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Long-term Care System

Inquiry--Debate Continued

November 19, 2020


Hon. Kim Pate [ + ]

Honourable senators, to be clear, mom was in one of the most positively rated care homes in this region. Like too many institutions, however, profit motives and margins too often give rise to yawning chasms between policy and practice.

I’m certain that the managers who assured us during mom’s intake and subsequent case management meetings sincerely believed that the long and detailed description they requested from us would guide her care. One thing on that list was mom’s love of bubble baths. How many of those who assured us that these could be happily accommodated actually knew the nature of their twice weekly bathing routine? We did not, until one visit when I was asked to assist by a kind and caring personal support worker. I’m still often undone when I think of the worker in her rubber boots and abattoir-style raincoat and gloves, trying to comfort mom after another staff member had stripped her and prepared to essentially hose her down for her shower. Words cannot describe the look of terror on my mom’s face as she sat crying and trying to twist away while clinging to a safety rail. The images and sounds still haunt me.

For all but the most wealthy, privatized care homes are failing many we hold most dear. Everyone in each care home, whether they are working or housed there, deserves dignity and humane treatment. We must take care seriously, invest in it adequately and create vital national standards and oversight to ensure that people have access to good health and good lives and do not disappear into institutions that rob them of their agency, their identities and their lives.

This, honourable colleagues, is the task as I see it in front of us. Meegwetch. Thank you.

Hon. Patricia Bovey [ + ]

Honourable senators, what worrying and horrific situations are happening across this country. Today I add my thoughts to those of senators who have spoken to Senator Seidman’s apt and timely inquiry.

Words fail as we digest the dire events in our care homes, with the numbers of COVID deaths and illnesses spiking, care lacking, our seniors isolated within and loved ones barred from visiting. Those not suffering COVID are also isolated. The isolation has bred despair, people have given up, and died. The courage and self-sacrifice of front-line workers are tremendous. Again, I thank them.

Last week we commemorated Remembrance Day, reflecting and thanking those who served in both world wars, the Korean War, Afghanistan and other global conflicts. Their bravery gave us our freedom — the lives we have been privileged to live.

My father served in World War II. My mother did not see him for over three years. My brother was three and a half before he and dad met. My family was like so many, including some of yours. But my father was spared a care home, dying in his own bed.

My mother suffered dementia for more than 15 years and spent her last few years in an excellent home in Victoria. How glad I am those were different times. We could visit daily, my girls would drop in with friends, she came for dinner at least weekly and we took her on drives. She shared graduations, birthdays and many special events, some providing touchstones for past memories, others being only momentary diversions. I cherish them all.

The pain now is unimaginable. Many in care cannot comprehend the circumstances. Families are filled with anguish, fear and unable to share their love with elderly family members.

Words starting with “H” are essential in facing this crisis: heroes, honouring, honesty, help, harmony, health and hope. History is another. History teaches, through events long past and those recent. This is not society’s first pandemic. In 1918 the Spanish flu witnessed similar reactions over wearing masks, washing hands and limiting contacts. The polio epidemic was another.

In recent months the alarming situations in Ontario and Quebec overwhelmed us all. Military intervention was requested, urgently needed and given, with military medics joining front-line care workers to fight the virus war. The cost was $53 million. A continuum of care would have cost so much less in dollars, deaths and mental health. The Ontario and Quebec reports were blood-curdling.

I cannot understand why their recommendations have not been heeded in my province. The lack of staff, lack of PPE, lack of consistent standards and lack of full honesty regarding the realities are repeating those Central Canada faced. Surely at the end of 2020, these could have been addressed. Surely we know the fix for at least some of these problems. Our front-line workers have been giving and giving. One Winnipeg nurse herself went out to buy wipes, masks and even socks for patients. Our systems are broken.

I quote Senator Seidman:

. . . it is evident that Canada is not short of sound evidence on how to achieve lasting change within the long-term care sector . . .

. . .Yet, despite this, tragic events continue to happen, deep-rooted issues remain unchanged and concern for the well-being and safety of our frail elderly deepens, even now, with each passing week.

The situation is deepening in Manitoba, becoming darker every day. We are failing to provide for our seniors in long-term care homes and they are dying because of it. Numbers are increasing exponentially. On November 17 there were 269 new cases province-wide, yesterday 400, today 475. Deaths climb, now to 198, and the infection rate today was 14%. I think 1.5% is what’s considered the safe level.

By November 17, 36 care homes in Manitoba had experienced outbreaks — 692 cases with 85 deaths. This past Saturday, in Opaskwayak Cree Nation’s Rod McGillvary Memorial Care Home, all 28 residents and 13 staff members tested positive. In that wider community, 124 cases have been reported in total, including those in that care home. Steinbach is another concerning centre.

