Alberta Politics
Canadian Armed Forces members prepare to support long-term-care facilities in Quebec at the 2nd Canadian Division support base in Valcartier, Quebec (Photo: Cpl. Marc-Andre Leclerc/Canadian Armed Forces via Canadian Military Family Magazine).

We know what’s wrong with long-term care in Canada — we need politicians with the courage to fix it, not an inquiry

Posted on May 27, 2020, 2:30 am
7 mins

There are bound to be calls for formal inquiries after the long-term care horror show discovered in Ontario and Quebec, and quite likely on its way to being discovered in other provinces.

This isn’t actually what Canada or any Canadian province needs, though. We already know what led to the collapse of the seniors-care system as the global coronavirus pandemic swept through Canada.

Canadian Federation of Nurses Unions President Linda Silas (Photo: avid J. Climenhaga).

And too often the purpose of formal inquiries is to delay change, deflect blame, and obfuscate solutions so that, in the end, nothing changes.

COVID-19 was a heavy burden, but you’ll notice it did not break the spine of our public hospitals.

Long-term care collapsed in many locations because of underfunding, both by governments and private-sector owners; a precarious, poorly paid and often badly trained workforce, by intent; and regulatory negligence by governments bent on eliminating “red tape” amounting to a near complete absence of standards.

The result is a deadly catastrophe.

There is plenty of blame to go around: profiteering private-sector long-term care operators, irresponsible politicians yammering about “red tape,” weak labour laws that give health-care workers, especially those not members of regulated professions, little ability to stand up for themselves or their patients.

And there is credit, too. The nightmare was discovered by Canadian Armed Forces troops sent into Ontario and Quebec’s seniors’ lodges to relieve their shell-shocked employees and rescue as many dehydrated and abandoned residents as possible.

This may not be the primary role imagined for the armed services, but it turned out to be one of the noblest missions in the history of Canadian soldiering. And having no particular stake in the way things were, and no reputations or profitable revenue streams to protect, the forces were able to act promptly and speak up bluntly — no doubt to the chagrin of many in power.

It’s ironic that Canadian nurses have been warning about this situation, and the potential for catastrophe, literally for years.

Yet Canadian politicians, who never skip an opportunity to express their supposed respect for the profession and its members, habitually blithely ignore what civilian nurses have to say.

It took the arrival of the armed forces to capture official Canada’s attention.

It was a near thing in Ontario, where the Conservative government apparently ignored the offer of the province’s Registered Nurses’ regulatory college to send in retired nurses, nurse practitioners and student nurses, and called for the army only when things began to fall apart.

I’m sure there are people in that government who wish they had listened to the RNs. If they had, sad to say, civilian nurses would have been easier to blow off when they reported the same things.

Naturally, the temptation is strong for political parties to demand inquiries, and when in power to implement them.

For opposition parties, demanding an inquiry is great political theatre. It gives the impression of a call to action. It may even be intended as such. This is true even of parties that once in power lack the courage to deliver what they know is needed.

For parties already in power, inquiries work as theatre too — although governments are more likely to see their real utility as a gambit to preserve the status quo. After all, by the time a commission of inquiry delivers its report, the sense of urgency has usually passed. If the recommendations are not to the taste of the government of the day, they are all that much easier to ignore.

Naturally, there are powerful people in this country, donors to certain political parties at both the provincial and federal levels, who would very much like nothing to change because, to put it crudely, there’s a lot of money in it for them if they can keep things the way they are now.

We already understand what’s wrong with seniors care in Canada and we know what the solutions are. As with prescription drugs, we need urgently to bring long-term care into the national health care system through either the Canada Health Act or similar legislation. That way, we can set national standards of care, and appropriate training requirements and compensation for health care workers of all types.

In 2015, the Canadian Federation of Nurses Unions published a paper called Before It’s Too Late: A National Plan for Seniors’ Care.

“We need a national plan for safe seniors’ care, with long-term, dedicated funding and effective enforcement mechanisms,” CFNU President Linda Silas wrote in the introduction. “In both home care and long-term care facilities, we need a stable workforce, adequate staffing levels and an appropriate staff mix.”

