# Long Term Care public vs. private



## Longtimeago (Aug 8, 2018)

So the cat is 'out of the bag' big time in regards to how we treat our seniors in Canada. While every Canadian has free access to medical care through our Provincial systems, that only extends to care by a doctor or in a hospital. Once a senior needs 'long term care' and is shunted out of their home or a hospital bed to a Long Term care nursing home whether public or private, they are no longer provided care under the Canada Health Act.

The fact that our treatment of seniors in these nursing homes is inadequate is not news to anyone who has looked into our system but just how bad it really is has now been forced into the view of the general public overall. Of all our Covid-19 deaths in Canada, 80% have been in LTC homes. What's more, if someone is in a private LTC have FOUR times as many deaths as in a public/municipal LTC. 









No easy fix for long-term care home problems highlighted by COVID-19


While the data suggests long-term care homes across the globe have suffered unduly from COVID-19, residents in Canada's system seem to be suffering more than others.



www.ctvnews.ca













Ontario says it will ‘review’ long-term care system post-COVID-19, but won’t commit to independence


Move comes after call for a public inquiry into the deaths of more than 1,100 residents and as it was revealed the province has been inspecting senior’s facilities during the pandemic by telephone




www.theglobeandmail.com





There has long been an unspoken and unseen neglect of our seniors. Once you are no longer seen as productive but only a 'burden', no one wants to know about you other than your immediate family perhaps and that's if they're lucky.

We call ourselves civilized. That's a lie.

This entire system needs to be changed and should be a major issue in any upcoming election at any level of government. We need to get rid of private nursing homes ENTIRELY and we need all nursing homes to come under the Canada Health Act, just like ALL OTHER healthcare in Canada. We need adequately paid PROFESSIONALLY qualified staff at all levels, in full time jobs. Just like we expect to encounter whenever we need to interact with any other part of our healthcare system from our family doctor to our hospitals.

Regardless of political party, I will be voting for those who clearly state their plans for addressing this issue.


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## kcowan (Jul 1, 2010)

Watch for the federal politicians that claim they will do something about it! Also watch for provincial politicians spouting about federal issues. These are common tactics for politicians because the average elector knows little about federal versus provincial clearly delineated responsibilities.


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## Prairie Guy (Oct 30, 2018)

Longtimeago said:


> There has long been an unspoken and unseen neglect of our seniors. Once you are no longer seen as productive but only a 'burden', no one wants to know about you other than your immediate family perhaps and that's if they're lucky.
> 
> We call ourselves civilized. That's a lie.


I guess my family is "lucky". We are taking care of our parents as they age...some are in assisted living and others are still on their own. Assisted living provides support but the kids must also do their share. Visit regularly and chip in at the very least.

For those who put their patents in a home and then just expect that the government will take care of everything until they gently pass away...well, I wish you good luck when you get old and your kids take the same attitude.


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## Longtimeago (Aug 8, 2018)

kcowan said:


> Watch for the federal politicians that claim they will do something about it! Also watch for provincial politicians spouting about federal issues. These are common tactics for politicians because the average elector knows little about federal versus provincial clearly delineated responsibilities.


It will have to be addressed both by the federal government and the provincial governments kcown, not just one or the other if that is what you were suggesting. 

The Canada Health Act is federal and set the criteria that the provinces must meet to get federal funding for the province's healthcare system. So I expect to see the federal government make changes there to include very strict and detailed criteria that must be met for nursing homes.

The provinces will then have to meet those criteria and I expect to hear them saying that they will do so and provide sufficient public nursing homes to accommodate all of their senior citizens who need that care. I also expect the provinces in doing that (proving enough public nursing homes), will put most of the private homes out of business. The only private nursing homes I see continuing are the very top end homes but I also expect the provinces to enact regulations that force them to meet the same criteria as the public nursing homes do. ie. fully qualified and certified staff at all levels and in full time positions.


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## sags (May 15, 2010)

There will be a reckoning when the virus is gone. Inquiries will look into government policy pre-pandemic.

The history is well documented in the media and it won't look very good for the Ford government.


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## MrMatt (Dec 21, 2011)

The problem is that nobody saved to pay for their care, and now everyone wants to be taken care of for free.

At our current 50% tax rate, we simply can't afford to provide all the services people want.


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## bgc_fan (Apr 5, 2009)

kcowan said:


> Watch for the federal politicians that claim they will do something about it! Also watch for provincial politicians spouting about federal issues. These are common tactics for politicians because the average elector knows little about federal versus provincial clearly delineated responsibilities.


