Promised new national standards for long-term care facilities in Canada have been published. This is part of Ottawa’s attempt to avoid a repeat of the alarming death toll in long-term care facilities that marked the early stages of the pandemic.
The Health Standards Organization (HSO) published a comprehensive 60-page standard on Tuesday to complement the 115-page standard published by the Canadian Standards Association Group (CSA) in December. The federal government has launched a standardization project in spring 2021.
Both organizations were tasked with developing standards to improve the quality of care in long-term care (LTC) housing nationwide. HSO focused on care itself, CSA on physical infrastructure.
The new standards are voluntary, but health experts say they won’t work unless nursing homes adopt them all without exception.
“It’s very kind of an all-or-nothing question. This is basically what standard care requires,” said the HSO technical committee that drafted the standard.
“My biggest fear is that unless we take these standards seriously and make them the basis for inspection, enforcement, quality improvement and accountability, they will be shelved. about it. “
The pandemic has exposed a fatal weakness in the LTC sector. In the first months of the pandemic, more than 80% of his confirmed COVID-19 deaths in Canada occurred in long-term care facilities and nursing homes. This is the highest percentage among Organization for Economic Co-operation and Development (OECD) member countries.
As of July 2022, more than 17,000 Canadian long-term care home residents have died from COVID-19, according to the National Institute on Aging.
Thousands of staff at LTC facilities have also been infected. More than 30 people died as a result. Some provinces had to call on the Canadian military to assist at LTC’s home.
Dr Sinha said the standards announced today would have saved many lives if they had been enforced during the COVID-19 outbreak.
“If these standards had been put in place earlier, I don’t think we would have led the world in the worst performance in long-term care. Frankly, I think we were one of the best,” he said. said.
The two sets of standards are intended to complement each other. They went beyond pandemic preparedness, from preventing falls and maintaining flexible meal schedules (some LTC residents didn’t eat during staff shortages over the course of the pandemic), We handle everything from end-of-life care to emergency planning for catastrophic events.
The new criteria also directly address how COVID-19 has affected the quality of long-term care. As such, flexible visitor policies, rules that balance the rights of LTC residents with the health and safety of others, and recommendations for maintaining social interaction with families during public health emergencies. is included. .
“These standards will first and foremost improve the quality of care for residents, but if these homes show that they are making these improvements, they will also improve the business of care,” Alex said. Mihayridis said: A professor at the Institute for Biomedical Engineering at the University of Toronto and chair of the technical subcommittee for the CSA Group that developed the infrastructure standards.
The New Standard for LTC Buildings
This standard sets new standards for the construction and renovation of LTC homes. They say single rooms in LTC homes should have three-piece bathrooms for residents only, while shared rooms should have access to special privacy rooms for “intimate acts.” .
CSA standards require access to dedicated hand hygiene sinks and outdoor spaces at all levels of long-term care facilities. They provide guidance on waste management, video surveillance, signage, and staffroom design.
“It costs money to change infrastructure and build infrastructure,” says Mihailidis. “But … with plans to build new long-term housing across the country, time is of the essence. Our hope is that they will consider our standards.”
Much of the pressure on LTC Homes due to the pandemic has resulted from staffing shortages and recruitment struggles. Not stipulated. However, they point out that the evidence strongly supports requiring an average of 4.1 hours of care each day.
“Right now, the biggest challenge for many long-term care facilities is staffing and recruitment, especially when hospitals are also facing significant staff shortages and paying much higher wages,” Sinha said. says the doctor.
For many people still grieving the loss of loved ones in long-term care during the pandemic, standards are a welcome step forward, but only the first step.
Eddie Calisto-Tavares’ father, Manuel Calisto, was one of 56 people who died at Winnipeg’s Maples Long Term Care Home during the second wave of COVID-19 in the fall of 2020. It was the worst damaged home in the state.
“How do families like mine get these standards[to enforce]? They are beautiful sentences, but how do they become enforced? How can we hold them accountable?” asked Callisto Tavares.
When her father contracted COVID-19 at the end of October 2020, Calisto-Tavares fought to be able to see her father. She said the sight she saw at the LTC home still haunts her.
“I heard people screaming. They were hungry…it was very cold. They were screaming thirsty,” she said. “She knew little help was coming, so she had no choice but to say, ‘Help is coming, help is coming,'” she said.
Although the standards are mandated by the federal government, the provision of health care is under state jurisdiction. Some critics and his LTC resident family are calling on Ottawa to set standards and mandate.
$13.7 billion problem
Elderly Minister Kamal Kellah said the government was very preparatory to formulate the Safe Long-Term Care Law promised by the Liberal Party during the last election campaign. She argued that the introduction of the standard itself was an important milestone.
“These standards make a difference, are a step in the right direction, and will definitely improve the lives of Canadians and seniors across Canada,” she said.
In its 2021 budget, Ottawa has set aside $3 billion to help the state implement the standards. Experts say that this work will cost much more.
Congressional budget officials estimate the cost to fix long-term care at $13.7 billion annually, more than is currently being spent. Many long-term care client advocates hope the long-awaited new federal-state health care contract can cover at least some of those costs.
“What kind of carrots and sticks will be involved? Will it be the Canadian Health Transfer and the money associated with it? Each state?” Terry Lake, CEO of the BC Care Providers Association, asked that it is a trade group representing long-term care and assisted living providers in British Columbia.
Former state health minister Lake said he fears the issue of long-term care has “lost off the political radar”.
“Of course, throughout the pandemic that was the biggest issue … and now it seems to have fallen off the priority list. And we can’t let that happen,” he said.
Much of the debate about long-term care in Canada has been about whether for-profit facilities should be allowed to operate. For-profit and non-commercial housing in B.C. had similar results, Lake said.
The process of developing standards has seen a very high level of input from the public. This suggests politicians need to keep up with the public’s desire for change, union officials said.
“If there is resistance from prime ministers across the country on any of these standards, or if there is any federal interference in this file, I believe they have grossly misunderstood the will of the people they represent.” Secretary of State Candace Rennick said Treasurer of CUPE, one of the leading unions representing tens of thousands of long-term care workers across Canada. She has worked in long-term care facilities in various capacities.
“People want enforceable standards. They want penalties and consequences for those who don’t follow the rules. I just want to know that it’s going to be the last day, respectfully, and it’s not happening.”
