Keep up to date on the latest issues related to Long Term Care.
Click on the links below to learn what is happening across the province.
Our own Carol Dueck speaks out on the issue of LTC in Niagara
DIVERTING PUBLIC MONEY FROM LONG-TERM CARE IN ONTARIO
Canada’s new national long-term care standards released. Here’s what is different By Saba Aziz & Aya Al-Hakim (Global News)
Read the Ontario Auditor General's Special Report on Pandemic Preparedness and Response in the Long-Term-Care Sector:
The webinar recording will be made available at the following link: https://rnao.ca/events/health-system-transformation-covid-19-webinar
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Crisis Shortage of PSWs in Ontario's Long-Term Care Homes Risks Safety of Residents and Staff: New Report
Toronto – The Ontario Health Coalition released a new report today developed in partnership with UNIFOR on the Personal Support Worker (PSW) crisis in Ontario's long-term care homes. The report “Caring in Crisis: Ontario’s Long-Term Care PSW Shortage” is available on the OHC website here. In a press conference at the Ontario Legislature, Natalie Mehra, Executive Director of the Health Coalition, noted that we chose the word "crisis" carefully. The situation is so extreme that funded long-term care beds cannot be opened because there are not enough PSWs to provide the care.
The report is based on eight round-table meetings held across Ontario over the last year, including more than 350 participants including home operators and administrators, PSWs, union representatives, family councils, seniors, college staff who develop/coordinate PSW courses, local health coalitions and other long-term care advocates.
“The conditions of work are the conditions of care for residents,” said Natalie Mehra. She emphasized, “The PSW staffing crisis is real. Every long-term care home, every shift, in the north and in the south, rural and urban, we are hearing the same thing from hundreds of front-line staff, families of residents and home operators. PSWs have taken heavier-care and more complex patients year after year, risking injury and harm, without pay and working conditions that are commensurate to the work. Most of the tools to fix this situation are in the hands of the provincial government which instead of acting urgently to fix the crisis, is actually cutting funding.”
Shortages mean that homes are working with one to two vacancies in every area. That might mean that they are trying to operate 5-10 staff short, or in some larger homes, they reported that they are 20-50 PSWs short. Work is rushed and stressful. Injuries are common. Compensation is too low for the heavy work burden. The impact of the critical staffing shortages on workload, quality of life and quality of care is profound. The report also finds that as a result of these conditions there is declining enrollment in PSW courses in colleges.
The Health Coalition made a set of initial recommendations to alleviate the PSW crisis in long-term care homes including:
Increased funding directed to improve PSW staffing levels, wages and working conditions;
A minimum care standard;
A provincial human resource recruitment and retention plan with concrete timelines and public reporting;
In-house Behavioural Supports Ontario (BSO) in all homes;
Tuition reductions and grants for PSW college programs;
Mandatory reporting of staffing shortages;
Publicity campaign with positive image of personal support work, and;
Restored capacity in our public hospitals to avoid offloading patients whose care needs are too complex for long-term care.
“Every step of the way, we heard that PSWs face impossible workloads and heavy physical labour that leads to preventable injuries. These unsafe conditions, paired with low pay, precarious working conditions and few or no benefits must end,” said Jerry Dias, UNIFOR National President. “I challenge Premier Doug Ford to spend a shift at a long-term care home in Ontario with me to witness the dangerous and disrespectful conditions that seniors in care must live with.”
“Intolerable” levels of violence and homicide spark renewed call for improved care standards in Ontario’s long-term care: new report
Toronto—In a Queen’s Park press conference today the Ontario Health Coalition launched a 30-community tour of a new report, “Situation Critical: Planning, Access, Levels of Care and Violence in Ontario’s Long-Term Care”. The report was inspired by increasingly frequent complaints by families and care workers of violence in long-term care homes (nursing homes). In its research, the Health Coalition found what it describes as “shocking” and “intolerable” levels of homicide, the extreme end of a “spectrum of violence that is escalating”. Almost 80,000 Ontarians reside in long-term care homes.
Among the key findings in the report:
There were 27 homicides in Ontario’s long-term care homes, according to the Ontario Coroner in the five years leading up to the report: a homicide rate that is 4-times that of Toronto and 8-times that of communities that are similarly-sized to Ontario’s long-term care home sector (80,000 people).
Resident-on-resident violence has increased since 2011 and staff injury rates in long-term care are among the highest of any industry in our economy.
Access to long-term care is poor, and even more difficult for equity-seeking groups.
By every measure the acuity, that is the complexity and heaviness of the care needs of the residents in long-term care has increased dramatically. This is a result of massive hospital cuts: Ontario has cut more hospital beds than any other province and is almost at the bottom of OECD rankings. As a result, today’s long-term care homes are yesteryear’s chronic care and psychogeriatric hospitals, but without the same resources.
In fact, long-term care beds are funded at 1/3 the rate of chronic care beds but house residents that used to be considered chronic care or psychogeriatric care. This shift is saving money at the expense of the health and safety of the vulnerable residents in long-term care and their care staff.
