The problem is the absolute patchwork of oversight when it comes to long-term care facilities. That problem should be solved with a national strategy. One of the after-effects of the pandemic will be a genuine interest in working collectively to upgrade the level of seniors’ care across the country.

By Sheila Copps
First published in The Hill Times on May 25, 2020.

OTTAWA—The latest post-mortem theory on Canada’s COVID deaths is that beefing up hospital resources fuelled the death rate in nursing homes.

That appeared to be the dubious conclusion in a front-page story last week in The Globe and Mail.

An elderly patient was transferred from an Oshawa hospital into a long-term care home, where she died three weeks later.

The inference in the article is that the transfer caused her death.

But the context reflected a superficial, and misguided critique, of the current triage system in Canadian hospitals.

For the past 40 years, critics have been pointing out that up to one-third of acute care hospital beds are being taken up by long-term patients who would be better served in a retirement facility setting.

The COVID crisis prompted a long-overdue transfer of patients from hospitals to nursing homes to free up acute care beds to treat patients in acute, current distress.

It appears more likely the reason this unfortunate death happened was entirely because the long-term care home to which she was transferred to was a COVID-19 hotbed, with 77 deaths.

But the journalists fail to ask the key question. Why do some retirement homes have zero infections while others are rampant?

The issue is not patients’ transfer, but rather the level of hygiene and best practices in nursing homes.

In a good home, infection isolation strategies were in place long before the pandemic struck. In a retirement home, if a flu bug is not properly managed by isolation and hygiene practices, it can and will spread like wildfire.

Proper medical practices, employed by medical staff and personal care workers, prevent the virus affecting a patient in one room from spreading to the rest of the facility.

Appropriate lockdown strategies, early in the game, while difficult for families, have also kept the virus out of some facilities.

So, the problem is not caused by moving chronic patients out of acute care hospitals. The problem is caused by lack of oversight of the chronic-care facilities that house our seniors.

The Globe report said that most patients have a preferred list of long-term care homes. Families aren’t stupid and when it comes to checking the quality of care in a retirement facility, you only have to look at the waiting list.

The longer the wait-list, the better the care.

The best long-term care facilities have not been hotbeds of infection.

The Globe goes on to reveal another shocking headline that “nobody is tracking deaths inside seniors’ facilities at a national level.”

That should surprise no one because health data is collected and managed by provincial governments.

Each province tracks its seniors’ facilities deaths.

But the real questions were not asked by the reporters.

Why are there some facilities with vulnerable patients who have managed to completely avoid COVID-19 infections while others are hotbeds?

What is the infection correlation between publicly run facilities versus privately provided care homes?

What impact did the reduction in inspections of Ontario nursing homes have on the infection rates?

What is the influence of differing labour laws in different jurisdictions?

British Columbia moved immediately to restrict health-care workers from working in more than one facility. Quebec waited until mid-cycle to do the same thing.

What is the correlation between salary scales in individual facilities and infection rates? Some of the largest companies in the private elder care business had zero national strategy to secure sufficient personal protective equipment for their patients and employees.

They left the decisions on equipping homes and health-care staff up to each retirement facility. Some obviously did not do a very good job.

Contrary to The Globe claim, the move of chronic care patients out of hospital is actually key to saving and supporting health care.

The problem is the absolute patchwork of oversight when it comes to long-term care facilities.

That problem should be solved with a national strategy. One of the after-effects of the pandemic will be a genuine interest in working collectively to upgrade the level of seniors’ care across the country.

Let’s not just throw money at the problem. We need to ensure proper accreditation and real consequences when homes fail to meet the basic statutory requirements. When was the last time a home was shut down because of improper eldercare, bedsores, and infection spread, all signs of a poorly managed facility?

Let’s tackle the real problem. We need an end to the patchwork of oversight currently governing Canadian nursing homes.

Sheila Copps is a former Jean Chrétien-era cabinet minister and a former deputy prime minister. Follow her on Twitter at @Sheila_Copps.

The debate about that strategy could well decide the next election.

By Sheila Copps
First published in The Hill Times on May 18, 2020.

OTTAWA—The prime minister’s admission that we are not doing well by our most vulnerable seniors should come as no surprise.

In reality, we live in a culture obsessed with the fountain of youth.

Media messaging is mostly about how to look young, stay young, be young.

Face creams and rejuvenating emollients do not target older women, they seek to influence the buying power of 20-year-olds.

The spike in plastic surgery and Botox enhancement procedures amongst young people is a direct result of the value we place on the superficiality of looking young.

Trendsetters include the Kardashians whose only claim to fame appears to be what they can wear and who they can sell it to.

Just try getting a job when you reach middle age. At the ripe old age of 50, it is not uncommon to lose your job, whether on a shrinking assembly line or because of a business failure or sale.

It matters little that you might have multiple years of experience in your field. Experience is generally not considered an asset. Employers want younger people whose wage rates are lower.

The survival of many companies actually depends on hiring less experienced people at reduced wage rates.

Just look at the pay differentials between an employee of Air Canada and Tango.

When I left politics at the ripe old age of 52, I was headhunted by a number of potential employers but in the final analysis my advanced age was a factor in their decision to go elsewhere.

Ageism is not only alive and well in the workforce, it is particularly prevalent in politics.

This is the only area where the more experience you get, the more people want to get rid of you.

When Justin Trudeau was elected in the sweep of 2015, the majority of his caucus and cabinet were under the age of 45. There were a few experienced ministers, like Lawrence MacAulay, Ralph Goodale, and Carolyn Bennett. But the general feeling amongst most Liberals was that the Prime Minister’s Office preferred to work with those who had little political experience, but met the age demographic.

After all, having an attractive young minister in front of the camera looks good for the party and the caucus.

The second term has brought more wisdom to the job, with ministers who are older and wiser by all accounts.

Some have learned on the job and other newer, but senior faces have been appointed in the last cabinet shuffle by a more wizened prime minister facing a minority government.

There is a nation-wide consensus about the problem. Something needs to be done to secure safe living accommodations for vulnerable people in long-term care. But consensus on the solution will be much harder to reach.

The Bloc Québécois has made it very clear, that it wants cash with no conditions.

The prime minister promises to respect the Constitution, which clearly designates the provinces as responsible for delivery of care but determines it is a shared responsibility.

Of all the provinces, COVID containment in long-term care facilities in Quebec has been the least successful. The number of deaths there is almost equal to all deaths in the rest of the country.

According to an article in The Globe and Mail, as of May 7, 2,114 of the 2,631 Quebecers who died of COVID-19 lived in an elder-care facility. That’s nearly twice as many as in Ontario, where 1,111 long-term care residents died. In addition, Quebec’s health-care system is missing 11,600 workers who are either sick, quarantined, or unwilling to show up.

So, the notion being floated by the Bloc Québécois that Ottawa should hand over money with no strings attached is a non-starter.

Almost 40 years ago, the Canada Health Act solidified the role of the federal government in establishing standards for institutional hospitalization.

That move is a model that could be considered in any attempt to reform the patchwork of care standards currently in place across the country.

The New Democratic Party proposition to shut down all private nursing homes is completely unworkable.

There are thousands of Canadians living in non-contaminated circumstances in homes across the country and the Canadian government cannot afford to nationalize their living quarters.

The fact that NDP Leader Jagmeet Singh is promoting nationalization is proof that his party’s last-place status is not about to change any time soon.

We need a national strategy to restore confidence in long-term care.

The debate about that strategy could well decide the next election.

Sheila Copps is a former Jean Chrétien-era cabinet minister and a former deputy prime minister. Follow her on Twitter at @Sheila_Copps.