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Only a public inquiry can fix Ontario’s long-term care system, town hall participants told

Pandemic highlighted systemic failures in province’s out-dated system of caring for vulnerable patients

Participants in an online town hall meeting held to discuss long-term care concerns in Ontario were told that only an independent public inquiry will ensure that the inherent problems in long-term care (LTC) homes are resolved and that accountability will prevail. 

The event was hosted live on Facebook by Sudbury New Democrat MPP Jamie West on Tuesday evening with invited guest speakers and members of the public submitting questions. 

West began the event by recounting what he said were the well-documented problems of long-term care homes in Ontario: residents being neglected by staff who are overworked; a shortage of available beds; long wait lists to get admitted; lack of air conditioning, and; shortages of staff.

Among those who commented on conditions in LTC homes was Terry Martyn, co-chair of the family council at Pioneer Manor in Sudbury. Martyn's wife has been a resident there since 2013. He remarked that too many of the problems are well known and have been in place for years.

"What needs to be improved?" Martyn asked. "A lot of things."

One of the key concerns he said is the "cookie cutter" approach taken by the provincial government in trying to solve problems. He said the one-size-fits-all idea doesn't work well because so many LTC homes are different. 

"We know that throughout the province that COVID hit some areas more severely than others. What needs to be improved I think is a more regional approach to decision-making," said Martyn.

By example, he said he can get a sense of "big picture" provincial health issues by listening to the provincial health officer, but when it comes to local concerns, he relies on the local Medical Officer of Health.

"I listen to Dr. Penny Sutcliffe, our medical officer of health, and she understands all the regional details," said Martyn. "She is actually the one I listen to more." 

Another concern, he said, is the need for homes to provide each patient with a "designated care person" such as a spouse or family member who would be allowed to come and go as necessary to care for their loved one. This idea was also floated in a recent column for from Ward 5 Coun. Robert Kirwan.

"That emotional attachment is extremely important," Martyn said. 

He added that a whole new protocol is required for whenever the second wave or a new spike of coronavirus hits. 

"Residents cannot go through another four months of lockdown," he said.

Also speaking on LTC concerns was Maria Casas, a Sudbury registered nurse with more than 36 years of experience including extensive work in long-term care homes and membership on a best practices group.

Casas said most of her experiences have been positive. That said, Casas also revealed that experiences from one home to the next can be different depending on available resources. She said this included pay levels and staffing.

She said the COVID-19 pandemic had changed everything by forcing all workers in all homes to put in extra effort.

"It has put all of our resources forward. Everyone has had to take on a role. It has been an all-hands-on-deck approach to managing it. Public Health Ontario and the Ministry of Health have been learning as they have been going," she said. 

Casas said new directives were being issued all the time, sometimes a new directive would come out just one day after the previous directive. 

"So we've had to learn to be very flexible and change very rapidly," she added.

She said one of the biggest concerns is the need for more staff and more funding.

Casas said an example is the fact that some residents have complex medical conditions and are regularly being admitted to long-term care homes whereas that never would have happened 20 years ago.

"There was a time when if you had a catheter to drain your bladder, if you needed to be fed by a tube or if you needed supplemental oxygen, you couldn't live in long-term care. Well, now we have all of that and more," said Casas. 

She said it demonstrates the need for a more professional and complex medical response. 

She added there needs to be a legislated staffing level that is more realistic with today's needs.

One odd requirement is that every long-term care home is required to have a registered nurse on duty at all times.

Casas said the odd part is that this could be for a 50-bed home or a 500-bed home, the requirement is still a minimum of one nurse on duty. There is no requirement to have more than that.

Another online speaker was London-Fanshawe MPP Teresa Armstrong, the NDP critic for long-term care and home care. 

She said her key concern is that everyone knows of the problems in long-term care yet very little has been done historically with past governments. She too spoke of the need for improved staffing levels and funding for additional staff. Armstrong said legislation should be introduced to mandate that individual residents get a minimum of four hours of direct care each day. This would be for things such as getting dressed, getting washed, toilet assistance and getting fed. 

Armstrong said the stories from LTC workers are heartbreaking.

"The workers, they don't get a lunch break. They don't get their breaks in between,” she said. “They're short-staffed when they go into work. At the end of the day, you know they've told me they get in their car and they just break down crying, because they couldn't look after the residents."

Armstrong said many families want the staff to have enough time to give individual care to their loved ones when family cannot be there.

West spoke up to remind the meeting the Ontario government has promised to have a commission look into the problems in LTC homes. He asked Armstrong to comment.

She said a commission is not the same as a public inquiry. She said a commission is a government run initiative and so it is not really independent.

Armstrong said commission members are hand-picked by the government and there is no input on the parameters of the investigation or how they will report back when their work is done.

"It's all secret. Nobody has a clue what's happening," said Armstrong.

She said with an open inquiry, everything is transparent and people are aware of when and how to participate.

"It's something that we need to do, and it is long overdue."

About the Author: Len Gillis, local journalism initiative reporter

Len Gillis is a Local Journalism Initiative reporter at covering health care in northeastern Ontario and the COVID-19 pandemic.
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