New post-pandemic standards for long-term care proposed to federal government

As hundreds of long-term care homes across the country grapple with new outbreaks of COVID-19, long-awaited draft national standards for those facilities were released Thursday.

The pandemic has exposed fatal weaknesses in Canada’s long-term care sector. In the first months of the pandemic, more than 80% of known deaths from COVID-19 in Canada occurred in long-term care homes and retirement homes – the highest rate among countries in the Organization for Economic Co-operation and Development (OECD) .

” I hope. My God, I hope this is a clear blueprint that can really empower provincial, territorial and federal governments to move long-term care to where all Canadians want it,” said Dr. Samir Sinha, director of geriatrics at Sinai Health and the University Health Network in Toronto.

Sinha chaired the technical committee of the Sanitary Standards Organization that drafted the proposed standards. The HSO is an independent, not-for-profit organization that develops standards and assessment programs for the health and social service sectors.

The federal government launched the project to write new national standards last spring. Today’s OSS report reviews standards affecting the quality of direct care. Among other things, it asks long-term care homes to adopt HSO’s existing infection control protocols for hospitals.

Infection control standards for the design and operation of long-term care homes are being developed by the Canadian Standards Association (CSA), which also reviews ventilation, plumbing and medical gas systems The establishments. Draft CSA standards are expected in February.

The national standards proposed by the ASS go far beyond the current standards, which were last updated in 2020. The draft regulations emphasize resident-centred care and include eight new sections , 17 new clauses and 148 new criteria.

“We didn’t want to leave anything out. We really want to outline everything that we think needs to be properly assessed…properly coordinated,” Dr Sinha said.

Giving residents more autonomy

The draft standards aim to give residents of long-term care facilities more control over their lives by giving them greater influence over day-to-day care decisions and visitor policies. They would ask long-term homes to plan meaningful daily activities and facilitate social connections between residents, both inside and outside the facilities.

The HSO document includes a section on defining and protecting the right of residents to “live at risk” – to, for example, balance the need for facilities to protect their residents with the right of individual residents to receive visitors.

Although the document does not clearly indicate where this balance must be struck, it is clearly intended to address the isolation and loneliness experienced by many long-term care residents who were cut off from in-person visits at first. of the pandemic.

Crosses representing residents who died of COVID-19 are pictured on the lawn of Camilla Care Community in Mississauga, Ont. on January 13, 2020. The long-term care home was among the hardest hit by the pandemic in Ontario. (Evan Mitsui/CBC)

“I was actually very disheartened that we hadn’t struck the right balance between protecting residents from a virus and separating them from their families. The result, in many cases, has been detrimental to residents,” said former British Columbia health minister Terry Lake. , now CEO of the BC Care Providers Association. Lake had not yet seen the draft standards when he spoke to CBC News.

Barbara, the mother of 86-year-old Susan Mills, who has dementia, is a resident of Grove Nursing Home in Arnprior, Ontario. Mills said the enforced isolation her mother endured for almost seven months in 2020 – when she could only see her family through a window – hastened her decline.

“I feel guilty (she was there) but…I didn’t really have a choice,” Mills said.

“We have to find that balance”

Barbara’s floor is locked again due to another COVID outbreak. Mills and her mother are fully vaccinated, and as an essential caregiver, Mills is allowed to visit. But the outbreak means more isolation within the facility.

“She’s confined to her room 24/7,” Mills said.

Dr Sinha said the HSO committee had heard many similar stories.

“We have to strike that balance by allowing residents to live with risk … but also balancing the safety of everyone who lives in a home,” he said.

The new standards proposed by the HSO would also require long-term care facilities to prove that they have enough staff to cover the hours of care required in each province and to continuously monitor the safety and effectiveness of the care provided.

The draft standards cover planning for emergencies, such as new epidemics or natural disasters.

Convince the provinces

Ensuring the new standards are adopted and enforced will cost the government money, Lake said – “a lot of money”.

He acknowledged that the provinces will be reluctant to let Ottawa set standards in their areas of jurisdiction.

“However, if there is a national standard that is being funded,” he added, “then I’m sure provincial and territorial governments will want to ensure that the results described with this new investment are achieved.”

Members of the Canadian Armed Forces arrive at the Villa Val des Arbes seniors’ residence Monday, April 20, 2020 in Laval, Quebec. The federal government has deployed soldiers to long-term care homes hard hit by COVID-19. (Ryan Remiorz/The Canadian Press)

The Liberals promised $9 billion for long-term care during the last election campaign, on top of the $3 billion over five years already committed in the last budget.

In the mandate letter Health Minister Jean-Yves Duclos received upon taking office, Prime Minister Justin Trudeau tasked him with introducing new legislation to improve the state of long-term care.

CBC News asked Duclos’ department when the legislation will be tabled and whether it will include national standards.

“If it’s not done now, it will never be done”

“As long-term care falls under provincial and territorial jurisdiction, any legislation will be designed to reflect jurisdictional responsibilities,” a ministry spokesperson said in an email to CBC News. “The federal government will work collaboratively with the provinces and territories, while respecting their jurisdiction over health care, including long-term care.

Many hope the silver lining of the pandemic will be tangible improvements in long-term care. Mills said she fears the window of opportunity for change is closing.

“In my opinion, if it’s not done now, it will never be done,” she said. “The pandemic has shown the flaws that obviously existed before and which have not been corrected.

“So if there is no legislation in the next few years, I would say there will be no change in long-term care.”

The draft ASS standards will be open for public review for 60 days. CSA’s proposed standards, due in February, will also be open for public comment for 60 days. Final standards are expected this fall.

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