Of course, by definition it is too late now. A global pandemic is exactly why a plan like this needed to be implemented long ago. This is an emergency piled on top of an emergency and we need to get on with fixing it.

That will require political courage, not more studies, and certainly not an inquiry that would make the solution less likely.

None of this is likely to come from any provincial government, deeply committed to the status quo for reasons of ideology and constitutional rivalry.

There is really only one politician in this country who can make the change we need happen, and we all know who he is. Yes, this is a test.

20 Comments to: We know what’s wrong with long-term care in Canada — we need politicians with the courage to fix it, not an inquiry

  1. Just Me

    May 27th, 2020

    Politicians with courage?

    I’m not holding my breath for that one.

    But once certain parties come to realize that seniors are their most committed voter base, I suspect that they will jump up to the challenge and make LTC a public health care right. In other words…if men could get pregnant, abortions would be legal and available on-demand.

    In other newsworthy comments, a American youth enjoying the US Memorial Day weekend responded to a query concerning his lack of a mask or social-distancing. His reply was golden — “Who cares? It’s only the old people who are going to die and who gives a sh*t about them? They’ve lived long enough, so f*ck em.”

    Reply
  2. ronmac

    May 27th, 2020

    It’s ironic, isn’t it. Canada’s armed forces, with its proud tradition of serving British imperialism during the last century and more recently the US empire, has come home to conduct moping up operations and clean up a mess left by our neoliberal masters.

    Reply
  3. Bill Malcolm

    May 27th, 2020

    I agree. Commissions traditionally are a complete waste of time in this country. They produce a report after years of deliberation stating the obvious, and are promptly added to the overburdened shelves containing previous reports. Nothing ever gets accomplished, and all the commissions turn out to be nothing more than a way for the politicians to get those complaining citizens off their backs. The only one that seemed to actually stymie silly resource development, for example, was Justice Thomas Berger’s enquiry way back in the 1970s into the MacKenzie Valley pipeline – they still haven’t got around to that project.

    Meanwhile, one wonders what those young armed forces personnel sent into LTCs think of their experience. Some have PTSD from it apparently. “Is this what we signed up to defend?” must ring strongly in their minds.

    The other thing I experienced personally when my mother spent three and a bit years in an LTC place was that my brother and I were constantly told that we were sometimes the only outside visitors in a 32 person ward for weeks. It was Northwood, the place where 52 of 59 people in NS have died of Covid-19 so far. I cannot really complain that they were bad at all – the place was clean, the patients were clean, the linen was changed, it got renovated one year, and there was an RN for that floor on duty 24 hours in shifts and a doctor for the whole place. The only thing was, few of the staff got flu shots, which perturbed me. My brother dropped in every weekday at the end of his workday. I took my mother out every week, wheelchair and all and gave her a car ride and a Tim Hortons and lunch. Well, I see it was only 77 times in fact. So I missed some in winter, living 20 miles away, sometimes it rained so we stayed in, and towards the end she couldn’t really move. She used to refer to the other old folk and herself as “inmates” with a laugh even though she was demented from strokes. Someone used to steal her (she was a chocoholic) large format Cadbury chocolate bars I bought in bulk for her on sale which I hid at the back of her clothes drawers except for the current bar in her bedside table, four squares a night was her routine – none of her roommates (two to a room) ever seemed capable of hopping out of bed, let alone rummage through her belongings. Four came and passed on. So as I discovered, the vast majority of folk dumped their parent in the LTC facility and forgot about them till Xmas or the annual lunch for the floor, when they’d turn up in finery and try to look interested at sandwich and soup fare. What did they expect for nothing at a non-profit? So let’s not be quite too “upset” at what has happened in far worse facilities. There’s blame enough to go around starting with families themselves essentially abandoning mum or dad, mostly mums. If they had cared enough to visit, some of this rubbish care would have been strongly protested by relatives before it got to the state it’s in.

