Restoring trust: COVID-19 and the future of long-term care in Canada

Abstract

The Royal Society of Canada Task Force on COVID-19 was formed in April 2020 to provide evidence-informed perspectives on major societal challenges in response to and recovery from COVID-19. The Task Force established a series of working groups to rapidly develop policy briefings, with the objective of supporting policy makers with evidence to inform their decisions. This paper reports the findings of the COVID-19 Long-Term Care (LTC) working group addressing a preferred future for LTC in Canada, with a specific focus on COVID-19 and the LTC workforce. First, the report addresses the research context and policy environment in Canada’s LTC sector before COVID-19 and then summarizes the existing knowledge base for integrated solutions to challenges that exist in the LTC sector. Second, the report outlines vulnerabilities exposed because of COVID-19, including deficiencies in the LTC sector that contributed to the magnitude of the COVID-19 crisis. This section focuses especially on the characteristics of older adults living in nursing homes, their caregivers, and the physical environment of nursing homes as important contributors to the COVID-19 crisis. Finally, the report articulates principles for action and nine recommendations for action to help solve the workforce crisis in nursing homes.

When apathy is deadlier than COVID-19

“…Inadequate LTCH funding from provincial governments and pandemic preparation revealed three existing systemic risk factors for poor outcomes among LTCH residents ( Fig. 1) 3,6 . First, LTCHs are structured so residents share rooms (two to four individuals per room) 3 , making physical distancing impossible.…”

Covid-19 and Priorities for Research in Aging

“…Although the pandemic has affected older adults across Canada regardless of their living arrangements, no part of this system has been impacted more profoundly than have long-term care (LTC) homes 4 . In Canada, 80 per cent of the deaths due to Covid-19 occurred in LTC homes, with this being the highest percentage of any reporting country worldwide 5 (Estabrooks, Flood, & Straus, 2020; Estabrooks, Straus, et al, 2020). However, only about 7 per cent of older adults in Canada reside in LTC homes, 6 with most of the older adults living in the community and requiring support from home and community care services or family members to allow them to function relatively independently 7 .…”

Characteristics and Work Life Quality of Nursing Home Care Aides in Canada

“…The need for profound, systemic change in the nursing home sector has been clear for decades. 1 The coronavirus disease 2019 pandemic has exacerbated existing deficiencies in the sector. 2 , 3 Care aides (called certified nursing assistants in the US) provide up to 90% of direct care in Canadian nursing homes.…”