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What's wrong with long-term care? Follow the money


$1992.00. That’s how much money a Canadian senior citizen gets in Canada Pension Plan (CPP) and Old Age Security (OAS) supplements every month. If he or she is living alone and doesn’t have any additional pension, it's not enough to live on — especially in Toronto. Perhaps this is the very first number we need to look at in order to take a good, hard look at the current state of long-term care (LTC) in this country.

Many seniors are driven into long-term care as soon as their pension makes independent living unaffordable. We have a public framework for LTC that says anyone who needs care in the final years of their life should get it for the total cost of their CPP and OAS. Here in Toronto, that means that you will get a bed in a shared room in a long-term care facility. You will receive three meals a day, nursing care and assistance from personal support workers as well as periodic visits from an attending physician. An explosive report from our Canadian Armed Forces, who provided emergency relief to the LTC system at the height of the COVID-19 outbreak, revealed deplorable conditions in some of our long-term care homes. It turns out that the $1992.00 pension that LTC residents hand over (plus a supplement from provincial governments) is not enough to provide any quality of care.

If that money can't sustain you at home, why do we expect it to sustain you in a setting where you are receiving full-time care? Just once, I would like to hold government responsible for a failing without having to discuss the tax dollars involved — but I'm afraid that in the case of long-term care in Ontario, you simply must "follow the money." Public vs private homes It appears the conditions of the 10 LTC homes run by the City of Toronto are slightly better than others. This is probably because, every year, the City contributes an additional $48 million of your property taxes to help operate them. All municipalities in Ontario are required by provincial legislation to run at least one long-term care home each. Toronto ended up with 10 when the six cities and Metro government amalgamated.

Currently there is no federal transfer of dollars to our LTC homes. The fact that residents pay their CPP/OAS to the homes is deemed a federal contribution. And unlike the bulk of Canada's universal health care system, the federal government has no jurisdiction over long-term care. Given that the damning exposé by our military covers LTC in both Ontario and Quebec — and one of the earliest and most shocking outbreaks was in British Columbia at the Lynn Valley Care Centre — maybe it's time the feds stepped in to raise the quality of care nationwide. Key areas Many of the issues with our LTC lie in these key areas: Labour: Reducing the number of full-time employees to the bare minimum erodes commitment to their jobs and sends caregivers all over the community in search of a living wage. While homes run by the City of Toronto pay an average of 13 to 17 per cent more than private-run homes, the scarcity of permanent, full-time positions with benefits is an issue across the board. Technology: There are several medical and health information issues. Total lack of investment in technology threatens medical record-keeping, cleanliness, human resources management and the monitoring needed to examine the correlation between cost-cutting and quality.

Quality control: Inspection and quality control by provinces is patchy at best. There is little accountability when governments cut inspections — something Premier Ford has been reluctant to admit is that he has scaled back inspections drastically since he took office. Upkeep: In terms of bricks and mortar, little or no new construction is happening since high-income baby-boomer markets are driving demand for luxury "retirement living," where the average cost for a room is about $8000 a month. Provinces take note of repairs and maintenance needed but then don't provide the funding to make those repairs. It's time My 93-year old Dad resides in long-term care. The hard-working women who care for him are amazing — they fought hard for months to have zero resident cases of COVID-19. Unfortunately, just today they marked their first two cases. The number of staff they function with bears no resemblance to the number who used to be on hand at Extendicare Guildwood, where my grandfather quietly passed away on a sunny day in May of 1981. This week, Guildwood has 93 resident cases, 25 staff cases and 27 residents have died of COVID-19.

It's time for a nationwide Royal commission into long-term care — and it must result in something tangible. Australia embarked upon such a commission and found themselves lacking. Elder care homes were in desperate condition and all the talk in the 1990's of "Aging-At-Home" had never come to fruition. Today, the Australian government offers home care packages that will pay up to $50,000 a year for qualified seniors to have one consistent caregiver coming to their homes. Already on a path to improving long-term care when COVID-19 began, Australia has flattened its curve. Of its just under 8,000 COVID-19 cases and 103 deaths, about 13 per cent were Australians over age 60. Thus far, 90 per cent of Canada’s 6,735 deaths have been people over 60, the bulk of them being over 80 years of age. Implementing a Royal commission will no doubt cost us as taxpayers. In a nation that is supposed to be a world leader in social responsibility, it's the very least we can do. Our parents and grandparents are worth it.

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