So, where does long term care fall into the clearly delineated responsibilities? I wouldn't consider it to be health care since not everyone in a long term care facility requires medical attention. 
https://laws-lois.justice.gc.ca/pdf/const_e.pdf


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## james4beach (Nov 15, 2012)

sags said:


> There will be a reckoning when the virus is gone. Inquiries will look into government policy pre-pandemic.
> 
> The history is well documented in the media and it won't look very good for the Ford government.



We're seeing a huge failure of the private healthcare system (care homes in Ontario). Private long-term care systems are not working. There needs to be stronger regulation and more uniform oversight and procedures.

Canada must put an end to privately owned long-term care homes: Singh



> OTTAWA -- In light of numerous COVID-19 outbreaks at long-term homes across the country, NDP Leader Jagmeet Singh says Canada should put an end to privatized facilities and establish a universal framework for seniors care.
> 
> In an interview on CTV’s Question period airing Sunday, Singh says the government must look to bring long-term care under the Canada Health Act and make it federally regulated, while doing away with the private system all together.


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## Money172375 (Jun 29, 2018)

I remember reading articles last year saying LT Care homes were a growth industry and a good place to invest due to the changing demographics. So much for that....


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## MrMatt (Dec 21, 2011)

james4beach said:


> We're seeing a huge failure of the private healthcare system (care homes in Ontario). Private long-term care systems are not working. There needs to be stronger regulation and more uniform oversight and procedures.
> 
> Canada must put an end to privately owned long-term care homes: Singh


I don't think it's a public/private problem.
I think it's a complete lack of oversight.

Care for the elderly is also a complex issue, who pays, and when should they pay?

Also if there are no spots available, would you chose second rate care, or no care?


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## Eclectic12 (Oct 20, 2010)

Longtimeago said:


> ... There has long been an unspoken and unseen neglect of our seniors. Once you are no longer seen as productive but only a 'burden', no one wants to know about you other than your immediate family perhaps and that's if they're lucky ...


From what I observed ... my parents received pretty much the same care as I received in the hospital.

Those in it for the pay cheque cut corners and those who were in it as a profession took extra care.

In either setting, being on one's own without an advocate dramatically changed what was discussed, what was done and addressing any gaps.


Don't get me wrong ... I'm all for improvements. I'm not convinced that being under the Health Care Act is a panacea that fixes everything without hard work and long term focus on the situation.


Cheers


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## Eclectic12 (Oct 20, 2010)

sags said:


> There will be a reckoning when the virus is gone. Inquiries will look into government policy pre-pandemic.
> 
> The history is well documented in the media and it won't look very good for the Ford government.


With the way people around me ignore their parents/those who are aging, I doubt much will change.

IAC, I'd rather have a long term fix than focus on johnny come lately as it's been a problem for decades.


Cheers


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## Eclectic12 (Oct 20, 2010)

MrMatt said:


> The problem is that nobody saved to pay for their care, and now everyone wants to be taken care of for free ...
> I don't think it's a public/private problem.
> I think it's a complete lack of oversight ...


I'd have to check the differences between the LTC act and the Retirement Home Act.

From what I've observed of the staff cutting, it seems far more aggressive in the private homes. It reminds me of the corp I left where the bean counters said the quarterly numbers added up to cutting two staff, the manager said all the staff on the bench had been cut so that doing so would mean having to call someone in from a paying contract and the bean counters said "do it".

Some around here who cut staff are charging $5K a month yet somehow, don't need the staff they did even a year or two ago. And that's staff that's making at least 10% less than those working in a nursing home.




MrMatt said:


> Money172375 said:
> 
> 
> > I remember reading articles last year saying LT Care homes were a growth industry and a good place to invest due to the changing demographics. So much for that....
> ...


There are likely going to be changes but unless kids/friends decide to take on people who would have gone to a retirement or nursing home - it will still grow.

How much is the fourteen year waiting list likely to shrink?


Cheers


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## Longtimeago (Aug 8, 2018)

MrMatt said:


> The problem is that nobody saved to pay for their care, and now everyone wants to be taken care of for free.
> 
> At our current 50% tax rate, we simply can't afford to provide all the services people want.


