According to the study by the Canadian Institute for Health Information, 69 per cent of Canada’s COVID-related deaths occurred in long-term care. That represents one of the highest mortality rates in the world. The international average was 41 per cent.

By Sheila Copps
First published in The Hill Times on April 5, 2021.

Shame on Canada.

When it comes to quality of life, we rank very well in the world on many fronts. But the treatment of incapacitated seniors has always been our dirty little secret.

COVID-19 has exposed the real story behind many of our long-term care facilities.

Last week’s report on Canada’s global status in residential care mortality rates is a must-read for anyone interested in improving lives for vulnerable elderly.

According to the study by the Canadian Institute for Health Information, 69 per cent of Canada’s COVID-related deaths occurred in long-term care. That represents one of the highest mortality rates in the world. The international average was 41 per cent.

The CIHI also underscored the COVID cost to those seniors dying from other causes.

Because of the focus on COVID, during the first few months of the pandemic, doctors’ visits and hospital transfers for other reasons also dropped dramatically.

The shameful conclusion: Canada suffered the worst record for COVID-19 deaths in long-term care homes compared with other wealthy countries.

The CIHI also reviewed the general trend of resident deaths, which was exacerbated during the pandemic.

Mortality rates ranged from a high of 28 per cent in Ontario to a low of four per cent in British Columbia. According to the report there were 2,273 more deaths during COVID than the number of deaths during the same period over the previous five years. Not surprisingly, the largest hike came during the peak of the first wave in April of 2020.

There are currently multiple inquiries going on across several provinces to get to the bottom of the issue. But clearly this story needs a pan-Canadian perspective to offer the insight that will inform future decisions.

According to the report, more than one-third of all Ontario long-term care homes and 44 per cent of homes in Quebec suffered an outbreak, compared to only eight per cent in British Columbia and 17 per cent in Alberta.

But as health-care delivery is provincial, each province is doing their own autopsy without reviewing the situation from a national perspective.

Most federal reports will get widespread attention for a few days and then get filed under the “federal interference in provincial jurisdiction” subject matter.

Provinces are generally more interested in protecting their autonomy than in actually protecting their vulnerable, elderly populations.

If British Columbia managed to keep its COVID outbreaks to single digits, it has something to teach the rest of the country. But because of our bifurcated system, the lessons will likely stop at the Rockies.

Instead, we will end up with 13 studies of how to improve an internalized process.

Some solutions are simple. Obviously, an injection of money into chronic care support will be required, especially to increase the salaries of those frontline workers who were struggling to make ends meet.

The issue of part-time employment is definitely one that needs to be tackled. It is not surprising that personal service workers are forced to take more than one job when their salary is limited to part-time work as a way of avoiding payment of benefits and labour law protection for full-time workers.

In British Columbia, a strong union has been able to negotiate better working conditions. The province had a prohibition on health-care workers operating in more than one home, and that single rule minimized the spread of COVID from one institution to the next.

According to federal New Democrats, the only solution is to close down all private facilities and replace them with public sector solutions. However, there were a number of poorly run public sector facilities that suffered deaths.

The issue involves developing a set of applicable standards, with the funding to support it, that can be implemented across the country.

Instead of solving 13 problems, the country would be finding a unified solution.

Surely the challenges in long-term care management cannot be that different from Newfoundland to British Columbia. So why not tackle the problem from a pan-Canadian perspective?

The CIHI report should serve as a wake-up call that the time has come to look beyond politics and focus on what is best for those most vulnerable seniors who end up in long-term care facilities.

Most of them have lost the ability to fight for themselves, and so it is up to the rest of the country to fight for them.

Long-term care facilities have been deteriorating for years.

We need a concerted national effort to clean up Canada’s sorry treatment of our aged.

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.

When we say we respect elders, the time has come to prove it. Giving the federal public health agency authority to nationally accredit nursing homes would be a good start.

By Sheila Copps
First published in The Hill Times on April 20, 2020.

OTTAWA—Canada’s dirty little secret is now out in the open.

While we all claim respect and reverence for seniors, when the time comes, they often find themselves in substandard conditions with little recourse or options.

The number of COVID-19 deaths in institutions is a clear signal that we need to revisit the deficiency of end-of-life and continuing care solutions.

It is also proof positive that running 13 independent nursing home systems makes absolutely no sense.

Because of the scarcity of COVID-fighting equipment, the federal and provincial governments have actually been coordinating international purchases and domestic distribution.

Incredibly, this is the first time in the history of our country that we have actually had agreement from all parties to cooperate on purchase requirements.

The federal government is also stepping in to offer updated guidelines for nursing home operations across the country.

But guess what. Their recommendations have zero legal authority. The federal government is responsible for guaranteeing the health of what we eat in Canada but has zero responsibility governing the health of our people.

The COVID death rate in institutional care is shining a light into an area that health advocates and the children of ailing parents have known for years.

The management and standards of public nursing facilities is a dog’s breakfast.

Several years ago, my own mother had to be institutionalized because of her increasing dementia.

Luckily, she was in a position to secure a place in a private facility that specialized in memory wards, a euphemism for people who no longer retain their memories.

She was thriving for almost two years but in the last four months of her life, she went rapidly downhill.

The community care experts who track placement for vulnerable seniors suggested it was time to move her into a public facility where there would be more focus on heavy care. We were given a list to visit, and quickly discovered the differences in facilities even in a single city.

There were at least three outstanding facilities, that would pass muster on any nursing inspection. The waiting list to get into these places was up to three years.

We were given another list that had immediate openings, and my husband and I scheduled tours with several of them.

The first one we visited was a retrofitted warehouse conveniently located beside what appeared to be a brothel motel.

The stench of urine was so pungent when we opened the front door that we recoiled. Patients were in the sunroom, some of whom were literally naked as their hospital gowns had come undone, and nobody seemed to think that their dignity was worth preserving.

I left the facility in tears, and vowed that I would never, never, never put a loved one into a place that was not even suitable for a dog.

I expressed my concern to community care and the workers agreed that there were some nursing homes in the nation’s capital that were absolutely substandard.

Luckily, my mother was able to stay in the private facility until she passed away, but to this day, images of the poor quality of some nursing homes in Ottawa still stings.

The other thing that stood out during my mother’s time in institutional care was the untiring devotion of staff, many of whom are surviving on minimum wage.

Dealing with demented patients is not an easy task, as they can suffer from inexplicable mood swings and sometimes, uncharacteristic violent behaviour. It is not uncommon for nurses and personal service workers to be slapped, cursed or spit on by people who have literally lost control of their minds.

I called the workers my mother’s saints, because they cared for her with dignity and gentleness, and never lost sight of the fact that she was a person, not just a patient.

Last year, the Ontario government rolled back a planned minimum wage increase. Many of these saints saw their wage hikes go up in smoke, while the workload did not get any easier.

Many nursing homes are owned by holding companies, that are focussed on one thing, the bottom line. And cutting food and care budgets help get to that bottom line.

If we learn one thing from this COVID nightmare, it is that the time has actually come to put our money where our mouth is.

When we say we respect elders, the time has come to prove it. Giving the federal public health agency authority to nationally accredit nursing homes would be a good start.

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