Question Period Note: ONTARIO PATIENT OMBUDSMAN POINTS TO ISOLATION OF SENIORS

According to the Ontario Patient Ombudsman, the isolation of seniors in long-term care homes is one of the main issues identified in the complaints it has received

• The COVID-19 pandemic continues to highlight longstanding challenges in long-term care, including gaps in infection prevention and control, staffing, infrastructure, and visitation policies.

• I am working closely with the Minister of Health to improve the quality and availability of long-term care homes and beds. This includes national standards to ensure seniors get the care they deserve.

• Our Government has made significant investments in long-term care since the pandemic began, including up to $4B to help provinces and territories improve the standard of care in those facilities.

• Our Government welcomed the news that the Health Standards Organization and Canadian Standards Association have launched a process to help address those issues.

IF PRESSED
• The Government, through the National Seniors Council, examined the issue of senior’s health and well-being, paying special attention to seniors in long-term care and congregate settings.

• The Health Standards Organization’s and Canadian Standards Association’s work with governments, stakeholders, and Canadians to develop national standards will help inform our ongoing discussions with provinces and territories on improving the quality of life of seniors in long-term care.

• We look forward to continuing to work with provinces and territories to help improve access to quality long-term care and to support training and better wages for personal support workers.

Although COVID-19 has affected all Canadians, seniors are particularly vulnerable to its health impacts, including a higher risk of hospitalization, health complications and death. Since seniors are more likely to live alone or in an institution, public health measures limiting social interactions also put seniors at greater risk of social isolation.

Seniors, especially those living in long-term care facilities, have been disproportionately affected by the pandemic and the need to physically isolate themselves to reduce the risk of infection. Many jurisdictions across Canada have limited visits in long-term care facilities as a result of COVID-19 outbreaks.

The Ministers of Health and Seniors’ December 2021 Mandate Letters included a number of commitments to support efforts to improve the quality and availability of long-term care homes and beds.

On March 21, 2022, the Ontario Patient Ombudsman released a report entitled: Courage, Compassion, Clarity – Informing change in a time of crisis, Annual Report 2019/20 and 2020/21
• This is the Patient Ombudsman’s annual report for Years 4 and 5 (2019-2021). It reflects on the offices’ last two years of operation and highlights important issues including the impacts of the COVID-19 pandemic.
• Key Highlights:
o Patient Ombudsman received a total of 2,470 complaints in 2019/20 and 3,595 complaints in 2020/21 – a 45% increase from year 4 to year 5
o Complaints about long-term care homes rose from 208 in 2019/20 to 650 in 2020/21 – a shift from 8% of total complaints in year 4 to 18% of total complaints in year 5
o The disproportionate number of complaints about long-term care homes prompted Patient Ombudsman to launch its first large-scale, system-level investigation in spring 2021
o The rise in pandemic-related complaints also prompted Patient Ombudsman to release two special COVID19 reports during this timeframe
o More than 2,400 referrals were made to other organizations and oversight bodies in 2019/20 and more than 3,400 in 2020/21, including 2,300 referrals to patient relations offices in health sector organizations

Long-term Care in Canada
• Healthcare is a shared responsibility between the Government of Canada and provincial and territorial governments.
• While the federal government provides financial support to the provinces and territories for health care services, the responsibility for matters related to the administration and delivery of these services, including long-term care, falls within provincial and territorial jurisdiction.
• While the Canada Health Act (CHA) covers physician and hospital services, long-term care is not publicly insured under the CHA.
• Every PT has LTC legislation, regulations, policies and/or standards, but variations and gaps exist in oversight, infection prevention and control, quality of care and workforce.

Situation in LTC homes throughout the COVID-19 pandemic
A number of long-standing issues in long-term care have been starkly revealed by the COVID-19 pandemic. This includes issues related to infection prevention and control; HHR; compliance with standards and regulations; infrastructure; and PPE. At the peak of the first wave, outbreaks in LTC and seniors’ homes accounted for 81% of deaths in Canada. Many stakeholders have released reports and recommendations on addressing issues faced in LTC facilities.

Government of Canada initiatives to support PT actions in Long-term Care
The Government of Canada has worked collaboratively with provinces and territories throughout the COVID-19 pandemic to protect vulnerable Canadians in long-term care. The federal government has responded to COVID-19 through a number of initiatives, including providing funding in Budget 2021 and through the 2020 Fall Economic Statement.

Third-party standards development process
The new National Standards of Canada for long-term care being developed by the HSO and CSA Group will take into account lessons learned from the COVID-19 pandemic. The standards will address both the delivery of safe, reliable and high-quality care, and the health infrastructure and environmental design of long-term care facilities. The process is being undertaken by expert standards development organizations, and is taking place at arms-length from the Government of Canada with broad engagement.

The HSO released their draft standard for public review on January 27, 2022. The CSA Group released their draft standard for public consultation on February 11, 2022. Both sets of standards have a consultation period of 60 days.

National Seniors Council
To inform the Government of Canada’s work during the COVID-19 pandemic, the National Seniors Council prepared advice on practical, high-impact, evidence based actions where the federal government could play a leadership role. The Council released the report: Seniors Well-Being in Canada: Building on Lessons Learned from the Pandemic. This report contains 22 short-, medium-, and long-term recommendations in support of seniors’ health and well-being within the full continuum of support and care. The Council based its advice on a review of over 40 national and international reports. It paid special attention to seniors in long-term care and congregate settings, including the social isolation of seniors.

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