Canada is great at commissioning studies and drafting reports, and sometimes terrible at taking action — and that is evident in the state of long-term senior care, says the author of a new book.
Andre Picard, a health reporter and columist for the Globe and Mail for more than 30 years, has written Neglected No More: The Urgent Need to Improve the Lives of Canada’s Elders in the Wake of a Pandemic, and is featured at Calgary’s Wordfest on March 11.
“The pandemic has exposed a lot of failings in our social policies across the board, but the one that’s been exposed most brutally is what’s happened in long-term care,” Picard told The Homestretch. “The carnage there is incredible.”
There have been more than 16,000 deaths in senior’s care homes across Canada, which relies heavily on long-term care to house its aging citizens.
“You hear lots of frustration, I think the biggest frustration is people just end up in homes by default,” said Picard, who conducted interviews with families as well as care home workers and more in researching the book.
“There have been a couple of polls in recent weeks saying 90-95 per cent of people don’t ever want to go to these homes, but they end up there, and they end up there in large numbers. In Canada, there’s 400,000 people living in institutional care, one of the highest rates in the world,” he said.
“It happens because we have inadequate home care and inadequate supportive housing and people just get sort of funnelled to this really costly, unpleasant place to live by default.”
Picard said Canada is world class at writing reports on the issue, but lagging badly when it comes to implementing some of the suggestions.
“We are the world champions, you know, there’s been 150 reports about this since Medicare’s advent, how to fix the Canadian health care system. Every one of them talks very prominently about long-term care,” Picard said. “So what’s happening is, I don’t know, it just kind of falls by the wayside.”
Canada is stuck in the system we created in the 1950 and ’60s, Picard said, and that system funds hospitals and physician care.
“So once you move out of acute care… once you need to be in institutional care, you kind of fall off a cliff and it’s not covered in any large measure by medicare,” he said, “You have to pay a lot out of pocket. One of the biggest shocks to people is how little is covered when they need this care. They kind of assume that medicare will take care of us until our dying days.”
Current system inefficient
Fixing the problem will take money, Picard said, but we are already spending a lot of money — inefficiently.
“There are people paying $15,000 a month for care, even the cheapest rooms are about $2,000 a month. So a lot of money is being spent that’s being spent inefficiently and it’s not being spent in an equitable fashion, government’s not doing it soundly,” he said.
“To put it in perspective, we spent roughly $400, $500 billion dollars on COVID aid. You could fix the long-term care system for two, three, four billion. It’s petty cash in the grand scheme of things. So I think this is really an opportunity to do something that will have a lasting impact and to do it with relatively little cost.”
Picard says the solution should start with the biggest problem — staffing.
“We have to get assurances that people are going to get hands-on care. So there’s a movement to have the standards of four hours a day, minimum hands-on care. And it can be done, really that could be done tomorrow,” he said, adding that many provinces could bump up the minimum hours.
Picard said Quebec is leading the charge.
“Quebec has hired 10,000 personal support workers … they hired 10,000 and they doubled their wages. They said ‘this is important, we have to fix this.’ And every province is doing this, but not to that degree. And so that’s a good starting point.”
Supportive housing key
We can also look to Denmark, Picard said, for a society that keeps people living at home, through a strong supportive housing system.
“I think the most important thing they do is they have a philosophy. Their philosophy is we want to keep people in the community among us until their dying days. So we want people to age in place,” he said.
“You don’t see these prison-like facilities that we have in Canada with 200, 300 beds. You walk down the street in Copenhagen, it’s a family home, family home, nursing home, family home. And you can’t tell the difference.
“So it’s all about wanting people to live in dignity regardless of their age, regardless of their disability.”
The 7 p.m. Wordfest event on March 11 is free, but if you RSVP there are extra goodies from Wordfest, including an emailed reminder and instructions on how to connect, and a follow up “digital doggie bag” with more links, and references from the conversation.
For more information go to Calgary Wordfest.
With files from The Homestretch.
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