A month after Prime Minister Justin Trudeau promised to tackle the issue of COVID-19 in long-term care homes, a childhood friend called me in a panic. Her mother, who has been housed for the past year in a care home run by the company Revera, had tested positive for the coronavirus.
Revera, one of Canada’s largest privately owned operators of long-term care, seniors housing and retirement residences, owns or operates over 500 properties in North America and the U.K. Hardly a day goes by without another terrible story about an outbreak in one of their homes — from the Rockcliffe Care Community in Scarborough to the Capilano Care Centre in West Vancouver — and they are currently the subject of at least two class-action lawsuits.
But my friend’s mother was the first person I knew and loved who had been directly affected.
Second wave washes away government promises
The first positive test at the care home happened just five days before my friend called me. My friend received a group email saying that a resident had been diagnosed with COVID-19, but 24 hours passed before she was informed that the resident was in fact her mother’s roommate, and another agonizing 72 hours went by before her mother was tested.
During this time my friend made numerous calls to the home, but with staffing shortages — several workers had been infected and quarantined — no one answered the phone. She says a private phone line she pays for monthly for her mother has not been connected for the past six months, in spite of multiple requests. My friend, who has two young children, is unable to visit her mother in person due to COVID-19 restrictions as well as a serious underlying health condition of her own.
When she was finally able to get through to a doctor, she says she was told that the facility lacked basic equipment, such as IV drips, and was warned that moving her mother to a hospital “might kill her.” She will be allowed to visit only if her mother’s condition worsens significantly and can only arrange for a transfer to hospital with the permission of the provincial Ministry of Health, whose mailbox, she says, is full and whose public telephone line is rarely answered.
As the second wave of COVID-19 hits some of Canada’s most vulnerable populations, Trudeau’s pledge to avoid a repeat of the first wave of deaths — when the military was called in to manage homes that could have featured in horror films — rings hollow.
According to a recent report from the National Institute on Aging, 76 per cent of the country’s COVID deaths have been in long-term care facilities.
What do these silent massacres say about the state of elder care in Canada? For starters, that privatization isn’t working to keep our elders cared for and safe.
A Toronto Star analysis published on May 8 concluded that “for-profit nursing homes have four times as many COVID-19 deaths as city-run homes” and that residents in for-profit homes were 60 per cent more likely to contract COVID-19 and 45 per cent more likely to die from the virus than were residents in non- profit homes.
A study published in the Canadian Medical Association Journal in July concluded that for-profit long-term care homes have larger COVID-19 outbreaks, more resident deaths, and “tend to deliver inferior care,” including “lower levels and quality of staffing, more complaints from residents and family, higher rates of emergency department visits, more acute care hospital admissions, and higher mortality rates.”
The story didn’t have to end like this
My friend’s mother ended up at the Revera facility after dealing with years of incompetent and even criminal at home care (she had over $10,000 stolen by one worker, and others routinely left her in urine-soaked sheets). Increasingly incapacitated by dementia, she was sent to a public hospital. After a month’s stay, she was pressured to go to the Revera home — the only available spot — or face fees of over $2,500 a day.
“It was my only option,” said my friend, who borrowed money to renovate her mother’s condo — damaged by the biohazard it had become as the situation worsened — and rent it out to cover just some of Revera’s $2,000-plus monthly fees.
As my friend told me her story, I remembered her beautiful mother — an artist and teacher with a vibrant personality — as she looked when I was a child, brushing her long brown hair and telling me fairy tales. None of them ended like this.
She could have been my mother. She could have been me. How did it all come to this?
Back in the 1970s, when we were children, most long-term care was not privatized, and middle-class families did not have to bankrupt themselves to afford elder care. Advocacy groups like the Ontario Health Coalition point to a neoliberal history of vested self-interest that led to the privatization of elder care, especially in the mid-1990s when Ontario’s Mike Harris government “ordered the closure of thousands of public hospital beds” and “then commissioned the creation of 20,000 new long-term care beds, for the first time paying from public funds for for-profit companies to build the beds that they would then own and operate on a profit-seeking basis.”
“During this period and following, the connections between political parties, the government and the for-profit long-term care industry are numerous,” says the OHC.
Meanwhile in B.C., where there are currently 40 Covid-19 outbreaks in long term care homes, by 2012, private contractors were providing the largest share of residential care for seniors.
Of profits and privatization
Revera, of course, is not the only care home operator with COVID-19 deaths on their hands. Private corporations own the big majority of the 36 long-term care facilities which have accounted for over half the COVID-19 deaths in Ontario. As the Globe and Mail reported from the OHC, 22 of them are owned by six nursing home corporations.
There are increasing calls for long-term care facilities to be brought under the national health care umbrella, and not only from the federal NDP. Ironically, Revera is now owned by the pension plan of the Public Service Alliance of Canada, whose president called last May for Public Sector Pension Investments to “initiate immediate and formal comprehensive consultations with federal and provincial governments for the transition of the management and control of Revera Inc. operations to the corresponding provincial health authorities” — effectively putting long-term care under public control.
After a meeting last month with provincial premiers about establishing national standards for long-term care homes, Trudeau said “this is a moment for us to step up and reassure Canadians that their loved ones, and that they themselves as they advance in age, won’t be left aside, won’t be made vulnerable.”
But pushback on pandemic response management from the provinces, which have de facto jurisdiction over health care, complicates matters. Quebec’s premier François Legault said that Ottawa dictating health care issues to the province would be tantamount to the province enforcing national borders. In Ontario, Premier Doug Ford balked at the idea of Trudeau implementing a national Emergencies Act to take full control of the management of the pandemic.
While both provincial and federal governments can share the blame for the demise of public care homes, surely there are better solutions to the ongoing crisis than class-action suits and calling in the army. “Too little too late” is a gross understatement. The way we treat our elders is a national shame and, increasingly, a crime.
Just as loved ones kept vigil in Winnipeg last week outside of another Revera care home, honouring 45 seniors who died of COVID-19, I lit a candle for my friend’s mother and for so many mothers isolated and afraid. I lit a candle for a nation where elders are respected, loved and cared for, not abandoned to the vagaries of unregulated, for-profit care.