A call to action for long-term care

Catholics are getting ready to play a role in the post-COVID look at what went wrong in long-term care, but that response is divided between a walk-softly approach and others demanding radical change.

Canada has had more than 5,800 long-term care homes hit with COVID-19 outbreaks and long-term care has accounted for 79 per cent of all COVID-19 deaths in the country (6,763 out of 8,552 total deaths), according to the National Institute on Aging’s online tracker as of June 29.

The numbers are appalling and a call to action, according to a joint submission from the Sisters of St. Joseph’s Office for Systemic Justice and the Centre Oblat - A Voice for Justice. For these religious-order based advocates, it goes far beyond a crisis in long-term care.

“The pandemic has shone a spotlight on inequality, the inadequacies of our social protections, particularly in response to gender-based violence and homelessness and the precarity of the labour market,” according to the joint submission. “We have seen starkly divergent impacts. We may be weathering the same storm, but we travel in vastly different boats.”

The problem in long-term care is that Canadians have tried to care for the elderly on the cheap, according to the joint submission prepared by Centre Oblat executive director Joe Gunn and Office for Systemic Justice director Sr. Sue Wilson.

“Care work has been undervalued in Canada for too long. Now is the time to set care work on a better trajectory,” they said.

In Ontario, where there have been 2,040 deaths in long-term care, the Catholic bishops and the Catholic Health Association of Ontario (CHAO) are sticking more strictly to just the situation in the long-term care homes.

“The CHAO wants to make a contribution to the conversation,” said Hamilton Bishop Doug Crosby, who sits on the CHAO board. “It doesn’t want to be critical, but it wants to share its experience and wants to provide wisdom — the wisdom of the shared experience for the well-being of seniors and of the whole system.”

Crosby isn’t ready yet to decide whether private ownership ought to be abolished or long-term care brought under the Canada Health Act, as the Canadian bishops had suggested 20 years ago to the Romanow Commission, the Royal Commission on the Future of Health Care in Canada.

In May, the Ontario Health Coalition found the death rate related to COVID-19 in for-profit homes was nine per cent, compared to 5.25 per cent in non-profit homes and 3.62 per cent in municipally owned homes.

Ontario Catholics are not bystanders in long-term care. The Catholic Health Sponsors of Ontario collectively operate 1,872 long-term care beds. Some of those Catholic facilities have weathered COVID extraordinarily well, said Crosby.

“There were long-term care centres that did things right. I think that’s the kind of learning that we’re going to discover,” Crosby said. “The Catholic community will have something to offer.”

In advance of a promised independent commission, the Catholic Health Association has submitted a “lessons learned” brief to the Ontario Ministry of Health, said CHAO executive director Ron Noble. The organization has agreed to keep that memo under wraps for now, but Noble did say the CHAO highlighted the advantages of not-for-profit homes.

At the ecumenical, conservative think tank Cardus, its analysis has come down heavily on the side of radical, systemic change.

“COVID-related deaths highlight the pre-existing crisis in Ontario long-term care homes,” said a Cardus release announcing a fresh study into the system.

For Cardus, the problems stem from what we pay and how we train personal support workers. 

“A PSW working full-time equivalent hours made almost $2,800 less per year in 2018 than she did in 2009,” said the Cardus report.

In its 2020 budget, Ontario renewed a promise to create 15,000 new long-term care beds — the first significant addition since 20,000 beds were added 20 years ago. At issue will be who owns those beds — big companies like Extendicare and Chartwell, churches and foundations or cities and towns?

Saint Elizabeth Health Care, one of the largest providers of home health care in the country, thinks the best solution may be keeping people out of institutions.

“The home-care sector has evolved significantly in the past 25 years and has the potential to keep people out of more costly institutional settings like hospitals and long-term care facilities,” SE Health CEO Shirley Sharkey said at hearings into Bill 175 to establish “Ontario Health Teams.”