Long-Term Care Statement from CCD

Residents in long-term care consist of individuals with disabilities requiring continued care, seniors with disabilities, or seniors requiring assistance. The Council of Canadians with Disabilities is an organization comprised of disability-based organizations from all walks of life, including seniors in long-term care, and individuals with disabilities who require assistance in long-term care facilities.

On May 20th, 2020, the 4th Canadian Division Joint Task Force released a report on the conditions inside five long-term care facilities in Ontario. The 15-page report highlighted that long-term care facilities were in “urgent and immediate need of personnel to provide humanitarian relief and medical support”¹.  The two-week observation highlighted extremely disturbing conditions which included inappropriate and unethical behavior towards residents and unsanitary environment. Among the most troubling: leaving residents in soiled garments causing skin breakdown; insect infections within facilities; compromising Do-Not-Resuscitate protocol; forceful feeding causing audible choking; lack of adequate resources to provide sanitary care to residents; insufficient procedure to reduce the spread of COVID-19; uncharted palliative care orders due to incompetence by staff; the risk of dismissal if conditions were reported; and, unsafe medication administration being among many other horrific conditions noted.²

Many articles and exposés have been released throughout Premier Doug Ford’s term highlighting these atrocious conditions. The Premier, Minister of Long-Term Care, and government as a whole have open access to internal and external reports that indicate the status of these homes. However, the Premier states that he inherited these facilities and was unaware of the extent of the unsanitary and inhumane conditions.³  Respectfully, this situation presents an array of issues. First, that the Premier and his government were aware of the conditions to some extent and failed to alter the conditions, instead cutting funding to health care and enabling the issue to continue. Second, that the government did not address these issues until able-bodied, non-senior members of the armed forces brought the issue to light while senior rights and disability rights sectors have been commenting on such conditions for years to no avail. Lastly, that Merrilee Fullerton, the Minister of Long-Term Care, has not resigned despite her abhorrent disregard for the conditions in which long-term care residents lived in under her watch.

Throughout the COVID-19 pandemic in Ontario, seniors living in long-term care facilities have been affected the greatest. Care has diminished due to the lack of resources, accountability, and aid by the government to Ontarians in these facilities. An estimated 1819 people have died in long-term care homes in Ontario since the beginning of the pandemic.⁴  The 2007 Overview of Long-Term Care in Canada reported that over 262,235 people with disabilities were living in long-term care conditions within Canada in 1991, an estimated 212,920 of those residents were elderly people with disabilities.⁵  Ontario health reports that as of 2015, there are 78,000 residents in Ontario’s 629 long-term care homes.⁶  Additionally, the Ontario government created the “Patients First: Action Plan for Health Care” resource stating the next-phase for improving Ontario’s health care system but have failed to adhere to many of their own promises.⁷  This initiative looked to build the health care system and long-term care initiatives with a “patient first” approach. However, Ontario Premier Doug Ford claims that he was not fully aware of the conditions surrounding the five homes in the May 20th report.⁸

Most notably, on January 24, 2019, the Ontario Health Coalition published a report surrounding the “shocking” conditions within long-term care homes in Ontario.⁹  This indicates that 80,000 residents across the province were subjected to “intolerable” levels of homicide, extreme end of a “spectrum of violence”, and insufficient care within these homes.¹⁰  The report states that the risk to residents include inequities in access to care, inappropriately staffed facilities, and unsafe living conditions for residents in long-term care and staff in those facilities. The most jarring of conditions show that the number of RN’s, RPN’s and PSW’s are at the lowest levels in a decade, the level of funding is not up to par, and there is not enough care for residents in their basic hygiene and living conditions.¹¹

To be clear, for years the disability and senior community have been vocal about the conditions inside long-term care facilities and the struggles that caregivers are faced with. The National Institute on Ageing published a report in September of 2019 titled “Enabling the Future Provisions of Long-Term Care in Canada”.¹²  This report highlighted that over 430,000 Canadians were estimated to have unmet home care needs with over 40,000 Canadians on wait-lists due to the lack of available home and community based-care.¹³  The report also indicated that the way services are organized remain less than ideal for older Canadians, their caregivers, and their care providers.¹⁴  The Long-Term Care Innovation Expert Panel in 2012 indicated a lack of transparency, lack of coordination, and negative resident and family experience. The same panel indicated that the burden of regulations reinforces a “culture of compliance” in performing regulated tasks and mandatory documentation.¹⁵  In fact, nursing home residents in Ontario appeared to have twice the odds of transferring residents to hospital independent of factors such as underlying severity of illness compared to Alberta and British Columbia.¹⁶

The disability rights sector has notably lived by the mantra “Nothing About Us, Without Us”. As a result, we have lived our lives as advocates assuring that our voices are heard when stating the truth of our communities. However, despite how many times we speak or how loud our voices are, some governments fail to listen to our pleas to reassess the conditions for which they are responsible. The government has only acted when able-bodied, non-senior individuals have spoken on our behalf. The voices of people with disabilities and senior citizens have been ignored and have led to situations where Ontarians have had their basic human rights impeded on, have been abused, neglected, and consistently put aside. Enough is enough. Listen to residents in these homes, consult with our communities, listen to the reports that credible and capable organization have released, and make a change.

