Long-Term Care Homes and COVID-19
The past year and a half have been difficult for all of us, but for those who have lost loved ones, the pandemic has been devastating. In Canada, the toll has been particularly high for seniors living in long-term care homes and nursing homes. Approximately 69% of overall COVID-19 deaths occurred in care homes, a much higher percentage than the international average of 41%. CBC reports that between March 2020 and February 2021, more than 80,000 residents and staff members in Canadian long-term care homes were infected with the coronavirus. Outbreaks occurred in 2,500 care homes, resulting in the deaths of 14,000 residents. Ontario and Quebec were the provinces with the worst records.
Delays in implementing measures such as mandating PPE and barring staff from working at more than one home meant that in Ontario, 1,937 people in long-term care died during the first wave. Unfortunately, the loss of life during wave one of the pandemic didn’t translate into coherent preventive action, and the second wave was even more deadly for seniors in long-term care. Ontario’s auditor general found that the provincial government “did not provide clear directions to homes, and did not inspect to ensure that homes were complying with containment measures.”
What Went Wrong?
The causes of the failure to control COVID-19 in LTC homes are numerous, and recommendations from federal and provincial inquiries to date have all pinpointed similar issues. A major problem during the pandemic was staffing. Care homes often didn’t have enough staff, so that when some caregivers were sidelined with COVID, homes did not have enough personnel to provide proper care. Personal support workers at LTC homes often work at more than one facility in order to earn a living wage, increasing the possibility of transmitting COVID-19. Some LTC homes did not have medical directors on each floor, resulting in inadequate supervision. Recommendations from all agencies to date include increasing staffing levels across the board and providing retention programs for both nurses and personal support workers. Housekeeping needs should also be assessed and addressed; augmenting housekeeping services is indicated in almost every case.
Before the pandemic, LTC homes were operating at 98% capacity, and transfers to these facilities meant added pressure. Crowding was found to be a factor in COVID-19 transmission and analysts are urging that we take steps to reduce occupancy to prevent the spread of infection. Homes should also adapt spaces so that sick patients may be properly isolated.
Last spring, more than 1,500 Canadian Armed Forces members were deployed to 32 of the most severely impacted LTC homes in Ontario and Quebec. They reported “poor infection prevention and control practices.” This was caused by insufficient medical supplies, poor training, lack of PPE, and extensive staffing problems. Recommendations from provincial and national agencies are, understandably, recommending that homes provide the training and necessary PPE and medical supplies to create a safe work environment. A related recommendation is to implement strong, mandatory infection control practices, and to establish a designated infection prevention and control lead in each home.
Statistics show that LTC home residents received less medical care last year than they did in other years, noting that they received fewer doctor visits and fewer hospital transfers. Reports recommend that residents receive more prompt and comprehensive medical attention.
The system itself was found wanting, with agencies calling for an increase in accountability at all levels, system-wide. This accountability would include improving the way LTC home inspections are done, how infractions are dealt with and penalties enforced. The province discontinued comprehensive annual inspections in 2018, and nursing homes had no relationships with hospitals or public health units at the beginning of the pandemic, and as a result were unable to benefit from their knowledge of how to handle infectious disease outbreaks. Reports also call for clarity in communication and coordination across all parts of the system, and the implementation of a specific crisis plan for outbreaks, including a disaster/emergency response team, as well as rapid testing and effective contact tracing strategies.
If You’ve Lost a Loved One
To add to the sorrow of those who lost family members, visits to LTC homes were restricted during the pandemic. This meant that family were often not able to see their parents and grandparents in the weeks or months before they passed away. Although financial compensation can never make up for loss, if your family member died while in a long-term care home during the pandemic, you may have grounds to bring legal action. Contact a personal injury lawyer and arrange for a free initial consultation. These lawyers work on a contingency basis, which means that they do not charge hourly fees, but rather work for a percentage of any settlement that you may receive. A personal injury lawyer can advise you about your situation and let you know what your options are.