That response irks me. Why would you single out seniors as not having saved to pay for their care? Why do you not suggest that anyone having children should have to save to pay for their children's education? Let's divert the money we spend on free education and use it to provide senior care. How's that sound to you? Why should kids get a free education but seniors who have contributed for a lifetime get cast aside? Seniors don't want to be 'taken care of for free', they want to be taken care of in RETURN for what they have contributed to our society throughout their lives. 

Or how about this solution, everyone should be expected to take care of their own parents, grandparents in their homes as was the cultural norm in most countries including Canada, in the past. Why should we allow people to say, 'I take care of me and my kids but my parents are their own or someone else's responsibility.'

To give you an example of how that would look, when I lived in Greece, if someone had a relative, even say a second cousin who needed a place to live and care, the family had the responsibility to insure they got the help they needed. If they did not provide for their extended family, they were seen as a failure by the cultural norms. In 7 years of living there, I never saw ONE homeless person living on the street. A family member HAD to take them in if they wanted to preserve their 'face'. We used to have 'family units' but today those do not extend to including seniors in a lot of families.


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## MrMatt (Dec 21, 2011)

Longtimeago said:


> That response irks me. Why would you single out seniors as not having saved to pay for their care?


Because it's a thread on long term care for seniors.



> Why do you not suggest that anyone having children should have to save to pay for their children's education?


Because that would be off topic.



> Let's divert the money we spend on free education and use it to provide senior care. How's that sound to you?


Shortsighted.



> Why should kids get a free education but seniors who have contributed for a lifetime get cast aside?


I pay for my childs education.



> Seniors don't want to be 'taken care of for free', they want to be taken care of in RETURN for what they have contributed to our society throughout their lives.


Ahh, the great "contribution". 
They didn't save.
They put our governments massively into debt, and promised themselves big benefits that they never planned to pay for themselves.
I'm glad the government finally got around to fixing CPP, (in 1996), but the plan was to dump the cost on future generations.

The reality is governments and individuals have been spending beyond their current and future means for decades, and we're getting really screwed by it. I don't blame the individual seniors, many elderly people aren't financially literate, and simply trusted that the government was taking care of things.

This is no different than voters today, who aren't taking responsibility either.

None of this changes the fact that we can't afford to give everyone everything they want all the time.


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## sags (May 15, 2010)

Premier Ford has some explaining to do.

In February 2019, the CBC Marketplace show did an undercover investigation of conditions and revealed them to Health Minister Christine Elliot.



https://www.cbc.ca/news/health/long-term-care-marketplace-hidden-camera-1.4988317



Now it is revealed that inspectors are "phoning in" their inspections, because they are afraid to go into the same homes people are expected to work in.



https://www.cbc.ca/news/canada/toronto/care-home-inspections-1.5558410


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## sags (May 15, 2010)

Full scale investigations need to be held, including criminal investigations where warranted. It is a criminal offense to deny the necessities of life.

Those profit seeking vultures who viewed nursing homes as government guaranteed cash bonanzas, should bear the consequences of their actions.


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## sags (May 15, 2010)

Make long term care part of the CPP program. Raise contribution levels if necessary. Just get it done.


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## Just a Guy (Mar 27, 2012)

It’s not a matter of money, I’ve been going to long term care places for decades...they try to optimize care as much as possible, and maximize profits. I’ve had relatives who’ve paid thousands of dollars each month out of pocket treated just as bad as people who didn’t pay anything.
if you are judged to be a problem, they put you on the ”screaming ward” and drug you into submission. The care workers do the minimum required to keep their jobs, not care wise, employment wise. Often patients have bed sores, are abused etc. They are breeding grounds for diseases and are worse than prisons many times for thee patients.
Food is colour coded brown is “meat”, white is “potatoes”, orange or green iS the “veggies”. 
id never want to go into one given a choice.


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## Longtimeago (Aug 8, 2018)

Just a Guy said:


> It’s not a matter of money, I’ve been going to long term care places for decades...they try to optimize care as much as possible, and maximize profits. I’ve had relatives who’ve paid thousands of dollars each month out of pocket treated just as bad as people who didn’t pay anything.
> if you are judged to be a problem, they put you on the ”screaming ward” and drug you into submission. The care workers do the minimum required to keep their jobs, not care wise, employment wise. Often patients have bed sores, are abused etc. They are breeding grounds for diseases and are worse than prisons many times for thee patients.
> Food is colour coded brown is “meat”, white is “potatoes”, orange or green iS the “veggies”.
> id never want to go into one given a choice.


