It’s rather extraordinary that some provincial premiers are saying the federal government should stay out of long-term care, arguing “What do they know about it?”
Well, the evidence coming out of the COVID pandemic is pretty clear— many provinces don’t know much either!
Pat Armstrong, Distinguished Research Professor at York University and principal investigator for an international study on ‘Re-imagining Long-term Residential Care’ says national standards are necessary.
“COVID taught us many lessons”, said Armstrong, “Outbreaks weren’t so different between for-profit, not-forprofit and public facilities, but deaths in for-profits were significantly greater.” The differences in staffing and contracting out were key variants.
Consistent staffing is critical for good senior’s care. Care is relational, staff who work daily with the same seniors provide better care.
Appropriate remuneration and job security for care workers is significant.
“The condition of work is the condition of care”, said Armstrong.
She recommends national standards requiring 70 per cent of the staff be full-time and the remaining 30 per cent be permanent part-time. B.C. is already moving in this direction.
She also argues that food service, laundry, cleaning and clinical/social care should be in-house.
“Today’s business model ignores the fact that food and hygiene are medicines”, said Armstrong.
In-house cooks better meet patient needs and likes; regular cleaners know what they cleaned yesterday and provide relational care by interacting with patients as they clean; and when staff know each other, the team’s outcomes are always better.
COVID spread in nursing homes was exaggerated by the constant parade of temporary care workers and contracted service providers tromping in and out and between facilities daily.
Minimum care ratios need to be set for each type of activity/procedure caregivers provide. Time studies have been done extensively in the U.S., they just need to be applied. If there were evidence-based time standards attached to bathing or feeding seniors, many seniors wouldn’t be going weeks between baths or needing family to come in daily to ensure their loved ones are fed adequately.
National standards should require consistent and regular training for workers, volunteers and visitors. Industrial workers have regular health and safety meetings and all visitors are prepped for safety, whereas temporary staff, contractors, volunteers and visitors in congregate care facilities were found to be willfully untrained and unprepared for a virus attack.
Regulations, inspections and infraction penalties must fall under national standards. Why should seniors in Alberta get less care than in Manitoba, or visa versa?
In the article, ‘It is a Scandal!’, findings show that, “scandals and regulations are most detailed and numerous in the countries with the most for-profit firms”.
To no one’s surprise, profits do trump care.
For-profit facilities call for ambulance services most often and send more patients to hospitals than publicly run facilities. Forprofit facilities operate on a business model that always looks to transfer risks and costs to others, preferably taxpayers.
We’re no longer ignorant about the conditions many fragile seniors live under in private care facilities.
It is obvious, a market economy is only fair and efficient when the buyer (fragile senior) understands the transaction and can react to protect their self-interest.
Lack of beds in the system continues to be a major barrier to senior’s care.
Wise use of taxpayer dollars would be to fund the construction of more not-for-profit and public facilities to house fragile seniors and let the private sector, without government welfare, compete for the rest.
As we baby boomers careen towards old age and fragility, national standards for senior’s care and the benefits gained from provincial governments working in cooperation with the federal government have become self-evident.
Brenda Schimke
ECA Review