    Reply
  4. Derek

    May 27th, 2020

    It would be an amazing thing for Canada to implement a retirement plan that includes a living facility with your old age pension. This crisis has proven that the private industry is only there to take profits. The elderly were simply a product they extracted money from. When the costs became too high they left them to die.

    Reply
  5. J.E. Molnar

    May 27th, 2020

    Canadians say it’s a “no-brainer” when it comes to the operation and funding of long-term care facilities in Canada.

    A recent poll conducted (May 14-May 18) by one of Canada’s largest federation of unions reveals that Canadians favour substantial changes to the operation and funding of long-term care facilities:
    • 90% of Canadians are aware of the deaths in long-term care facilities.
    • 86% are in favour of bringing long-term care facilities into the Canada Health Act; only 2% oppose this action.
    • 81% of Canadians want to see the government invest whatever money and resources are needed to rebuild health care and other public services that were previously cut/minimized.
    • 78% support increasing funding for long-term care.

    The full poll results (click on link below).
    https://nupge.ca/pdf/nupge-long-term-care-poll

    Reply
  6. tom in ontario

    May 27th, 2020

    From the CBC News website, May 26, 2020
    “At the Altamont Care Community in Scarborough said the (Canadian Military) report, residents faced ‘inadequate nutrition’ because most of them were not getting three meals a day__and when they did, ‘underfeeding was reported.’ It was also there that a ‘non-verbal’ resident wrote a disturbing letter alleging ‘neglect and abuse’ by a personal support worker.”

    The Altamont Care Community says it is affiliated with Sienna Senior Living Inc., a major player in retirement and nursing homes in Canada. Sienna’s website boldly states, “Feel the warmth of human connection.”

    Reply
  7. TENET

    May 27th, 2020

    In the early ’70s as I began my political engagement I heard from the desperate residents and families of people in private (for profit) homes. The local physicians were equally concerned. I finally persuaded CBC to do an expose. The result was not what I expected. The staff and many PC locals turn on me (us). It was like Ibsen’s An Enemy of the People. Ironically, the same people so eager to defend private nursing homes are now “living” the dream.

    Reply
  8. Political Ranger

    May 27th, 2020

    “____________ collapsed in many locations because of underfunding, both by governments and private-sector owners; a precarious, poorly paid and often badly trained workforce, by intent; and regulatory negligence by governments bent on eliminating “red tape” amounting to a near complete absence of standards.
    There is plenty of blame to go around: profiteering private-sector [] operators, irresponsible politicians yammering about “red tape,” weak labour laws that give [] workers, especially those not members of regulated professions, little ability to stand up for themselves or their _________.”

    mmm – sounds like you’re talking about Alberta’s petro-industry?

    One other quibble David: this nightmare wasn’t ‘discovered’ by the CAF; it was reported, publically reported, by the CAF. And did the forces a great honour by doing so too! The discovery was common knowledge for decades.

    It is becoming obvious each day that we are slowly, step by step, walking away from the conservative, corporatist playbook on capitalism. Away from the idea, that has prevailed in conservative circles and out in the open, that the only ‘good’ government is a small and weak government; that only business can provide real solutions and that government can only provide roadblocks.
    These corporate crooks and their criminal lap-thingys in gov’t have had 4 decades to demonstrate their abilities. We can see it. We are now seeing it! They are morons. They are corrupt. They are incompetent.

    I’m all for a capitalist system. Especially when considering the alternatives.
    But such a system has to serve society. It’s morally wrong to have a system in which society serves a few corporate elites.
    We need a strong corporate sector AND an even stronger, more aggressive, no-nonsense public regulatory sector. And yes, tax the hell out of the corps!
    Only the strong survive they like to say. Well, a corporate sector that exists to serve the needs of society and will be wiped out if they’re too stupid to stay legit will be a strong and vibrant contributor to the Canadian economy!

