, 2020

Speaking at Queen’s Park, the minister summed up: “There’s no doubt that lessons have been learned from the first wave and the data shows our homes are doing much, much better.”

Really? On Tuesday, 26 of 32 new COVID-19 deaths were in care homes. The province says 678 nursing home residents have the virus. And 100 of the province’s 626 care homes have outbreaks. 

Does that sound like “much, much better” to you? It doesn’t to us, either. And it doesn’t to many health experts. 

Health experts like Dr. Amit Arya of McMaster University, who described the first wave in long-term care as “a horror movie” and who says now: “We really have not done anything close to what we should have done to prepare for the second wave.”

Natalie Mehra, executive director of the Ontario Health Coalition, agrees. She has said in media reports: “It’s devastating … The numbers right now are just exploding.” She also says “we’re shaping up to have a worse second wave.”

Indeed, according to Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario: “The number of residents with COVID is increasing, the number of staff with COVID is increasing and the number of residents who die is increasing. How can anyone sleep well at night with that?”

May 27, 2020

It’s a good question. Notwithstanding Minister Fullerton’s claims to the contrary, it doesn’t seem as if Ontario’s retirement home care system is in a better place than it was during the first wave. It’s clear that the Ford government is concerned and has been trying to put improvements and protections in place, but the reality is that it started too late, and it had repeated warnings during and after the first wave.

The Registered Nurses’ Association, for example, asked the government to make investments in staffing with registered nurses, nurse practitioners, registered practical nurses and personal support workers in homes across Ontario. The government didn’t act. And so when the second wave hit, staffing levels were already at or below operative minimum, and that was before staff began to get sick and be absent. 

The government’s own LTC commission, in its interim report on fixing the system, released a series of recommendations urgently calling for action on things like staffing levels and compensation. Fullerton said her department was “carefully reviewing” the recommendations. 

July 17, 2020

This is all happening at the same time as a Toronto Star investigation revealsprivate LTC operation is such a lucrative business opportunity, private equity funds are being set up to cash in on the potential. That’s not surprising given the shortage of beds that continues to exist and our aging population. 

But keep in mind this is specifically about private, for-profit LTC operations. In Ontario, for-profit homes account for a little more than half of the province’s long-term-care beds. But they also accounted for 70 per cent of COVID deaths in the first wave of the pandemic. According to a Star analysis, so far in the second wave for-profit homes have just under 80 per cent of the deaths.

So if you’re a wealthy investor, there’s money to be made in for-profit long-term care. What is less clear is whether the for-profit model, where the bottom line is always going to competing for the top priority, even over resident care, has a place in the long-term-care system. That the government isn’t even considering that is troubling. (Hamilton Spectator Editorial)

Friday July 17, 2020

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Friday July 17, 2020

Heavy lifting for long-term care awaits Doug Ford

In the 100-kilometre journey to deliver a decent long-term-care system for Ontario, Doug Ford took a baby step forward this week.

June 17, 2020

By offering a 10 per cent subsidy hike to private-sector nursing home operators who open new beds, the premier should rid the province of at least some of those disgusting, overcrowded, four-person wards that became death-traps in the COVID-19 pandemic. 

That change alone represents welcome, if overdue, progress. Indeed, the Ontario Long Term Care Association, which represents 70 per cent of the province’s 630 long-term-care facilities, applauded the changes Ford’s making.

But there’s less in the government’s new funding formula than meets the eye. If the goal is rebuilding an entire long-term-care edifice, Ontario’s stuck at the stage of digging the new foundation.

The COVID-19 pandemic laid bare the serious, even shameful, deficiencies in a vital part of Ontario’s public health-care system. The province’s nursing homes have witnessed the deaths of 1,730 elderly residents and eight workers since the outbreak began in March. That’s almost two-thirds of Ontario’s officially reported COVID-19 fatalities.

May 27, 2020

The fact that the Canadian military had to be ordered in to save seven nursing homes that were overrun by the disease proved beyond any doubt that this province had turned a blind eye to grave systemic failings. The abuse, neglect, bug infestations, bleeding infections and the residents crying for help for hours that the army discovered should have no place in this affluent, supposedly caring country. 

Correcting that, along with improving homes that if not as bad are beneath basic, acceptable standards, is a monumental challenge. What Ford did this week was simply provide new details about a previously announced $1.75-billion infusion into long-term-care facilities. 

When that money was first committed, the government promised 15,000 new beds and renovations of 15,000 existing beds over the next decade. It’s unclear if that bold commitment still stands.

April 9, 2020

Ford did say this week that his new funding changes mean 8,000 new beds and 12,000 redeveloped beds are in the works. Air conditioning and improved ventilation is on the way for many nursing homes. Safer, more comfortable facilities will benefit nursing home residents and staff alike.

Left unanswered is how Ford plans to provide the 30,000 beds he originally pledged for the coming years. That’s a nagging question that will not go away. There are 36,000 seniors on the waiting-list for long-term care in Ontario. Ford needs to show us all his road map for moving forward.

COVID-19 Cartoons

He needs to say if his nursing home system overhaul will include providing more hands-on, daily care for residents. It should. And what about the personal support workers who provide such essential services? They receive miserable wages for a demanding job that offers minimal security. Ford needs to increase staffing levels but also the pay and working conditions for that workforce.

In addition, the Ontario government needs a detailed plan for improving the oversight of the province’s nursing homes. If Ford is content with allowing the long-term-care system to rely so heavily on private providers, he must ensure proper transparency and accountability. That could come from the independent commission Ford wants to investigate the system. But he has yet to say when that commission will begin its job.

Not every long-term-care facility does a bad job. Too many do. Ford has signalled that transforming the system is one of his highest priorities. But what he announced this week will raise red flags that suggest he’s content with superficial fixes. We need him to completely re-invent how we care for our elderly. (Hamilton Spectator Editorial)