Seventy years ago today, June 9, 1950 was my mother and father’s wedding day. I still remember their anniversary day. I remember them every day.
In the last few years of their life, they both wound up in the same designated long-term care facility in Ontario, with different health conditions but with similar medical and care needs. Although eleven years ago, the experience my brother and I shared, caring and advocating for them during that time, seemed so far away until recently. Memories of my parents were more intense as COVID pandemic arrived.
Long-term care facilities shut down, as quickly the virus spread in these confined spaces and so many deaths occurred. Confusion in communications, knowledge of rapid systems breakdown and then in came the Canadian military, Ontario and Quebec specifically. Then only two weeks ago, came the bad news – the military’s report detailing the horrors they uncovered. Upon reading and hearing this, it made you either ill, mad or both. The whole narrative lives in our heads, weighs on our hearts. Certainly it does, for those who have had any previous or current exposure to long-term care realities.
For in the days back in 2004, when my family began that journey, navigating within the long-term care system, as good as that particular facility was, there were numerous obvious moments where we witnessed cracks in the system including staffing issues. Our role as proactive family advocates made the difference at almost every step, and as my brother and his wife lived closer, only a five-minute drive away, they were able to make more frequent unannounced pop-in visits. In short, we were on the case.
In Ontario, as the COVID shut down continues with long-term care facilities, the government detailed their response to the Canadian Armed Forces (CAF) report. Inspections increased, protocols enhanced and promises of inquiries or a transparent, non-partisan independent commission then followed. But, this “no stone will be left unturned” promise must be clear, as to what we are to learn and what will change.
Personally, I would ask for total public media broadcasting of any such inquiry or commission. First, there is the need to investigate what happened in the heat of the immediate COVID catastrophe in these long-term care facilities and then trust what we must expect to see as positive outcomes, so 2020 never repeats. Then any reformation dialogue must be inter-generational and include older adults in care, their family caregivers and others in their caregiver and social network.
For decades, inquiries and reports on the so-called “Long-Term Care System” have surfaced, shocked us and then drifted into the files, sort of a “bubble and squeak”, if I dare borrow a bit slang from the British dish. A more recent famous episode, also in Ontario, shameful to say, was the 2019 report on the trial of nurse, Elizabeth Wettlaufer. She pled guilty to and was convicted of eight counts of first-degree murder, four counts of attempted murder and two counts of aggravated assault while she worked in Long Term Care facilities in southwestern Ontario.
However, more broadly, this is a moment for public education. Remember, in Canada, health care management and delivery, including long-term care, is a provincial responsibility while the federal government sets and administers national standards for the health care system under the Canada Health Act. It’s important to keep this in mind as many call again for a national dialogue and strategy for long-term care. But, how far do we really need to look for a script to help us discuss and transform our system?
How timely then, almost on cue it is, that in September/October of 2019 the National Institute on Ageing (NIA) released two reports:
These I strongly suggest should be a first read in our public education. Reading and commenting on these reports for the first time in a pre-COVID world, was a highly instructive process for me and now it seems worth another read. However, for more of a haunting statement to reflect on, look at the line in July 31, 2019 Commissioner’s Remarks on the Public Inquiry into the Safety and Security of Residents in the Long-Term Care Homes System
“Long-term care homes are the most highly regulated area of healthcare in Ontario. Despite limited resources, the staff in these homes must meet the regulatory dictates and provide care for residents with ever-increasing acuity. However, while the long-term care system is strained, it is not broken.”
Almost one year later, are we still reluctant to say our care system is not broken? If not, then what are we to say? While framed around the Wettlaufer case, and 91 recommendations are in the report, there is enough in there to bring forward into our COVID context. It is also important that we widen our context and understanding of what a continuum of care is and could be into the future, not simply sticking solely with institutional long-term care, flipping it like a Rubik’s Cube waiting for all the colours to line up.
Next week I will expand further my thoughts on this continuum of care. In the meantime, I highly recommend reading the blog post from May 27th by Sue Lantz, Founder of Collaborative Aging – NEGLECT. ABUSE. CRISIS. REVIEW. REPEAT… IT’S TIME TO BREAK THE CYCLE.
For one thing, says Lantz:
“it’s also time to create a parallel track that moves us “upstream” to create alternative and sustainable solutions to help the growing number of seniors wanting to age in in their homes and communities. Going upstream is the only way we will stop the larger cycle to prevent the over-reliance on the institutional models and pressures on the LTC sector.”
Happy 70th Anniversary Mum & Dad! They always demonstrated to me, by example, how to think upstream.