By Jodi Hall and Terry Lake
Canada’s federal, provincial and territorial (FPT) ministers of health are meeting in Vancouver on Monday, hoping to negotiate a new health accord that will inevitably lead to greater public spending. What remains to be seen is how much and what the funding priorities might be. With the health care system’s troubles lately creating headlines, there is significant public and fiscal pressure on governments to address systemic gaps.
When it comes to the care of elder Canadians, lack of adequate funding is not the only challenge facing providers. There are also not enough trained staff to meet the sector’s needs, either now or in the foreseeable future when Canada will have many more older adults.
And even if there was more funding and staff were plentiful in the span of a few years, it’s possible that Canadians still won’t get the services they will need as they grow older thanks to inefficient and outdated methods of tracking health care data, combined with a lack of investment in new care beds.
Whether before COVID-19 arrived, during its most devastating impacts, and now as the pandemic threat subsides, voices across the country have argued that our long-term care sector is on track for a significant crisis.
Systemic failure is not an option as it will impact too many Canadian families living in every community and every province and territory.
Observers who’ve analyzed Canada’s long-term care sector agree upon multiple principles. For example, how the model of care must shift away from being clinical to being more person-centred. This means meeting the needs of individuals in the care setting. While this is already happening in several care homes – whether they’re operated by private providers or by government – it requires more staff and more dollars for training.
It’s agreed that care homes themselves must be more home-like, and with increasing acuity the minimum daily hours for hands-on care must shift upward. In British Columbia, for example, each resident in publicly subsidized long-term care is entitled to 3.36 hours of care per day. This number was arrived at in 2009, when acuity levels were lower on average than today.
Shifting toward 4 hours per day of care – a widely agreed upon new minimum amount – will require both more funding and more trained healthcare workers.
During the FPT meeting, the federal government can choose to make funding for long-term care a condition of acceptance of a new health care accord. Provinces have always been loathe to accept any “strings” attached to federal funding, but new long-term care beds are needed now. There is too much at stake for seniors to waste precious time on political maneuvering.
Canadians are living longer, and our healthcare system is reeling under the pressure of too many seniors occupying hospital beds due to the lack of care options in their community. It means their family members and loved ones are facing agonizing choices on how to support an aging parent, companion or spouse.
While a proposed federal “Aging in Place” benefit looks promising, the sheer number of Canadians eventually requiring increasingly complex long-term care cannot be met by current plans.
Lack of care options has huge ripple effects on Canada’s economic productivity, as people increasingly leave the workforce to support their mom or dad.
So, what does success look like if Canada was to make caring for our older adults a top priority?
To start it means addressing critical shortages in health human resources. Immigration is a critical lever, and thankfully changes are coming to provide express pathways for qualified job candidates. More effort is needed to streamline credential recognition, and provinces need funding to address gaps in training.
Low interest financing for new care beds and to upgrade existing LTC homes is another measure that the federal and provincial governments can play a part in. Without tens of thousands of new beds getting built in the next few years, the system will not cope.
Better budgets are needed to ensure quality care — such as increasing funding to improve food and create more opportunities for recreation.
And the lack of quality health data continues to be a critical concern. We cannot improve the system if we cannot understand what is happening on the ground.
When it comes to seniors and long-term care, Canada is at a tipping point. But it presents a clear opportunity for all stakeholders to work together nationwide — including health authorities, private companies and innovators, nursing colleges, associations, family councils and governments of all stripes.
That message needs to be heard by our ministers of health as they come together in Vancouver.
Jodi Hall is CEO of the Canadian Association of Long-Term Care and Terry Lake is CEO of BC Care Providers Association and EngAge BC, and a former B.C. Minister of Health.