On May 20, 2020, the Canadian Armed Forces wrote a report on the “number of medical professional and technical issues” present in five prioritized long-term care facilities in Ontario. Within this report, it highlighted significant gaps in care for a vulnerable population. Some of the notable issues in the report were: poor wound care, sharing of equipment between COvid-19 infected and non-infected individuals, residents calling out for help with no staff response, rotten food, residents sitting in soiled diapers, and bug infestations (Mialkowski, 2020). As of May 25, long-term care residents accounted for 81% of all reported COVID-19 deaths in Canada, compared with an average of 42% in 16 other OECD countries. The data ranged from less than 10% in Slovenia and Hungary to 66% in Spain. (CIHI, 2020)
In June 2017, Elizabeth Wettlaufer was convicted of eight counts of first-degree murder when she intentionally overdosed 8 residents, 7 of which were in regulated long-term care homes, with insulin. These murders took place between 2007 and 2016, and only came to light when she confessed to her treating psychiatrist at the Centre for Addiction and Mental Health in Toronto (Gillese, 2019).
In both instances, it took an ‘outsider’ to point out the care issues that the vulnerable in long-term care facilities face. According to the CBC, in 2019 only nine of the 626 long-term care homes in Ontario underwent their resident quality inspections. There were 2,800 total inspections in 2019, that were the results of complaints or critical incident investigations (Pederson et al., 2020).
The Patient Ombudsman reported in October 2020 that the rate of long-term care complaints historically comprised less than 10% of their total complaints. It is now 44% (Frook, 2020).
When it comes to a significantly vulnerable aging population, Ontario is failing those in the long-term care homes. Covid-19 just forced the current conditions under a microscope where people were outraged enough that an inquiry will undoubtedly follow.
It is estimated that 90% of residents have some sort of cognitive impairment (McBride, 2020), which may leave them vulnerable when they cannot always advocate for their care. When considering that patient families are limited in visiting and inspections are not occurring, these vulnerable patients are falling through the cracks. It is my hope that ‘outsiders’ continue to speak up, and that the multiple inquiries that are sure to follow will create a real change in long-term care.
References
Canadian Institute for Health Information. (2020, June 25). New analysis paints international picture of COVID-19’s long-term care impacts. https://www.cihi.ca/en/new-analysis-paints-international-picture-of-covid-19s-long-term-care-impacts
Gillese, E. (2019, July 31) Public Inquiry into the Safety and Security of Residents in the Long-Term Care Homes System. The Long-Term Care Homes Public Inquiry. http://longtermcareinquiry.ca/wp-content/uploads/LTCI_Final_Report_Volume1_e.pdf
McBride, J. (2020, November 11) Houses of Horror. TorontoLife. https://torontolife.com/city/how-ontarios-long-term-care-homes-became-houses-of-horror/
Mialkowski, C. (2020, May 14). JTFC Observations In Long-Term Care Facilities on Ontario. http://www.documentcloud.org/documents/6928480-OP-LASER-JTFC-Observations-in-LTCF-in-On.html?_ga=2.5634801.37986390.1605466521-1478251246.1601415646
Pederson, K., Mancini, M., Common, D. (2020, April 15). Ontario scaled back comprehensive, annual inspections of nursing homes to only a handful last year. CBC News. https://www.cbc.ca/news/canada/seniors-homes-inspections-1.5532585
Frook, C. (2020). Honouring the voices and experiences of Long-Term Care Home residents, caregivers and staff during the first wave of COVID-19 in Ontario. Patient Ombudsman. https://www.patientombudsman.ca/Portals/0/documents/covid-19-report-en.pdf