Honourable colleagues, two long-term care homes in Winnipeg have been absolutely overwhelmed by the virus. The Maples and Parkview Place homes have experienced some of the deadliest outbreaks in Manitoba. What happened in these two homes is a bloodbath, perhaps one of the saddest chapters of the pandemic in my province.

As of November 17, Parkview Place had registered 158 cases, including 117 residents and 41 staff members infected with the virus, and 25 deaths. These numbers are certainly sobering, but what happened at the Maples home is even worse and represents a real tragedy for Winnipeg. The Maples home reported 207 cases of COVID-19. No fewer than 40 residents lost their lives. These numbers are increasing daily.

The media has reported heartbreaking stories regarding Maples Long Term Care Home. Over the weekend of November 7, paramedics responded to 18 calls and encountered a scene reminiscent of what occurred in Ontario and Quebec earlier in the pandemic. Paramedics administered IVs and oxygen, and helped feed patients. Eight residents died over that 48-hour period.

Winnipeg’s fire paramedics chief said if all these patients had been transferred to hospitals at the same time the system would have been overwhelmed. Winnipeg Mayor Brian Bowman described the events of that weekend as “sickening.”

The province will investigate the events at Maples, but the Winnipeg Regional Health Authority already stated that it has discovered the company that owns the for-profit home, Revera, was not accurate in stating the home was fully staffed. Indeed, only 7 of 19 health care aides were present for that Friday evening shift.

I am repulsed by the atrocious conditions and negligence in some of Manitoba’s homes. How did our care homes descend into this crisis, this crevasse, abyss? Why do we allow our elders to die of malnutrition and dehydration? We don’t let any other sectors of our society die that way.

Why are staff shortages still rampant? Where is the support for our brave front-line workers? Why are individuals, not care homes, forced to call paramedics to intervene at care homes? Did Manitoba have no option but to follow the sad steps of negligence seen in the homes in Ontario and Quebec? I say no.

We must develop proper standards of care, staffing, pay and job safety. Is protecting Canadians not both a federal and provincial responsibility?

The poignancy of Manitoba’s situation over Remembrance Day is visceral for me. At the Ottawa cenotaph on November 11, Major-General Chapdelaine quoted our Queen: “Hope may be found in the care we give to the vulnerable in a time of need.”

Are we giving the care to the vulnerable in this time of need that truly gives hope? I believe we are not. Canada unfortunately leads the OECD countries with the highest rate of deaths of COVID in long-term care. We should not only thank our elders and pay tribute to their sacrifices for our freedoms, but we have a responsibility to ensure they have the best of care, both physical and mental. We must do more. There are actions we can take that are in the federal domain.

First, we must develop national standards, as Senator Pate has said, for long-term care, as raised in the Throne Speech. All government levels must work together in developing these and not block each other in dealing with this crisis. I am encouraged to learn that NGOs agree. Standards must include proper and enough PPE, and the training to use PPE properly. And had we allowed one person per family with, and trained in, PPE use to visit their elderly family members, I believe we would not have seen the deaths we have seen from isolation.

Second, bricks and mortar are important. Having individual rooms with individual bathrooms is essential to providing quality care. I am proud that my province imposed tighter restrictions for newly constructed care homes, but older buildings have unfortunately been grandfathered in, which means that they can have up to four people per room. Talk about a perfect recipe for spreading the virus. I believe that the federal infrastructure program could and should fix this problem, providing for smaller buildings in which the rooms have just one bed.

Third, in order to address the staffing shortage, I urge the federal government to bring in more nurses and support workers through immigration so that they can work in our long-term care homes. We know that the immigrants who work in the medical field and in personal care are essential to Canada, and I think that is even more true today.

Fourth, we must address the increasing incidents of elder abuse during this pandemic — physical abuse, emotional abuse, neglect, abandonment and financial abuse. I am told by professionals that since the outbreak of COVID, people manning elder abuse lines have experienced a dramatic increase in calls. We have all witnessed increases in scam emails and calls in the past months, many targeted to seniors, especially those showing incidents of dementia.

I spoke recently with Margaret Gillis, President of the International Longevity Centre Canada. They partner with the University of Ottawa’s LIFE Research Institute, do impressive work and are actively engaged with the United Nations. With increasing loneliness, the need for intergenerational and innovative approaches to connecting with the marginalized is real. We must see and act.

Canada should support the UN’s work for an international convention on the rights of elder persons now. That UN convention for older people would confront ageism, assist in policy-making and accountability, and educate and empower the rights-holders. Canada supported the UN Secretary-General’s paper this May calling for such a convention. Until then, it seems, the developed world was blocking that step, which had been strongly supported by developing countries. I am pleased we’ve changed our tune, and I gather that some European countries are now coming onside.

Colleagues, we must support this initiative and protect human rights based on compassion and empathy. I love the line “Human rights do not have a best-before date.”

