The waves of the COVID-19 pandemic have revealed and created many competing public policy priorities. Perhaps no revelation has been more shameful than the state of care for the elderly in Canada. A quote often attributed to Mahatma Gandhi reads: “The true measure of any society can be found in how it treats its most vulnerable members.”
As Canada recovers and rebuilds from the pandemic, addressing the health of our seniors must be one of the country’s top political priorities.
For decades there has been much talk about the need for a national strategy for older people. However, politicians follow public sentiment and a lack of political will has stalled any meaningful reform.
Age discrimination smolders below the surface. Many Canadians were indifferent and cynical about the impact of COVID-19. Statements that COVID impacts only the elderly and those with medical comorbidities have dehumanized them and minimized the devastating impact of the disease on our most vulnerable.
Canadians are proud of Medicare and like to uphold its commitment to a just society. Only when our most vulnerable are treated with the dignity and respect they deserve will we achieve both the Gandhian measure and the just society to which Canadians aspire.
There are many ways to achieve this goal. Respect and care for our older adults must be supported through political ideology. Provincial and federal governments of all political persuasions can work together to achieve this. As we emerge from this pandemic, we must not be complacent about what has come to light; but instead, through sound public policy, work towards the betterment of older people in Canada.
Although the provision of publicly funded health care has evolved since the Health Care Act was passed. adopted In 1966, Medicare is still outdated, focused on treating disease rather than improving health. The system was built for the young, at a time when the average Canadian was 25 years old and Life expectancy he was 72 years old. The care that seniors require most, such as prescription drugs, community health services or long-term care homes, was not intended to be part of Medicare.
Despite recognition by provincial and federal governments over the past few decades of the need for reform, little progress has been made to revitalize health care. As such, the care we provide to our seniors has not kept pace with advances and has lacked innovation. The impact on the elderly, and more specifically those within community care settings, both private and public, during the pandemic is a tragedy that must be used as a platform to bring about change.
The Doug Ford government established the Ontario Long-Term Care COVID-19 Commission in July 2020 and its final report was published on April 30, 2021. Specific to long-term care homes in Ontario, its measures cover infection control practices, staffing and practice standards of care, leadership and accountability, and better integration with the healthcare system. broader medical care, among other things. The recommendations have application to other Canadian provinces and should be the basis of the reform.
More work has been done to develop new national standards for long-term care services. The Canadian Standards Council, the Health Standards Organization and the Canadian Standards Association are collaborating to develop these benchmarks, shaped by the needs of Canada’s residents, families and long-term care workforce.
The development of national standards is needed; it is encouraging to know that this work is underway and that an evidence-based, resident/family led approach will be adopted. The publication of the proposals is scheduled for December.
National standards are needed not only for care provision, but also for enabling mechanisms. We should have guidance on practice care expectations, staff complement, pay equity, and the mix of skill sets needed in long-term care. We must also have common principles for a model of care that balances the social and medical needs of older people. This would include agreement on infrastructure requirements, such as creating environments where residents are happy to call the place home rather than feel institutionalized, as well as integrating long-term care homes into the wider community. and the participation of residents. and families to co-design services.
Furthermore, it should be recognized that best practices exist in models such as the green house Y butterfly models where small houses of about 10 residents are cared for in an environment that feels like a home and not an institution. Governments commit heavily to these models when considering new long-term care infrastructure projects.
The federal government could play an important unifying role by implementing a dedicated federal transfer to care for the elderly to alleviate regional disparity and inequity. Such a transfer would be based on provincial compliance with criteria similar to those described in the Canada Health Law.
These conditions must arise from national standards to be released later this year. However, they need to be broader than simply focusing on long-term care and should extend to home care and health promotion initiatives for older people. Public dialogue and provincial collaboration should inform the final criteria and conditions.
There are examples of excellence in elder care provision that we can learn from and adapt to in the Canadian context. Denmark has focused on keeping older people living in their homes, through strengthened home care and assisted living services. Most older people prefer to live in their own homes as long as possible. Health systems must enable them to do so not only by expanding home care services, but also through the use of new technologies and an emphasis on prevention and early detection.
Strong home care services are both the patient-centered way of providing care for the elderly and a cost-effective model. When older people can stay in their homes and care is provided, the infrastructure and associated costs are avoided. Needs can be met in the community and addressed sooner rather than seeking expensive acute care services through emergency departments and urgent care centers.
Preventing the disease is preferred to treating it, for the good of the patient and the system. If we can better address the health needs of older people earlier, they will stay healthy longer and avoid premature intensive practical care.
Elder care policy should include a focus on wellness, education, adoption of healthy lifestyles, literacy with new technologies that can support health, and fostering a sense of community. To achieve this, it will be necessary to look beyond a system’s health portfolio and engage organizations that have the capacity to impact the social determinants of health, such as nonprofit groups, senior advocacy groups, community services and other human organizations. service ministries within government.
COVID-19 has brought to light the unsustainable state of elderly care in Canada. People of all ages and walks of life have felt shame and dismay at what the light has exposed. The widespread public reaction holds out the promise of action. Politicians will respond if the public is loud enough to demand change. ![[Tyee]](https://i0.wp.com/news.google.com/design-article.thetyee.ca/ui/img/yellowblob.png?resize=16%2C16&ssl=1){kind=small}