At the end of April, only a few months into the COVID-19 pandemic, the picture was already stark: More than half of Ontario’s long-term care homes had faced outbreaks, and more than three-quarters of deaths in the province had occurred in these facilities. How to avoid similar grim numbers during the second wave? A three-person commission looking at the issue released some interim advice Friday.
The trio, which includes Dr. Jack Kitts, former CEO of The Ottawa Hospital, mercifully avoided the ideological battles that have clouded the crisis in order to offer common-sense guidance, some of which can be followed up quickly. For example, the commission recommends:
• That families and caregivers not be cut off from their loved ones in long-term care during the pandemic. In the first wave, these essential people, who help with not just physical needs but “the psycho-social wellbeing of residents” were booted to the sidelines – a disaster in care homes where staffing was inadequate to the COVID challenge. We know now how family caregivers can safely enter care homes to help their loved ones, taking some burden off staff.
• That each long-term care home put someone formally in charge of infection prevention and control (known as IPAC). This person would monitor for proper cleaning and use of protective equipment; and would train staff and evaluate compliance with the rules. The commission also suggests provincial or local health unit staff do “focused inspections” to ensure good protocols exist. Given the problems the province has inspecting long-term care homes generally, it’s really up to the homes themselves to name an IPAC supervisor. But most will want to do this, if they haven’t already.
• That the province spend whatever’s needed to ensure a daily minimum of four hours of direct care for each resident. That means more permanent funding for nurses, personal service workers and others so care facilities can boost their staff-to-resident ratio.
There really is no way around the need for more (and better paid) staff, costly as this recommendation may be. We know that seniors in long-term care today are a frailer group than those who entered care facilities a generation ago: More than 80 per cent have cognitive impairments, for instance, and many suffer advanced medical and physical conditions. They simply need more hands-on attention.
The onset of the pandemic last winter showed us – to our shame – how poorly we treat people in care. During the second wave, we can do better. And in the long run, better still.