Conservative leadership candidates are weighing in on the crisis in long-term care, calling for everything from new funding to keep people in their homes to a criminal crackdown on those who abuse the elderly.
CBC News asked all four leadership candidates what they would do to address the issue — which was exposed recently in grim detail by Canadian Forces members tasked with backstopping staff in long-term care homes hit hard by the pandemic.
The issue could be particularly prominent in the Conservative leadership race — because the reports about dire conditions in some long-term care homes have rattled a country already dealing with a pandemic, and because many Conservative supporter are senior citizens themselves.
“I think [Canadians will] expect more from their Conservative candidates and they’ll expect more from any government that wants to be in charge of their future,” said Dr. Samir Sinha, director of geriatrics at Mount Sinai and the University Health Network Hospitals in Toronto.
Crime and punishment
Ontario MP Erin O’Toole’s leadership campaign tells CBC News a government led by him would take action against those who mistreat Canada’s seniors.
An unreleased portion of O’Toole’s platform says he would protect seniors “by toughening the penalties for elder abuse and broadening the definition to ensure that mistreating or failing to care for vulnerable seniors is a criminal offence.”
It’s a more detailed take on a suggestion already made by rival candidate Leslyn Lewis, who emailed supporters last week to say she would “introduce measures that will allow law enforcement to crack down on elder abuse.”
A Lewis campaign spokesperson said those measures could include new criminal laws.
Dr. Sinha co-authored a 2019 report on improving long-term care in Canada. He said the pursuit of criminal sanctions misses the point.
An ‘underfunded system’
“It does absolutely zero to deal with the fact we have an underfunded system that’s more likely to warehouse people than care for them where they actually want to be,” said Dr. Sinha, who has advised both Liberal and Progessive Conservative governments in Ontario on senior care strategies.
The vast majority of long-term care homes have trouble retaining and recruiting staff, who are often underpaid and offered only part-time work without benefits, he said.
“You’re probably just going to drive more people away from that sector” by introducing new criminal penalties, he said.
An elderly person is also more likely to be abused by a family member or a friend than by a care worker, said Dr. Sinha, who helped to develop national elder abuse prevention guidelines.
Elder abuse is often committed by burned-out, exhausted caregivers, and is often unintentional, he added.
More home care
Peter MacKay’s campaign told CBC News it’s not quite ready to unveil much of its plan for seniors’ care. “But it will include a focus on providing the financial aid and institutional support to keep seniors in their own homes for as long as possible if they want,” said a statement from MacKay’s campaign.
The money to do that will come from “tax measures for individuals” and increased funding to the provinces for home care, a MacKay campaign spokesperson added.
Dr. Sinha called a focus on home care an “enlightened” approach.
“I think it’s understanding that when you ask any older person where … they aspire to end up, they want to stay in their homes for as long as possible,” he said.
High-quality home care also saves money by keeping people out of nursing homes and hospitals, he said.
Lewis’ campaign has called for a re-evaluation of the way the federal government disburses health care funding to the provinces.
“If more funding is needed, then we need to have that conversation. But with a clear understanding from provinces that their current LTC models cannot continue with business as usual,” she said in an emailed statement.
A royal commission
O’Toole has pledged to create a royal commission to probe Canada’s response to the pandemic.
His platform said that a “key issue” for the commission would be the state of long-term care and what the federal government can do to improve it. In emails to supporters, however, O’Toole has suggested the commission could expose the federal government’s missteps in responding to the pandemic.
A commission could tackle many many legitimate questions, such as why Canada has seen long-term care home deaths at a rate twice the international average, said Dr. Sinha.
He said he fears that such a commission’s conclusions might be ignored.
“If Erin O’Toole says they want to actually run a royal commission that will obligate us to actually act on those recommendations in a meaningful way, then absolutely,” he said.
MacKay has criticized O’Toole’s suggestion. A statement from his campaign said that the problem requires urgent action now, not a royal commission report later.
Lewis is pitching a dramatic shift — “a wholesale change in the culture towards the elderly and the sick,” she told supporters in a recent email.
For Lewis — considered one of two socially conservative candidates in the race — that shift includes stopping a proposed new law to expand medical assistance in dying.
She’s also pledging to introduce new national standards for long-term care facilities that would help ensure heating, ventilation, air conditioning systems and occupancy standards limit the spread of viruses like COVID-19.
Dr. Sinha said that while he applauds any move to ensure seniors residences have adequate heating and cooling systems, he thinks the emphasis on ventilation misses something about how the virus spreads.
“This is not Legionnaires’ disease that basically passes through the ventilation system,” he said.
But he agreed that long-term care facilities need new standards on the number of residents. After SARS hit, several Asian countries began to insist on single-bed accommodations. Dr. Sinha said he would like to see Canada follow suit.
“Yes, national standards would be great, but they have to be nationally enforced as well,” he added, noting that long-term care still falls under provincial jurisdiction.
Any national building standards, he added, could put the federal government on the hook for the necessary infrastructure spending.
Derek Sloan’s campaign team has indicated it will provide some information on his plan for long-term care. CBC News will update this story when that information is made available.