I'm not clear on what your point is Just a Guy. The care sucks, we know that. So what do you suggest should be done about it? That is really what this thread is about. How would you suggest solving the problem?


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## MrMatt (Dec 21, 2011)

Longtimeago said:


> I'm not clear on what your point is Just a Guy. The care sucks, we know that. So what do you suggest should be done about it? That is really what this thread is about. How would you suggest solving the problem?


Audit and post details.
Ontario does this, but the audits have never been adequate.

The local health unit audits restaurants, and posts letter grades, if you did this at homes, it might have an impact.
I won't eat at anything other than an A rated restaurant.

Third party audit systems,I bet nobody asks if the home meets any independantly audited standards. 
Maybe if people demanded third party certification, rather than relying on the government, it could happen.


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## Eclectic12 (Oct 20, 2010)

One set of rules and standards instead of two different sets IMO would help in Ontario.


Cheers


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## MrMatt (Dec 21, 2011)

Eclectic12 said:


> One set of rules and standards instead of two different sets IMO would help in Ontario.
> 
> 
> Cheers


I think the lack of visibility is an issue.

Also many of the government run homes are $47+holes as well. They need visible accountability.


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## Eclectic12 (Oct 20, 2010)

Sure ... but that's going to cost money.

My parents weren't typically complainers so my brother panicked when they complained about the food. He was ready to tear a strip off any staff he encountered. My sister said let's get details because I'm here regularly, often stay for supper with no prior notice and the food's been good. On direct questioning, they couldn't come up with examples of meals they didn't like. 

Near as we could figure out - they were parroting the complaints of their table mates. These were farmers who wanted a specific diet. Boiled potatoes are fine but twice baked, fancy potatoes were crap, not fit for animals.


Later when the owning family retired, the home was sold to a group out of Montreal. Within a couple of weeks, there was 1/3 the staff to serve meals, the number of nurses was cut in half etc. The fees, went up.

Cheers


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## Longtimeago (Aug 8, 2018)

Premier Ford has finally taken a real step to take over control where necessary of LTC homes. 








Ontario adopts emergency order allowing control of COVID-19 outbreaks at long-term care homes


The Ontario government has adopted an emergency order that will allow it to appoint a manager to oversee the response to COVID-19 at long-term care homes struggling to deal with an outbreak.



toronto.ctvnews.ca





So now, they can put a manager in place if warranted, REGARDLESS of whether the residence wants them to or not.


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## Longtimeago (Aug 8, 2018)

The number of military personnel now infected in LTC homes has risen to 36 from 28 in Quebec and Ontario. There are 14 in Ontario and 22 in Quebec. The evidence of the inability to control the virus in LTC homes continues to mount. 

We are no longer hearing how many new cases are still developing in LTC homes. They've just stopped telling us.

Now there is also another issue being highlighted due to the current heat wave in parts of Ontario and Quebec. Only 25% of individual rooms are air conditioned. The common practice in the past when there was a heat wave has been to move residents into common areas of the buildings where there is air conditioning. That option can't be done when you are trying to maintain distancing obviously. So we now face residents perhaps dying as a result of the hot weather in addition to those dying from the virus.


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## MrMatt (Dec 21, 2011)

We're running out of money to give everyone everything they want.
It is expensive to have isolated AC for every room, so they don't.

Nobody is proposing real solutions.


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## sags (May 15, 2010)

It is the kind of lame excuses that are offered here that created the atrocious conditions in LTA homes.

The Canadian military is posting a report on the conditions of the LTA homes and it is very, very, very bad for the homes, workers and government.

There will be criminal investigations and the Ontario government has run out of excuses. If there were regular inspections they must have wore blindfolds, earbuds, and nose plugs while in the homes. The LTA homes are named and investigators will want to see proof of inspections.

The Trudeau government is going to publish the report and the **** is going to hit the fan.


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## Just a Guy (Mar 27, 2012)

Holding the places accountable would be a good start. Bad food and abuse can be easily seen by anyone actually entering the buildings. The number of sedated patients is also impossible to hide, but there is no downside to a home doing these things as demand is much higher than beds. These places get away with it because there are no consequences to getting caught. So, in fact, they get worse because they can. I suggest we put politicians in an old age home for a month, then you’d get change.


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## Longtimeago (Aug 8, 2018)

https://www.cbc.ca/news/politics/long-term-care-pandemic-covid-coronavirus-trudeau-1.5584960



The question I have for all those who have family members in these homes or may have in the future, is what are YOU going to do about it?

