The Ontario Health Coalition is calling on the government to establish a minimum care standard for residents in long-term care homes as well as open up more beds in other medical facilities to work toward fixing the long-term care crisis, according to their report from Jan. 21.
Devorah Goldberg, research and campaigns coordinator for the report, spoke on the report findings at a presentation in Huntsville on Jan. 28. The report cites a crisis in long-term care caused issues like lack of staff, violence and overcrowding in facilities, which results in inadequate care for patients. The OHC is pushing the government to create a minimum standard of four hours of hands-on care per resident per day and to open up capacity in hospital beds and beds in complex and continuing care to reduce overcrowding in long-term care. The minimum standard of care is something the OHC said they’ve been recommending for years without success as quality of care has decreased.
Goldberg said they started the report because they were getting calls and emails from people about their family member being beaten, bruised or otherwise mistreated in long-term care, which made them wonder if violence in long-term care was a trend. They started to compile data while the Ontario coroner flagged resident-on-resident homicides.
“We found that the homicide rate in long-term care is seven times higher than similarly sized cities across Canada and Ontario,” Goldberg said. “It’s three or four times higher than the city of Toronto, which is really, really shocking. You don’t think about things like that when you’re thinking about long term care. They’re supposed to be safe places where someone goes and they’re cared for.”
Violence against staff is also a common problem in long-term care facilities and health care is already the second highest industry for lost workforce time due to injury, according to the report.
They also looked into the care for residents in the facilities and found it to be lacking in many ways. As fewer hospital and continuing care beds become available, more patients go into long-term care and some of them have complex needs that can be difficult for the staff to meet. That means a rise in acuity, or the intensity of nursing care required by a patient, which is further complicated by inadequate staffing.
“As acuity is going up, staffing has gone down, which we believe has caused this massive issue with violence in long term care and just inadequate care in general,” Goldberg said.
And it’s not just nonprofits. Long-term facilities owned by for-profit corporations have poorer quality of care, according to the report. One study found that for-profit facilities have a 10 per cent higher risk of mortality and a 25 per cent higher risk of hospitalization one year after admission.
Despite the issues in care, there are currently almost 80,000 people in long-term care and more than 33,000 people on the waitlist, according to the report. The median wait time is over five months, but in some places, the waitlists can be over two years long and the research shows additional hurdles for racialized people. The growing aging population could also worsen the issue.
Pam Brown, a support worker for over 35 years and a steward for the United Food and Commercial Workers union, knows these problems firsthand.
“[Personal support workers] used to have time to take the residents outside for fresh air and a walk around,” Brown said. “They used to be able to sit for a few minutes and listen to stories about the residents that they wanted to share. Now, it feels like an assembly line with little time to share.”
Brown agrees that long-term care is in crisis and said that it’s imperative for the government to follow the recommendations set out by the OHC to fix it.
“Long term care facilities are maxed out trying to balance ministry requirements, resident needs and staffing levels,” Brown said. “There is little to no education provided based on resident need. Our residents in Ontario deserve much better.”