    Reply
  9. alan

    May 27th, 2020

    Don’t you know already? Once you know you cannot simply ‘unknow’. Can you not see? Once you see, you cannot ‘unsee’, how the corporate state and its revolving door operates. The entire catastrophe is symptomatic of the larger corporate, profit driven, assembly line reality and a planned obsolescence that apparently even extends to some people. In this case, the effects of the resulting ‘externalities/spillovers’ will be left for the legal system to hopefully attempt a ‘clean up’ and not a cover up.

    https://www.thelawyersdaily.ca/articles/19020/largest-covid-19-class-action-in-canada-launched-against-long-term-care-chains

    “For-Profit Nursing Homes Hire Tory Insiders To Lobby Ford Government”

    https://www.huffingtonpost.ca/entry/for-profit-homes-conservative-insiders-coronavirus_ca_5ec5922cc5b63de4aabdd95f

    Reply
  10. Murphy

    May 27th, 2020

    What would Confucius think of Covidmania?
    “A superior man, in regard to what he does not know, shows a cautious reserve. If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot be carried on to success. When affairs cannot be carried on to success, proprieties and music do not flourish. When proprieties and music do not flourish, punishments will not be properly awarded. When punishments are not properly awarded, the people do not know how to move hand or foot. Therefore a superior man considers it necessary that the names he uses may be spoken appropriately, and also that what he speaks may be carried out appropriately. What the superior man requires is just that in his words there may be nothing incorrect.”

    Was the Chupacabra really a heavy burden here in Alberta?
    A maximum daily hospitalization of 99 patients, province-wide, occurred on April 30, with only 21 in ICU. That was six weeks into full-blown Covidmania, just as the Sprung “MASH” unit was set up and nobody was going to the hospital for customary procedures. There were over 1200 influenza hospitalizations this flu season by the end of this February, whereas the total ever hospitalized with Chupacabra is 297. So perhaps it might be more appropriate to speak of Covid-19 panic as a burden, rather than the disease?
    Given that a grand total of 6901 people have tested positive, with 1400 at least directly linked to testing the people at Cargill, another 1000 at Brooks and JBS, another thousand in care homes, is it really correct to assert that Chupacabra “swept through” Alberta? Less than a quarter of a million people tested so far, with a 3% positive rate, with almost half in two specific industrial settings, seems a far-cry from a region that has been subject to a “sweep”.

    If taping off playgrounds and cancelling soccer was all that saved us from the Red Death, why don’t we adopt these rituals permanently in order to defeat seasonal influenza, which, according to available data in Alberta, is significanly more harmful than Chupacabra?

    I find it sadly amusing that the “progressive” people in this province have waded straight into the water to be baptized in the name of Covidia, given that it is beyond dispute that this panic is the product of ultimate neoliberalism. While corportate and state media have been frantically churning out scolding moral proclamations, about “debunking conspiracy theories”, that would make the most staunch Red Guard green with envy, the fact is that the WHO is a neoliberal abomination, just like the World Bank and the other imperial grotesquery that came from Bretton Woods and the US National Security State.
    The Bill and Melinda Gates Foundation is the second largest funder of WHO, after the US, and ahead of the sovereign industrial powers of Germany and Japan. Also ahead of Germany and Japan in funding the WHO is the GAVI Alliance, another private entity, in which Gates has substantial financial interests. But you know, it’s just kooky conspiracy theory to question the actions of an organization dominated by the people who blew up Iraq, partnered with Microsoft.

    “GAVI’s approach to public health has been described as business-oriented and technology-focused, using market-oriented measures, and seeking quantifiable results. This model, termed the “Gates approach” or US-type approach, GAVI is taken to exemplify.”
    “Although Gavi has adopted HSS as its key principle, Storeng interviewed related key persons of Gavi and found that Gavi’s HSS support has become emblematic of the so-called ‘Gates approach’, i.e., focused on targeted technical solutions with clear, measurable outcomes, which can run counter to the concept of HSS that emphasizes multiple social and political dimensions.29 This apparent paradox of Gavi raises questions about the content of Gavi’s HSS. How much of Gavi’s HSS-labeled funding is actually invested in activities that could be deemed as HSS activities? Perhaps more importantly, what is the logic underpinning Gavi’s HSS?”
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281386/

    https://companyprofiles.justia.com/company/microsoft/dockets/case?page=3

    Only State Street and the CIA can save us from Xenu!

