Dr. Samir Sinha is one of Canada’s most respected doctors advocating for seniors. A leader in geriatric care, he is the director of public health policy research of the National Institute on Ageing at Ryerson, and the director of geriatrics at Sinai Health and the University Health Network.
What is the state of Canada’s long-term care system?
We have 13 long-term care systems across 13 provinces and territories. The amount of care available and the qualifying criteria are different in each. The pandemic has shown we have grossly underfunded long-term care compared to other OECD countries. For example, Denmark spends 2.4 per cent of its GDP on long-term care, and two-thirds of that spending helps people age in their homes. Canada spends 1.3 per cent of our GDP on long-term care, with 87 cents of every dollar going to warehousing older people in expensive long-term care homes to provide two hours and 45 minutes of direct care per day. Our government’s own research suggests people in long-term care need at least four hours of direct care per day.
What can we do to ensure better care?
We could move the needle quickly by addressing three fundamental areas. One, staffing. In addition to hiring more workers, we need to create more opportunities for full-time work and provide better training and more pay.
We also need to upgrade facilities. One-third of the rooms in Ontario’s long-term care homes were built to 1972 design standards, with four beds to a room. These are infection prevention and control nightmares.
Finally, we need to implement and enforce a comprehensive inspections and compliance process. Inspections that include emergency preparedness and infection and prevention and control haven’t been done in the majority of homes since 2018.
Do you think the spotlight the pandemic has placed on seniors in long-term care will lead to better care?
The pandemic has reinforced the fact we are an ageist society. We know 96 per cent of deaths have occurred among Canadians aged 60 and older, but we’re not prioritizing them as we should be. Israel, the U.K. and the U.S. acted much more quickly in getting their older populations vaccinated than Canada did. COVID has made people afraid to age, and older Canadians afraid to age in long-term care homes. We clearly need to do better as a nation.