Wake-Up Call: Canada's Long-Term Care Crisis

Seniors’ advocates have been calling for reforms to address the crisis in long-term care for years. Now, the COVID-19 pandemic has given a powerful—and painful—wake-up call to the systemic gaps in our long-term care sector, with 82 per cent of pandemic-related deaths in Canada happening in care homes. 

Event moderator Habib Chaudhury, Professor and Chair of SFU’s Department of Gerontology, opened the event by advocating for systemic reformation founded upon holistic care, stating that the current crisis provides us with a historic opportunity to enact transformative change within the long-term care system.

He was joined by the following speakers for a deeper discussion of the issues and how to address them.

Dan Levitt
Executive Director, Tabor Village

Dan Levitt asserted that individuals living in long-term care “have a life worth living” and that their choice of address during a pandemic should not necessitate them revoking their human rights. He argued that people in aged care should maintain the following rights: self-initiated access to medical care, the ability to move out and have a choice in where they want to live, the capacity to maintain familial and community connections, and access to end-of-life care. Dan recommended balancing the risks against such factors as loneliness to maintain the foundational rights of those in aged care.

Jennifer Lyle
CEO, SafeCare BC

Jennifer Lyle used three terms to describe the ongoing issues within the long-term care sector: “understaffed, under-resourced, and under pressure.” COVID-19 has exacerbated existing challenges and resulted in new ones, such as the critical shortage in personal protective equipment (PPE). Jennifer stated that the single-site staffing order – instituted by the B.C. government to reduce the spread of infection by ensuring care staff do not work at multiple care sites – has led to further staffing shortages. Further, she spoke to the hidden mental health pandemic caused by the pressures placed upon staff. Care workers are anxious, burned out, and afraid they may introduce COVID-19 into their facility or take it home. While community efforts have improved the situation in B.C., Jennifer cautioned that these issues will arise again; they may just look different.

“We must do better. We owe it to our elders and we owe it to our future selves,” she said.

Lou Black
Director of Research and Policy, Hospital Employees’ Union (HEU)

Lou Black delved into the issues faced by care aides who work in long-term care. As a union, HEU represents many care aides, of which one third work in the long-term care sector. Lou stated the single-site order both highlighted and helped remedy existing issues in long-term care. Existing staffing shortages were exacerbated by the single-site order because there are fewer casuals to provide relief in the system; however, the order also illuminated that equitable wages for these essential workers are possible. Sustaining the temporary wage increases, introduced by the single-site order, holds the potential to mitigate the need for care aides to work at multiple sites again. The pandemic clarified the need for wage increases and stabilization, permanent full-time positions, and enhanced benefits.

“We call them heroes, we did the 7:00 p.m. cheer for many months, and we need to make sure we back that up with actual investment,” Lou said.

Joy Parsons
CEO, Fair Haven Homes Society

Joy Parsons oversees the care of 600 older adults in addition to supporting 400 staff members. She spoke about the chaos of this unprecedented time, the overwhelming amount of daily information, the associated staff and family member anxiety, and her race to support her staff to enable them to provide care. Joy noted that the average age of the health care workers in her facilities is 47, with many belonging to the “sandwich generation” who support both their children and their parents while maintaining full-time employment. Despite these pressures, Joy’s staff worked to develop unique solutions to allow for safe family visitation and access to PPE.

“Our staff are the foundation of making sure we’re doing the best we can,” she said.

Isobel Mackenzie
BC Seniors Advocate

Isobel Mackenzie talked about the fragmentation of the long-term care system and how the current model of complex care is no longer adequate. Isobel advocated for a shift in how we conceive aged care, beckoning us to focus on the intrinsic needs of those in long-term care in addition to their basic needs. The public outrage in response to the conditions in facilities demonstrates the necessary public and political will to advance an agenda for reformation. 

However, “we need to ensure this groundswell of public support for seniors is sustained once we are through the pandemic,” she said.

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What remains clear is that our current system is characterized by a complex set of issues which impact care provision. The impact of this crisis is different depending on your role and interaction with this system. Addressing the crisis will require a coordinated multidisciplinary approach; maintaining siloed perspectives will cause conflict and slow progress.

Nevertheless, we are unified by our passion for change, representing an opportunity for a collective effort to drive meaningful systemic reformation. We unequivocally owe this to the individuals who have lost their lives to this, to those who are at risk in this system, and to the individuals who will need this system in the future. As Jessie Williams, Director of Indigenous Relations for SFU’s Faculty of Arts and Social Sciences, eloquently stated in her opening welcome to the event, “We must protect our elders as they have protected us. We are all elders in training.”

Further reading: “A Billion Reasons to Care” – BC Seniors Advocate