Shining the Light on Long-Term Care: The Pandemic or a Broken System?

Less than a year after the completion of the public inquiry into the Long-Term Care sector, the headlines in Ontario read that another public inquiry is urgently needed as the

corona virus continues to spread through hundreds of homes. More than 1000 residents and frontline staff members have died and there have been more than 200 outbreaks. This has left the public questioning why this has occurred and what can be done to prevent this in the future.

Why has there been such tragic impact in this sector?

The system has been designed to care for the most elderly in our population. These individuals are entering the end of their life cycle and require supportive care, may suffer from illness and have limited mobility or neurological or degenerative diseases that make communication and self-advocacy difficult. Over the next 20 years, it is anticipated that there will be more than twice as many seniors over the age of 75  and by extension, a growth in the number who need long-term care support.

The crisis in Ontario has been developing slowly. Additional threats due to the pandemic have burdened an already strained system include staffing and PPE shortages, inadequate infection control and prevention measures, an inability to meet patient care needs and poor communication with stakeholders such as residents and their families, resulting in legal action and complaints.

Recently, extraordinary measures have been taken to support Long-Term Care homes at the federal and provincial level through the deployment of Canadian Armed Forces and Mandatory Management Orders. Despite these efforts, there has been a devastating impact on staff and residents demonstrating high rates of infection.

Can the broken system be repaired?

The province has accountability for the oversight for all Long-Term Care homes in Ontario. The global pandemic has shone the light on an already taxed system which has outdated infrastructure, lack of adequate staff, poor pay and disorganization.

The Government has made the decision to set up an independent commission to examine the devastating impact of the pandemic but critics say that this approach may fall short and a full-scale public inquiry would be more useful. The Commission will be launched in September and details will be finalized over the next several months on the scope of the review and who will participate. Part of the reasoning behind this approach is that a non-partisan, independent commission is the best way to conduct a thorough and expedited review.

What does it mean for facilities and healthcare professionals who currently work in Long-Term Care?

There have been large class actions launched where families have suspected negligence by a provider. These may be on the rise as a result of what is being uncovered. Typically, claims may be related to failing to protect residents due to inadequate measures being in place such as adequate staffing and proper training, supervision of employees, screening for visitors with applicable policies, communication with families, adequate PPE and appropriate record keeping.

In the interim, healthcare professionals who work in this sector must be vigilant when it comes to their practices. In particular:

• They must raise concern and awareness when policies and procedures are non-existent or unclear

• They should seek out support that may be available through their regulatory bodies or professional associations

• They need to be aware of the standards of practice that they will be accountable for such as medication administration and documentation

Long-Term Care homes should also be thinking about:

• Policies and procedures which reflect best practices and educate staff about topics such as infection control and communication

• Ensure that all statutory requirements are being met

• Maintaining standards related to documentation and protection of personal health information

• Communication with family members to keep them apprised of what is happening with regular frequency

This global pandemic has inflicted tremendous tragedy on this already taxed sector in Ontario. The sliver lining is that Long-Term Care may finally receive the attention it deserves thereby affording better protections to some of the most vulnerable in our society.