In addition to what I said for our governments, we all individually have a responsibility as told to us every day by health officials. We must wear masks, wash our hands, limit contacts and avoid large crowds.

Senators, a 2006 report on Manitoba long-term-care homes, prepared by the Manitoba Nurses Union, observed:

Personal care homes are just that – peoples’ homes. Many residents will spend years in these facilities and the standards maintained will profoundly impact their quality of life. . . . Since virtually all of our families have been touched by the long-term care system, as citizens and taxpayers we expect our family members to be treated with dignity and be provided the best care possible.

Colleagues, we can and must do better. Necessary deaths and losses, as I know, are hard enough; avoidable, unnecessary ones are unconscionable. Our vision for hope must be achievable. Thank you.

Hon. Yonah Martin (Deputy Leader of the Opposition) [ + ]

May I ask a question to Senator Bovey?

The Hon. the Acting Speaker [ + ]

Senator Bovey, would you take a question?

Senator Bovey [ + ]

Yes.

Senator Martin [ + ]

Thank you for your speech, senator. I know this is a topic and an inquiry that’s important to all of us in the chamber.

I was listening, and there are certain things I wish to refute and/or add some other examples just to balance what we have been talking about in this chamber on this topic.

Just as you were speaking, I had a message from the care home, which is actually managed by Revera in B.C. It’s where my mom is a resident. The care has been really amazing, as I have talked about; it’s not perfect, but everyone is doing their best under the circumstances.

Senator, do you think that it is important for us to ensure that this debate on this inquiry really balances the information and that we not — I’m not saying you exaggerated what you were saying but that the alarm that you are raising is something that we have to be very mindful of, because there are those of us who have family in care, and there are care homes that are doing such good work across this country.

I’m just mindful of some of what I’m hearing, which I’m reacting to personally.

Would you mind responding? I know your answer will be very — you are very honest in what you’re saying. But I was just reacting to some of the very extreme examples. Would you respond to that, please?

The Hon. the Acting Speaker [ + ]

Senator Bovey, if you want to answer the question, you have to ask for five additional minutes. Are you asking for five additional minutes?

Senator Bovey [ + ]

Yes, please.

The Hon. the Acting Speaker [ + ]

Is leave granted, honourable senators?

Hon. Donald Neil Plett (Leader of the Opposition)

No.

The Hon. the Acting Speaker [ + ]

I’m sorry, Senator Bovey, but leave is not granted.

Honourable senators, I will not take very much time, and then I will adjourn it for the balance of my time.

Senator Bovey, I am really afraid to go back to Manitoba tomorrow, because what I heard here today is just not the way I saw Manitoba when I left. I need to put at least a few thoughts on the record since we aren’t going to be here for a week, and then I do want to enter the debate on this.

Colleagues, my mother lives in a personal care home in Steinbach. You referred to Steinbach, and then you just said, “Steinbach’s terrible,” and left it at that. You maybe didn’t use that word, but you referred to Steinbach and you did not explain yourself.

My mother lives in a personal care home in Steinbach. It has 43 beds. There are 21 or 22 on the first floor, and the balance are on the second floor. My mother is on the second floor.

Out of the 21 or 22 residents there, 11 got diagnosed as positive. My mother was one of them. My mother is 92 years old. Yesterday, I got an email that she is now green; she is out of it. She has gotten absolutely Cadillac care.

Just down the hall from my mother is a 97-year-old who was diagnosed as positive. She is now green; she is out of it. She is 97 years old. This kills every old person, we hear.

My mother is doing fine. So far, from what I have heard, one person died out of the 11 that were diagnosed positive between the ages of about 85 and 97. That person would have died if he would have gotten the flu, I was told by the manager.

They all have their own bathroom. They all get absolutely excellent care. Down the road is Bethesda Place, and it is exactly the same thing. And we heard last weekend that there was a rally in Steinbach, and the premier went on the air saying a third of a mile away people are dying, and a quarter of a mile away the hospital is overflowing.

I had somebody — not on my behalf — send me pictures of the waiting room in the Bethesda Regional Health Centre. Not a person in the waiting room. Not a person in the emergency room. Not a car in the parking lot, yet they were triaging people in this parking lot.

Senator Bovey, I just want to reiterate what Senator Martin said. When we talk about this, colleagues, let’s also talk about the great people we have working in our country. We have wonderful people taking care of the elderly, the people at the Rest Haven Nursing Home are second to none. It is not necessary that our seniors die in nursing homes and in long-term-care facilities, because a lot of them don’t, and they are more than the Maples in Winnipeg; there are more long-term-care facilities than just the Maples.

But what we do, colleagues, is we pick the very worst, we talk about the cases. We don’t talk about the deaths, we don’t talk about the recoveries; we talk only about the cases. Let’s talk about it all.

When I’m a little settled down, I will get my thoughts together, and when we come back, I do want to continue. I will take the adjournment for the balance of my time.

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