Canadians have lost faith in the country’s long-term care system, says the doctor tasked with trying to reform them..Dr. Samir Sinha, director of Health Policy Research at Ryerson University’s National Institute of Aging, told the Western Standard the pandemic made Canadians more averse to care homes than ever..“Canadians have never aspired to end up in a long-term care home. Pretty much everybody would like to stay in their own homes for as long as possible,” Sinha said in an interview..“What this pandemic has done is given by the first wave, 80% of Canada’s reported deaths, had occurred in long term care and retirement homes, people realized they have been long underfunded and, as a result, poorly staffed..“Canada’s rate of [COVID-19] death in its long-term care settings are about twice the international average overall, and the highest rate of any country in the world.”.Public health orders and care home policies were hard on residents, 90% of whom have a cognitive impairment, and 60% of whom have dementia, said Sinha..“A video visit, that might not be the same as having family members and friends come in, physically, to hug you and hold you and just hold your hands,” Sinha said..“For a lot of families, they just couldn’t bear the fact they couldn’t interact with their loved ones, let alone the residents who were beside themselves. People were literally pulling their loved ones out of care, repatriating them home, just because they couldn’t stand the isolation and being separated in that way.”.The agony seemed worse than death to some care home residents. In Toronto, 90-year-old Nancy Russell chose euthanasia despite not being ill or dying..“She just truly did not believe that she wanted to try another one of those two-week confinements into her room,” her daughter told CTV..Ironically, friends and family were allowed to gather around while a doctor administered her death..“There were reported increases in symptoms of depression, and anxiety, mental health symptoms amongst residents, but also a huge increase in what we call chronic prescribing [of] antidepressants, antipsychotics, and so on. This isolation can only really make your memory and mood issues worse,” Sinha said..“I’ve had several patients who’ve lived through prolonged lockdowns in their own long-term care retirement homes, and it was quite devastating for some. Those lockdowns hasten their deaths or hasten their cognitive and functional declines. A lot of my patients really, really struggled with significant loneliness, isolation. And it was really a traumatizing experience.”.Sinha has been tasked by the federal government to establish better standards for such homes..Canada spends a lower percentage of its GDP on long-term care than the OECD average and directs just 13% of that towards home care..Sinha said Canada could learn from Denmark’s example..“It aligned itself with what people actually want and need…to stay in their own homes for as long as possible. It also made sure that by providing good quality care in people’s homes [unlike] Canada, where 15% of our acute care hospital beds are filled with people literally being held hostage because there’s not enough care to send them back to their own homes,” Sinha said..Canadians receive medical assistance in dying [MAiD] with no out-of-pocket costs, while palliative care can be expensive and hard to find..“One of the big things we need to worry about is, in a country that also doesn’t have adequate palliative care services available to Canadians, medical assistance in dying is enshrined,” Sinha said..“In some cases, if you want to die at home, you’ve got to pay a huge amount…There is a concern that people will choose MAiD or be pressured to think about that more because there just aren’t adequate options available.”.Lee Harding is a Western Standard correspondent living in Saskatchewan.
Canadians have lost faith in the country’s long-term care system, says the doctor tasked with trying to reform them..Dr. Samir Sinha, director of Health Policy Research at Ryerson University’s National Institute of Aging, told the Western Standard the pandemic made Canadians more averse to care homes than ever..“Canadians have never aspired to end up in a long-term care home. Pretty much everybody would like to stay in their own homes for as long as possible,” Sinha said in an interview..“What this pandemic has done is given by the first wave, 80% of Canada’s reported deaths, had occurred in long term care and retirement homes, people realized they have been long underfunded and, as a result, poorly staffed..“Canada’s rate of [COVID-19] death in its long-term care settings are about twice the international average overall, and the highest rate of any country in the world.”.Public health orders and care home policies were hard on residents, 90% of whom have a cognitive impairment, and 60% of whom have dementia, said Sinha..“A video visit, that might not be the same as having family members and friends come in, physically, to hug you and hold you and just hold your hands,” Sinha said..“For a lot of families, they just couldn’t bear the fact they couldn’t interact with their loved ones, let alone the residents who were beside themselves. People were literally pulling their loved ones out of care, repatriating them home, just because they couldn’t stand the isolation and being separated in that way.”.The agony seemed worse than death to some care home residents. In Toronto, 90-year-old Nancy Russell chose euthanasia despite not being ill or dying..“She just truly did not believe that she wanted to try another one of those two-week confinements into her room,” her daughter told CTV..Ironically, friends and family were allowed to gather around while a doctor administered her death..“There were reported increases in symptoms of depression, and anxiety, mental health symptoms amongst residents, but also a huge increase in what we call chronic prescribing [of] antidepressants, antipsychotics, and so on. This isolation can only really make your memory and mood issues worse,” Sinha said..“I’ve had several patients who’ve lived through prolonged lockdowns in their own long-term care retirement homes, and it was quite devastating for some. Those lockdowns hasten their deaths or hasten their cognitive and functional declines. A lot of my patients really, really struggled with significant loneliness, isolation. And it was really a traumatizing experience.”.Sinha has been tasked by the federal government to establish better standards for such homes..Canada spends a lower percentage of its GDP on long-term care than the OECD average and directs just 13% of that towards home care..Sinha said Canada could learn from Denmark’s example..“It aligned itself with what people actually want and need…to stay in their own homes for as long as possible. It also made sure that by providing good quality care in people’s homes [unlike] Canada, where 15% of our acute care hospital beds are filled with people literally being held hostage because there’s not enough care to send them back to their own homes,” Sinha said..Canadians receive medical assistance in dying [MAiD] with no out-of-pocket costs, while palliative care can be expensive and hard to find..“One of the big things we need to worry about is, in a country that also doesn’t have adequate palliative care services available to Canadians, medical assistance in dying is enshrined,” Sinha said..“In some cases, if you want to die at home, you’ve got to pay a huge amount…There is a concern that people will choose MAiD or be pressured to think about that more because there just aren’t adequate options available.”.Lee Harding is a Western Standard correspondent living in Saskatchewan.