While acuity has skyrocketed hands on care levels have actually declined. The result is the escalating violence that we are witnessing.
“By any reasonable measure the twin issues of insufficient care and violence in Ontario’s long-term care have reached a level that can no longer be ignored,” she added. “Voluntary approaches to improving staffing are a proven failure. If you put your child into day care there is a staffing ratio: a limit on the number of children for each staff person. We are asking for the same thing: a minimum care standard that would guarantee a minimum average of 4-hours of hands on nursing and personal support for each resident, and we are insisting that this be a requirement that is enforced.”
“No one should have to go through what my mother and my family went through,” added Lance Livingstone, a senior himself, who struggled for months to find his mother a space in long-term care and was ultimately unsuccessful and she passed away. “The government has cut care and continues to ration it in order to give tax breaks to the wealthy. We can afford to provide decent long-term care for seniors and others who need it. The truth is families can’t afford to go without it.”
For more information: Devorah Goldberg, Research & Campaigns Director; Natalie Mehra, Executive Director.
Ontario’s pledge to improve care in nursing homes falls short, critics say
BY KAREN HOWLETT
Globe & Mail – December 6, 2021
Ontario’s commitment to provide nursing home residents with four hours of daily care will be based on an average across the entire sector, a standard that critics say falls short of ensuring that all facilities meet the basic needs of seniors.
The new standard is aimed at addressing staffing shortages in the years leading up to a global pandemic that cut a deadly swath through the province’s nursing homes. Many of the 3,826 residents who succumbed to COVID-19 died in virus-stricken, understaffed homes.
The provincial government initially promised in November, 2020, to phase in the four hours of care by March, 2025. Under proposed legislation introduced in October governing long-term care – the tightly regulated and publicly subsidized spaces most people know as nursing homes – the province would spend billions of dollars on hiring more workers, doubling the number of inspectors and building new facilities to replace crowded, older ones with multibed wards.
Bill 37, called the Fixing Long-Term Care Act, enshrines the four hours of care and stipulates how the average is to be calculated: The number of residents in all homes across the province will be divided by the total hours of direct care they received from registered nurses, registered practical nurses and personal support workers.
Nursing home activists and labour leaders representing health care workers have long called for a provincial standard for daily hours of care to fix a sector often stretched to capacity. They said the increasingly complicated needs of elderly residents, many of whom are frail and cognitively impaired, demand a hiring spree to boost care beyond the current average of under three hours a day.
During two days of public consultations at a legislative committee reviewing the bill in late November, the government was criticized for not guaranteeing a minimum of four hours of hands-on care a day at each home, and for not making the standard legally binding.
The advocates called on the government to calculate the average of four hours on a home-by-home basis, hasten its implementation, and impose consequences for those facilities that fall below the threshold.
“We know there is disparity in the quality of care offered in long-term care homes,” Briana Broderick, a vice-president of the United Steelworkers, told the committee. “The proposed method of measuring care hours shields underperforming homes from scrutiny and leaves the people in care in those homes unprotected.”
Jane Meadus, a lawyer at the Advocacy Centre for the Elderly in Toronto, said, “Residents need these hours now, not in four years.”
Bill 37 is scheduled for debate in the Ontario Legislature on Monday, and is expected to pass third and final reading this week.
Premier Doug Ford’s government used its majority in the legislature to vote down every proposed amendment to the wording of the four-hour standard. In doing so, his administration ignored the advice of an independent commission that examined the devastating impact of the coronavirus pandemic on Ontario’s long-term care homes. The three-member commission, led by retired associate chief justice Frank Marrocco, specifically warned against calculating hours of care on a sector-wide basis.
In its report released in April, the commission says the average of 2 hours 45 minutes of care that residents currently receive has long been inadequate. It says the situation is “even worse” for some residents who receive less than the average.
“The presentation of staffing data as an average is misleading; the danger lies in the extremes, where insufficient care is being provided,” the report says.
Several studies have found that between four and four-and-a-half hours of care a day are necessary to promote the health and well-being of seniors in nursing homes. In 2008, health care expert Shirlee Sharkey recommended guidelines that could provide nursing home residents in Ontario with up to four hours of care each day, depending on their needs. But the Liberal government of the day resisted implementing the minimum standards.
Nursing homes are not currently required to publicly report the number of hours of care they provide to residents. But one study published in the Canadian Journal on Aging in 2016 found that residents in municipally owned homes typically receive more care than those in for-profit homes.
Colin Best, a board member of the Association of Municipalities of Ontario and chair of its health task force, told the legislative committee that the province’s towns and cities contribute an estimated $350-million annually to the homes for operating costs over and above funding from the province.
By contrast, the for-profit sector, which accounts for two-thirds of the province’s 626 nursing homes, pays out a portion of its funding in dividends to shareholders.
Warren (Smokey) Thomas, president of the Ontario Public Service Employees Union, said the four-hour target is meaningless because it cannot be enforced.
“An individual home could fail to deliver four hours of care and still not be in violation of the act,” he said.