The blatant disregard by Minister Fullerton towards the conditions in these homes has caused pain and suffering to families and residents. The Premier has a responsibility to appoint a Minister who is capable of addressing the struggles present in long-term care. Minister Fullerton must take responsibility for her neglect for long-term care residents. The actions of this government are unacceptable.

The government is asking for federal funding to solve the issue they created, claiming that “if we get the funds we can make some massive changes”.¹⁷  Though, in 2019 the Premier cut funding from healthcare, including long-term care facilities, to provide more funding to other initiatives in the province.¹⁸  In Alberta, the Minister of Health and Minister of Seniors and Housing have announced that the province is investing $170 million ($14.2 per month) to supportive long-term care facilities for senior living during COVID-19.¹⁹  Provinces are listening to these pleas and allocating adequate funding to COVID-19 measures, except for Ontario. The government of Ontario has nowhere to hide, the truth is out in the open, and it is time for the Premier to help those in need, to find a Minister who is capable of change, and to be held accountable for the suffering of residents on his watch.

In solidarity,

Council of Canadians with Disabilities

Roxana Jahani Aval -JD Candidate, University of Windsor, Faculty of Law
Secretary - Council of Canadians with Disabilities
Past-Chair and Member-at-Large – National Educational Association of Disabled Students

References

1. Joint Task Force, Lieutenant Colonial George Taylor, “OP-LASER – JTFC OBSERVATION IN LONG TERM CARE FACILITIES IN ONTARIO” (May 20, 2020) JTFC 1-15 online: MacLean’s <https://www.macleans.ca/wp-content/uploads/2020/05/JTFC-Observations-in-LTCF-in-ON.pdf>.
2. Ibid.
3.  Chris Fox “’I think it is disgusting’ Ford says as military details dozens of Ontario long-term care homes”, CP24 (May 26, 2020) online: CP24 <https://www.cp24.com/news/i-think-it-is-disgusting-ford-says-as-military-details-dozens-of-issues-at-five-ontario-long-term-care-homes-1.4954722>.

4. National Institute of Ageing, “NIA Long-Term Care COVID-19 Tracker” (2020) online: NIA <https://ltc-covid19-tracker.ca>.

5. An Overview of Long-Term Care in Canada and Selected Provinces and Territories https://pdfs.semanticscholar.org/798f/d65b27ebeb5f53eb1ed06f91d823cd77b5...
6. Government of Ontario Ministry of Health, “Ontario Redeveloping 300 Long-Term Care Homes” (February 6th, 2015) online: Ministry of Health <http://www.health.gov.on.ca/en/news/bulletin/2015/hb_20150206_1.aspx>.
7. Government of Ontario Ministry of Health, “Patients First: Action Plan for Health Care” (2015) online: Ministry of Health <http://www.health.gov.on.ca/en/ms/ecfa/healthy_change>.
8. Global News, “Coronavirus outbreak: Ford says province wasn’t aware of the full extent of conditions in some long term care homes” Global News (May 26, 2020) online: Global News <https://globalnews.ca/video/6989364/coronavirus-outbreak-ford-says-province-wasnt-aware-of-the-full-extent-of-conditions-in-some-long-term-care-homes>.
9.Ontario Health Coalition, “Situation Critical: Planning, Access, Levels of Care and Violence in Ontario’s Long-Term Care” (January 21, 2019) 25-30 online: Ontario Health Coalition <http://www.ontariohealthcoalition.ca/wp-ontent/uploads/FINAL-LTC-REPORT.pdf>.
10. Ibid at page 29.

11.Ibid at page 25.
12.  National Institute on Ageing, “Enabling the future provisions of long-term care in Canada” (September 2019) 56-75 online: National Institute of Ageing <https://static1.squarespace.com/static/5c2fa7b03917eed9b5a436d8/t/5d9de15a38dca21e46009548/1570627931078/Enabling+the+Future+Provision+of+Long-Term+Care+in+Canada.pdf>.
13. Ibid at page 11.
14. Ibid at page 22.
15. Supra note 5.
16. Ibid at page 70.

17. Ryan Tumilty, “For-profit companies running troubles long-term care homes will be held accountable, Doug Ford says” (May 28, 2020) online: National Post <https://nationalpost.com/news/for-profit-companies-running-troubled-long-term-care-homes-will-be-held-accountable-doug-ford-says>.
18. Shawn Jeffords, “Doug Ford to move ahead with Ontario municipal funding cuts in 2020” (August 19, 2019) online: Global News <https://globalnews.ca/news/5782431/ontario-municipal-funding-cuts/>.
19. Voice of Albertans with Disabilities, “Strong Protections for Vulnerable Seniors” (May 19, 2020) online: Government of Alberta <https://www.alberta.ca/release.cfm?xID=71386D035BB2D-B631-0BFC-9D02B950AD5AF7D0>.