I can only thank God that my parents never had to live in one of these homes. They both died in a hospital before they could get to the stage of living in such a place. I hope my wife and I do the same.


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## sags (May 15, 2010)

662 LTA homes and 9 full inspections. Doug Ford is responsible and his excuses are pathetic.

In the last year of the previous Liberal government there were 600 inspections conducted.

Doug Ford's "restructuring plan" for LTA homes was to eliminate inspections and cut funding.

No government appointed friendly committtee. There must be a full public inquiry.


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## Longtimeago (Aug 8, 2018)

sags said:


> 662 LTA homes and 9 full inspections. Doug Ford is responsible and his excuses are pathetic.
> 
> In the last year of the previous Liberal government there were 600 inspections conducted.
> 
> ...


Yes I noticed today how he and Christine Elliott repeatedly avoided telling the truth about inspections since Ford came into office. She was also the Ombudsperson for LTC at one time. 

But here's the reality. If you ask a question which has political consequences such as someone deciding not to vote for someone, you are not going to get a real answer and to expect otherwise is just stupid or very naive. No one is going to cut their own political throat no matter how many times they get asked a relavant question they will just dodge the question with the usual political babble.

Ford made it worse but he is not alone in having blame. Every political party, public health department and EVERY relation who has or has had relatives in these homes also shares the blame. Dwelling on the past or who should get cruxified is not SOLVING THE PROBLEM.

What we need to hear is EXACTLY what is going to be done to solve the problem. Not, 'everything is on the table' as Ford said today. When that answer is given, the next question should be, 'yes, but what are you doing TODAY to deal with the residents who are in these homes TODAY. It's fine to say there will be changes made in the future and it's not unreasonable to say it will take time to work out and implement them permanently but what is being done TODAY for the residents living there TODAY?'

I have not heard of one thing that is being done today other than bringing in the military who then had 36 (and counting) personnel get the virus. Clearly, that wasn't an improvement for anyone.


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## :) lonewolf (Feb 9, 2020)

https://stevegruber.com/2020/05/michigan-governor-continues-to-ship-covid-19-patents-to-nursing-homes-while-ordering-us-to-stay-in-our-homes/

Above link would not take which was about another governor seeding Covid 19 patents in nursing homes.


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## MrMatt (Dec 21, 2011)

What should happen is they should be audited, and given posted grades,just like restaurants.
What is measured, matters, and when you measure those criteria, they'll be incentivised to fix them.


Right now we don't objectively know what kind of care they provide. Lets fix that problem first.


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## sags (May 15, 2010)

:) lonewolf said:


> https://stevegruber.com/2020/05/michigan-governor-continues-to-ship-covid-19-patents-to-nursing-homes-while-ordering-us-to-stay-in-our-homes/
> 
> Above link would not take which was about another governor seeding Covid 19 patents in nursing homes.


Perhaps it exists only in your mind. If there is a link and there is nobody to click on it.......does the link exist ?


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## kcowan (Jul 1, 2010)

Longtimeago said:


> https://www.cbc.ca/news/politics/long-term-care-pandemic-covid-coronavirus-trudeau-1.5584960
> 
> 
> 
> ...


Yes MIL was in Extendicare in Guildwood for 8 years. We talked we tried we cried but nothing improved. In fact it got worse through retaliation of the staff. Fortunately no others were subject to that system, dieing at home or in the hospital. (FILs and second MIL)

Now any changes made will only affect us, although we are taking steps to avoid it if it becomes necessary.


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## Longtimeago (Aug 8, 2018)

The military's report on the 23 homes they have been working in in Quebec is going to be released today. I expect it to be much the same.

To be fair, I expect such a report based on homes in any province would be much the same. It is a Canada wide problem and I agree with Jagmeet Singh who is again today calling for a national standard for nursing homes and an end to for profit nursing homes.


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## m3s (Apr 3, 2010)

Longtimeago said:


> The military's report on the 23 homes they have been working in in Quebec is going to be released today. I expect it to be much the same.


Here it is









Canadian Armed Forces Report On Ontario Long-Term Care Homes | PDF


The Canadian Armed Forces report on the Ontario long-term care homes




www.scribd.com


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## Longtimeago (Aug 8, 2018)

That's the Ontario report m3s, not the Quebec report.

The report on Quebec was bad but not as bad as that on the Ontario homes the military has been working in.


https://www.cbc.ca/news/canada/montreal/quebec-caf-military-report-1.5586408


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