    Reply
  11. Andy M.

    May 27th, 2020

    I appreciate the passionate way you’ve made your points. In the “spreading the blame” part, (necessary step toward making meaningful changes) you’ve missed some key players, though. They include all of us who vaguely if not directly know about conditions in some long-term care facilities and failed to impress on facilities management or our elected representatives the need for reform, or didn’t even want representatives who would take action. Think of all the relatives who visit their elderly, so-called loved-ones and don’t see or want to see conditions in these “caring” warehouses. Or the relatives who visit as infrequently as they can.

    Looking after physically infirm and mentally fragile older folk is an incredible challenge. Older people are rarely sweet, uncomplaining, rational or compliant. (I’m becoming one of them!) Why should we be, except in some sentimental fairy tale? It takes a team of dedicated people, working with relatives, to provide the care they need. Instead, we delegate the onus to underpaid, and, in many cases, new immigrant workers. Who’s going to pay for the necessary changes and support?

    That leads me to want to assign blame to people constantly fighting against taxpayer support for seniors’ institutions, the people who convince themselves the profit-motivated private sector is the only answer to providing services to seniors — and other services to a whole range of humans, for that matter. Then, there are the people constantly pushing for even lower taxes and, therefore, lower public support for these services and facilities. As in so many aspects of our lives, we want the best, while paying as little as possible.

    So, I don’t get your riddle. The answers lie in all of us, not one politician.

    Reply
  12. Bruce Turton

    May 27th, 2020

    Having gone through the hell of seniors’ “care” with both parents, like many others of my generation, deciding to die anywhere but within the confines of those places came and comes to mind rather quickly (how to do so is another question!!). In both instances, in separate facilities, the staff were as acommodating to the greatest degree possible by mostly marvelous people – just not enough of them, and quick and frequent staff turnover due to pitiful pay. The profit motive and shareholder dividends are obviously upfront problems, but in the so-called public sector the 40+ year old neoliberalist pandemic also holds sway. One can almost hear the advocates of that parasitic ideology claim that there is no real reason to retain certain elements of our societies who may never have been or no longer are “productive”.

    Reply
  13. John T

    May 27th, 2020

    I remember taking a course on geriatric psychiatry out of Calgary many years ago (over 20) and in one class we discussed the demographics of the aging of Canadians.

    People and organizations (read: government) knew what I learned that day. That populations over 65 were going to increase and we needed to plan accordingly. Thus problem is that government didn’t want to or were lobbied successfully to leave that planning to private enterprise.

    I can think of a few services that should never be privatized…with health care being the top one.

    Reply
  14. Lulymay

    May 27th, 2020

    A number of years ago I read an interesting article based on research conducted by (I believe) a Canadian Registered Nurses Association that concluded that health care delivered through a government sponsored (Canada Health Act) was far superior both in terms of cost and quality of care than that operated by a private sector model. They examined costs in the United States (private model) and Canada (public model). The results spoke for themselves: again, I’m drawing from my elderly memory here, but they found something like the US spent the same $$$ in one month that we in Canada spent in one year! on a per capita basis.

    Given that information, why, oh why, did our primarily right of centre politicians decide then that the private model was superior to the public model when it came to long term care of the elderly? After all, is this not basically a continuation of health care? Your province has had a continuous parade of very right of centre politicians (except for one recent term) and would privatize our health care in a heartbeat but are afraid to because every poll taken still massively supports our current delivery model in Canada. It boggles the mind!

    Reply
  15. David in Sask

    May 27th, 2020

    Now we can see the problems that privatization brings. In addition to being more costly due to profit seeking private care homes provide ineffective care. I am glad that at 80 years of age I am still living at home rather being in a death trap.

    Political courage is difficult when political parties are funded by corporations which expect payback.

