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More than years ago, Pat Armstrong, a sociology professor at York University, released a study of long-term care of the elderly in Canada.
She exposed the abysmal lack of staffing required to provide quality care. Residents, she wrote: “sit in soiled diapers for hours because there are no workers available to answer their call … they miss their bath because there are not enough staff the get everyone adequately bathed. And they sit in their rooms without exercise or conversation … ”
Underpaid and overworked staff “come to work when they are injured or sick because they know that otherwise there will be no one there to provide care. They work unpaid hours to make up for the care deficit. They go home physically exhausted because they looked after far too many residents …”
Some residents “often become violent towards care providers because they are frustrated beyond endurance with the lack of care … Workers fail to report the violence, racism, and sexual harassment they face, in part because they feel their complaints will not be heard or, worse, that they will be blamed for the problem … This low pay and the limits on training reflect, at least in part, the value attached to this female-dominated work … ”
Professor Armstrong’s critique of the appalling conditions in mostly private long-term care homes was just one of dozens of such complaints aired by health-care specialists, care-givers and their unions over the past several decades.
Revelations of such colossal mistreatment were not overlooked by the media, where they were published and sometimes even headlined. But, after a few days, when Canadian political leaders failed time and again to react, the plight of the ill-treated elderly faded back to obscurity.
So it wasn’t until members of the Canadian Armed Forces released scathing reports of the terrible conditions rampant in some long-term care homes in Ontario that our federal and provincial governments finally expressed outrage and pledged to soon take proper corrective measures.
As if they had previously never been informed of such blatant mistreatment of the country’s retired citizens!
Will governments keep reform promises?
It’s far too soon, of course, to applaud this belated political pledge. To actually implement urgently needed reforms of the privately operated homes will necessitate upsetting their business owners. Owners whose abuse of their residents our political leaders have up to now dutifully overlooked by ignoring staff shortages and making very few inspections.
Whether the politicians will really deprive themselves of the financial campaign support and other benefits they derive from the private-care owners is far from certain. They certainly won’t insist that all such private care homes be converted to public care operations, which would be the ideal reform.
But the alternative, to be effective, would be to impose far better levels of care and staffing for residents, along with frequent oversight and enforcement. These measures, of course, would force owners to increase services and reduce profits — which in turn would undoubtedly cut or even stop their political donations.
Either way, our governments will have to accept such a decline in private-sector approval if they seriously undertake the necessary home-care reforms they now so vigorously guarantee.
In her 2009 study on Canada’s barbaric care system, Armstrong referred to the far superior service retirees receive in the Scandinavian countries and the Netherlands.
“Even with significantly more dependent elderly,” she noted, “these countries are able to provide higher staffing levels and more time for social support, as well as more choice and autonomy for both workers and residents.”
Not surprisingly, in the Netherlands, Norway and Sweden, public spending on long-term care is between 3.7 per cent and 3.2 per cent of GDP. This is about double the OECD average of 1.7 per cent. Canada spends just 1.3 per cent of GDP. In some other European countries where private care facilities are permitted, such as Latvia and Estonia, the amount drops as low as 0.2 per cent.
It should be kept in mind, however, that in Europe, a large share of the spending on long-term care services is covered by government or compulsory insurance schemes. In Germany, for example, although its long-term care spending is listed as only 1.5 per cent of GDP in the OECD’s scale, it actually provides the highest and most comprehensive long-term care in Europe. Germany’s mandatory social insurance plan covers virtually the entire population. About 90 per cent of its citizens are covered by a public insurance plan, while the remainder are covered by a funded mandatory private insurance plan.
Private operators must comply
However, even the European countries with the lowest long-term care spending have enacted laws and policies that compel private operators to adhere to high standards of service. These governments feel they have an obligation to monitor levels of care that ensure their elders are properly fed, socially engaged and free to have regular visits from family and friends.
A systemic cross-country collaboration in Europe helps professional experts and researchers in the aging health-care field to provide the best available training and care services.
Europeans are understandably horrified by the extent of the mistreatment and neglect of the elderly that they have recently seen on TV and read in their newspapers. How could an allegedly progressive country like Canada allow such malignant abuse of its oldest and most vulnerable citizens to fester for so long?
That’s a question Canada’s political leaders can’t possibly answer, a stain on our country’s reputation they can neither erase nor explain. Their only recourse is to live up to their promise to take prompt remedial action.
Let’s fervently hope and pray that they do.
Ed Finn grew up in Corner Brook, Newfoundland, where he worked as a printer’s apprentice, reporter, columnist and editor of that city’s daily newspaper, the Western Star. His career as a journalist included 14 years as a labour relations columnist for the Toronto Star. He was part of the world of politics between 1959 and 1962, serving as the first provincial leader of the NDP in Newfoundland. He worked closely with Tommy Douglas for some years and helped defend and promote medicare legislation in Saskatchewan.