Pandemic Reveals Gaps in Care of Older Adults
Who would have guessed that I could be facing some of the same issues as an older person that I did as a parent of a toddler.
There was a time in the mid-1970s in the Yukon when there were no standards for childcare. As well, no standards for training nor certification levels for childcare workers linked to their wages. The pay was a little above minimum wage and there was no government funding for operation of facilities or subsidies for parents. Many of us were vocal in our call for change. Change happened… slowly.
Although there’s still much to do in the way of adequately compensating childcare workers and making childcare accessible and affordable for all, we’ve advanced somewhat in the last 45 years.
As I reflect back on that time, I can’t help but draw some parallels to the conditions for some in long-term care and residential facilities for older people.
Vulnerable population
Just as babies and toddlers are unable to speak for themselves, many older people in long-term care, residential facilities or hospitals may be unable or reluctant to speak up for themselves. They may have dementia that affects their ability to express their care needs, or they or their family members may be hesitant to make requests or complaints due to fear of retaliation, harassment or mistreatment.
One way to address this concern is an advocate for the Yukon’s older people, similar to the Child and Youth Advocate. The advocate could investigate and ensure older people are being treated equitably and their needs are being heard. A complaint process needs to be readily available for caregivers and those people in residential or long-term care facilities.
Standards and regulations
The publicly funded, government operated long-term care facilities such as Whistle Bend Place and Copper Ridge, have regulations and standards in place that meet Accreditation Canada certification.
Due to the standards and health measures put in place in Yukon, we’ve been fortunate not to have experienced the COVID deaths and infections faced by long-term care residents in mainly private facilities, particularly in Quebec, Ontario and British Columbia.
Presently there are no non-government, independent assisted living facilities for older people in Yukon. There are two being planned in Whitehorse — one by a private developer and the other by a non-profit society. Currently there are no regulations in place for standards of care in private or non-profit residential and long-term care facilities in Yukon.
Regulations and standards need to be in place for non-government operated assisted living and residential care facilities being planned in the near future. We need to ensure the standard of care, staffing levels, training of workers and their working conditions are monitored and maintained at a high level. In the same way that childcare centres receiving government subsidies must meet specific standards, non-government operated assisted living and residential care facilities should also have to meet standards, particularly if they are receiving government grants and subsidies.
Private and non-profit facilities
Dr. Pat Armstrong, distinguished researcher and professor of sociology at York University co-authored a report, Re-imagining Long-term Residential Care in the COVID-19 Crisis, which identified that for-profit care homes tend to have lower staffing levels, more complaints, more transfers to hospitals and higher rates for both ulcers and deaths. According to the researchers, those homes with managerial practices based on a business approach are geared for making a profit, rather than providing good care. Often staff are paid low wages, work casual or part-time with little or no benefits. Laundry, cleaning, food and security are often contracted out, thus increasing the risk of exposure to more people in the home.
We need to monitor the situation in Yukon to ensure that the proposed private and non-profit facilities maintain the standard of care we have grown to expect from our existing public facilities.
Aging in Place Action Plan
The government is expected to release their Aging in Place action plan as well as their followup to the recommendations of the Independent Expert Panel for the Comprehensive Review of Health and Social Services. I look forward to seeing what plans are being proposed. I hope that it won’t take 45 years to bring about progressive changes for improved care of older people in Yukon.
Lillian Nakamura Maguire, Co-chair
Seniors Action Yukon
Whitehorse, Yukon