    Reply
  16. CallmeHal2000

    May 27th, 2020

    #1: Do not hire untrained health care aides off the street. Not surprisingly, families of residents in long-term care will tell you that incidents of abuse seem to have a higher chance of occurring on weekends and during holiday periods, when the chances of untrained, temporary and agency staff on duty are higher. Abuse cases are extremely stressful and ultimately expensive for all concerned, as they move through the court system.

    I have many other concerns, but nobody cares. Families can tell stories. They’ve known about the problems for years.

    Reply
  17. alan

    May 27th, 2020

    The ‘status quo’ and the historical record goes back a long way and it is always the same old political song and dance. Apparently, for some individuals, $$$$$ have always meant more than human lives, or even human dignity. The ongoing moral/ethical corrosion is perhaps, the harbinger of even greater, future social decline, as everyone becomes habituated to the ‘new normal’.

    From 2001:

    “CBC Television has learned there may be a link between political contributions by nursing home companies and the awarding of licences. It’s a very lucrative business for private sector nursing home companies and many are getting contracts despite their lack of quality.”

    https://www.cbc.ca/news/canada/relationship-between-nursing-homes-ontario-government-questioned-1.265866

    From 2002:

    “The evidence to date shows that an increasingly privatized and consolidated long term care industry promotes an influential and well-connected interest in deregulation of patient care standards and increasing sources of revenue for profit-seeking owner/operators. It does not reduce costs, has not improved staffing conditions and has promoted the growth of a “second tier”. It is not the answer to improving services. Governments should take heed: ownership matters.”

    http://www.ontariohealthcoalition.ca/wp-content/uploads/Summary-May-27-2002-Ownership-Matters.pdf

    Reply
  18. Jim

    May 28th, 2020

    We are suffering the consequences of years and years of the majority of Canadians voting for governments who put in place policies that don’t create a society that works for the vast majority of people. Off shoring manufacturing to lower cost jurisdictions has cushioned the effects of inflation which is a result of our debt money system, thanks again Trudeau Senior. Anything that can’t be off shored has increased dramatically and this includes long term care. Putting aside the private for profit care centres which we can clearly see don’t work and should be eliminated what would be the cost to provide proper care in long term care facilities? Can those who require this type of care and their families afford to pay the cost of providing proper care? Boomers seem to be in slightly better shape with more pension income so perhaps some can cover the cost but what happens to the generations that follow?

    Reply
  19. Farmer Brian

    May 29th, 2020

    The Federal government owns Revera, the second largest extended care provider in the country and how is that working out for those who live there?

    cbc.ca/news/politics/crown-corporations-long-term-care-homes-1.5584098

    What has and is happening in long term care facilities across Canada is truly an embarrassment but fixing it will not be a easy task.

    Reply
  20. alan

    May 31st, 2020

    The corporate state bottom line and its revolving door are symptoms of the greater underlying global dis-ease. Too bad for the investing class that the push for even greater profit might have moral/ethical strings attached to it, because that apparently requires an abundance of crocodile tears and phony mea culpas, after the fact. And that “sideshow”, the “inconsequential” collateral damage and its aftermath, simply distracts from their all important activity of making even more money.

    1. “Push for Profits Left Nursing Homes Struggling to Provide Care”

    https://www.nytimes.com/2020/05/07/business/coronavirus-nursing-homes.html?action=click&module=Top%20Stories&pgtype=Homepage

    2. https://www.thestar.com/politics/political-opinion/2020/05/04/mike-harris-expanded-the-privatization-of-long-term-care-doug-ford-is-discovering-that-wasnt-a-magic-cure.html

    3. “While an increasingly aging society will certainly affect the future of retirement savings and health care in Canada, this growing demographic shift may also offer an opportunity for institutional investors.”

    But, “The problem is that it’s not so much a real estate play as an operating business. That’s the dilemma,” says McKellar. “There’s people that build seniors housing, but the sad part is that the operation of these homes has left a lot to be desired.”

    https://www.benefitscanada.com/news/opportunities-for-institutional-investors-in-an-aging-society-123442

    Reply

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