We have nearly 5 million citizens aged 65 and older in Canada, according to census data from Statistics Canada. The majority of these older members of our population live in their own homes. 2.6% live in residences for seniors. 4.5% reside in long-term care homes (LTCH), such as nursing homes, chronic care facilities, or long-term care hospitals. And almost 30% of seniors age 85 and over live in special care facilities.
As Covid-19 continues to tear through our nation, the places that are hardest hit are our long-term care homes. As of this writing, our seniors who reside in these facilities make up nearly half of all Coronavirus deaths across Canada.
Why Are Long-Term Care Residents More at Risk from Covid-19?
As you age, your immune system becomes less efficient at fighting germs, viruses and infections. Conditions that you would have been able to fight off easily in your youth become more difficult to beat. Many older adults also have heath conditions that tax their immune systems, leaving them more vulnerable to attack.
Long-term care residents have other additional risks than at-home seniors, including:
- A revolving door of caregivers and visitors from outside of the facility who may have been exposed to the coronavirus
- Staff members who may work at more than one facility
- Multiple residents sharing a room
- Shared common areas where residents, caregivers and visitors can gather
- Inability to quarantine sick residents from healthy residents
- Staffing shortages which subject residents to poor living conditions or sick workers
Long-term care homes suffer from staffing shortages even at the best of times. When a contagion such as Covid-19 sweeps through an establishment, staff members struggle to keep up with the increased demand for attention that illness brings.
Sick residents require more help eating, dressing, bathing and toileting, while health care workers struggle to keep up.
Unlike a hospital, where patients enter for a specific condition and leave when their treatment is complete, nursing homes are residences where people live year-round. Their caregivers go directly from one room to another, often not washing their hands in between, particularly if the residents do not show symptoms of illness.
Government Policies for Long-Term Care Homes in Canada
Certain policies from the government or the facility also increased risks for residents, such as:
- Failure to provide adequate personal protective equipment to staff
- Directives against wearing personal protective equipment
- Refusal to test staff members who may or may not have shown symptoms of Covid-19
- Requiring staff members to work when sick
After other provinces adopted more stringent safety measures, Ontario followed suit to protect the vulnerable older population.
On April 15, the Ontario Ministry of Health issued COVID-19 Outbreak Guidance for Long Term Care Homes (LTCH) to provide directives for combating the spread of the virus.
This document includes the following topics:
- Active Screening of Staff and Essential Visitors. LTCHs must immediately implement active screening of all staff, essential visitors and anyone else entering the home for COVID-19 except for emergency first responders, who should, in emergency situations, be permitted entry without screening. Essential visitors would include medical personnel and visitors of terminally ill patients.
- Active Screening of All Residents. Long-term care homes must conduct active screening of all residents, at least twice daily (at the beginning and end of the day) to identify, and test for COVID-19, if any resident has typical or atypical symptoms of COVID-19.
- Ensure Appropriate Personal Protective Equipment (PPE). Facilities should have adequate amounts of proper PPE available to staff and visitors.
- Staff and Essential Visitor Masking. Long-term care homes should immediately implement that all staff and essential visitors wear surgical/procedure masks at all times for source control for the duration of full shifts or visits in the long-term care home.
- Receiving positive test results. Long-term care homes must consider a single, laboratory confirmed case of COVID-19 in a resident or staff member as a confirmed respiratory outbreak in the home. Once an outbreak has been declared, residents, staff or visitors who were in close contact with the infected resident or those within that resident’s unit/hub of care should be identified.
- Communications. Long-term care homes must keep staff, residents and families informed about COVID-19.
- New admissions and re-admissions should be screened for symptoms and potential exposures to COVID-19. All new residents, including readmissions must be placed in isolation under droplet and contact precautions upon admission to the home and tested for COVID-19 within 14 days of admission.
Other measures that should be undertaken by staff include:
- Modifying internal activities to promote adherence to physical distancing measures for residents and among staff.
- Ensure sufficient swabs are available to facilitate prompt testing, if needed.
- Conduct an outbreak assessment if even one resident or staff presents with new symptoms compatible with COVID-19. The sick individual should also be quarantined as possible as appropriate.
Lawsuits Against Long-Term Care Homes from COVID-19
Families who have loved ones who have been injured or who have perished due to exposure to COVID-19 while in the care of Long-Term Care Homes are seeking justice. These lawsuits claim that these facilities were negligent in their duties and failed to protect residents from the pandemic, resulting in 79 percent of the coronavirus fatalities across Canada.
Families have been outraged about the conditions that their vulnerable loved ones have been forced to endure. After entrusting the LTCHs with care of their elderly relatives, the families believed that they would be cared for properly. Instead, facilities suffered breakdowns in structure. The LTCHs instead failed to:
- Adequately staff facilities. Companies operated with too few staff members in an attempt to maximize profit. There was inadequate number of personnel to compensate for sick staff members and increased need of care for sick residents.
- Provide access to sufficient quantities of Personal Protective Equipment. Many facilities which had PPE on hand did not have sufficient amounts to protect residents and staff.
- Limit exposure to the COVID-19 virus. Many LTCHs continued their open-door policies for visitors, allowing contagions to freely enter the home from the outside.
- Implement stringent protocols. Staff at many locations did not wash their hands frequently enough while moving from resident to resident.
- Separate sick residents from healthy residents. Infected and uninfected individuals were frequently housed in the same room, spreading infection. Infected individuals were permitted into common areas where healthy residents were exposed to the virus.
- Test for infection. Tests for staff members, visitors and residents were not available, even when outbreaks were in progress and residents were actively exhibiting symptoms of COVID-19.
Notable LTCH COVID-19 Outbreak Examples
LTCHs across Ontario are on the front lines of the battle against the coronavirus as families struggle to figure out what they can do to protect their loved ones.
Eatonville Care Centre (Etobicoke)
The military stepped in to assist overwhelmed staff members when the number of COVID-19 deaths at the facility approached 40, with nearly 150 other residents and 88 staff members testing positive for the virus. With so many infected individuals, isolation became impossible. The numbers continue to escalate.
Pinecrest Nursing Home (Bobcaygeon)
Pinecrest attracted media attention when the death toll shot to 29, with 20 additional residents and eight staff members who showed symptoms but have not been tested.
Seven Oaks (Scarborough, Toronto)
Seven Oaks achieved notoriety when 35 residents at Seven Oaks died due to complications from COVID-19. Another 72 residents have tested positive for the virus and 25 staff members are showing symptoms of the virus.
Orchard Villa (Pickering)
Orchard Villa made headlines when 31 of its residents died of COVID-19-related complications. Over 100 other residents tested positive for COVID-19, as did over 40 staff members.
Standing for our Seniors
Although COVID-19 affects people in all walks of life, no group is affected as tragically than our elderly population living in Long-Term Care Homes. Living in close proximity to others provides a greater opportunity for exposure, while having immune systems that are more likely to be compromised leaves them at risk for serious complications.
If you have a loved one who has been injured or has passed away due to complications from COVID-19 while in an Ontario Long-Term Care Home, contact us today to find out how we can help you get justice for your family.