With the announcement last week of the pending closure of another long-term care home in Regina, concerns about the availability of long-term care for older citizens are again at the forefront. Most older adults want to remain in their own homes for as long as possible, but there may come a time when that is no longer practical or safe, and at that time people want to know that there is a safe, caring, and comfortable space where their health care, housing, and social care needs will be met. As of 2021, there were almost 200,000 people living in Saskatchewan over the age of 65. Of those, 27,675 are over the age of 85. With people living longer than before the need for long-term care beds is not forecast to diminish.
The Regina Lutheran Home, currently run by Eden Care Communities, is home to 62 residents who will be moved in stages to other facilities over the next six months. Eden Care has decided to exit long-term care and instead focus on affordable and low-income housing. The SHA assumes responsibility for the care of residents in April 2024 and has decided not to purchase of the property at this time, since the age of the building indicates that it is at the end of its lifespan. Given the current building is at the end of its lifespan. (https://globalnews.ca/news/9995966/regina-residents-long-term-care-home/)
One of the appeals of RLH was its small, home-like, family-oriented community where the dedicated staff focussed on making it more than just a long-term care facility, it was a home. Darlene Gilewich, who has worked at RLH for over 39 years said in a CUPE news release, “I feel awful for all the residents who are going through this. All the staff do. We care for our residents. They’re like family to us. We’re their family.”
“People across my community are outraged by the government’s decision,” said Coronation Park NDP MLA Noor Burki. “Many people feel that their parents are essentially being kicked to the curb. When you get to a certain age or have greater medical needs, sometimes you can’t just pack up and move out of your home when the government snaps its fingers.”
The Conference Board of Canada projects that Saskatchewan will require an additional 4,648 long-term care beds by 2035 to address the growing numbers of older adults. Yet the number of long-term care beds in the province has dropped from 9240 in 2001 to 8517 in 2018, and since that time more beds have closed, including 180 at Regina Pioneer Village. (https://cupe.ca/saskatchewan-health-authority-failing-seniors-union-representing-staff-regina-lutheran-home-speak) Many families can’t afford the high prices of private care homes and yet publicly funded ones are disappearing rather than being developed.
The real victims are the residents who are losing their home and the care of the individuals they had bonded with, and those who are waiting for beds in long-term care all over the province as the ripples of such a significant loss of space in one jurisdiction impact all along the chain. As Val Schalme, who has family members in Regina Lutheran Home, told CTV News, these are individuals who have been dutiful taxpayers all their lives and are now being forced into accommodation that may not resonate as ‘home’.
As the SHA places the residents of RLH wherever they can as spaces come open, they seem to be ignoring their own statements regarding long-term care, “Like all communities, each home is unique and has a culture with distinct qualities, characteristics, and members. Connections and building relationships are integral to establishing a resident and family-centred culture within the home and to creating a harmonious community environment. Care providers strive to know each resident and will respect their individuality. This means connecting with residents on an emotional, spiritual level and honouring all traditions and cultures.” As these residents are ‘divvied’ up the connections and relationships that have been built between them and their fellow residents and the staff will be torn apart and the stress of having to vacate a place that has been home can often have negative health impacts.
In an April 2022 submission to the United Nations Independent Expert on the Enjoyment of all Human Rights titled “Older Persons Living in Long-term Care Homes and the Right to Adequate Housing in Canada” by the Centre for Equality Rights in Accommodation (CERA), they state that although “LTC homes are governed under healthcare legislation, the right to housing applies to them. In order to ensure that requirements of the right to adequate housing defined in international law are met for older persons, LTCs should be viewed through a right to housing lens.”
The Centre for Equality Rights in Accommodation (CERA) is Canada’s leading non-profit organization working to advance the right to housing for the past 35 years. In the aforementioned submission, they identified that the “right to adequate housing is an element of the right to an adequate standard of living under Article 11(1) of the International Covenant on Economic, Social and Cultural Rights (ICESCR). Having acceded to the ICESCR in 1976 and adopted the National Housing Strategy Act (NHSA) in 2019,13 Canada has an obligation to progressively realize the right to housing.” The right to housing is not merely a right to have a physical structure over one’s head, but the right to have a home in which one can live in peace with security and dignity, and as any family who has members in LTC will attest, it is more than just a place to wait out the rest of their years…it is their home.
International law requires governments to fulfill the right to housing in their countries, and while not meaning directly providing housing to every person in the country, in certain circumstances where people cannot provide housing for themselves, for example, the homeless, those living with disabilities, and medically fragile older citizens, the CESCR obligates governments to prioritize disadvantaged and vulnerable groups and provide them with access to adequate housing. Publicly funded LTC homes that provide housing for older persons who need extra care, therefore fall into these categories. In Saskatchewan, the number of publicly funded spaces has continued to decrease while the government encourages the development of private for-profit personal care homes, which are not an affordable option for many older persons.
Canada spends less on long-term care than the average for all 38 member countries of the Organization for Economic Co-operation and Development (OECD), and significant investments are needed in order to make necessary improvements and replacements to LTC homes’ infrastructure long before the buildings are in an irreparable state so that staff and residents can transition to a new structure as a unit.
Providing support so that older persons can remain in their homes would help ensure that they are receiving necessary care while remaining safely housed, avoiding long hospital stays or remaining on a LTC home waitlist for lengthy periods. Care could be provided by home care providers and community service agencies and could be of significant benefit for older Canadians who report that they prefer to remain in their homes as opposed to being moved into an institutional setting, such as an LTC home.
Dr. Susan Braedley, a Carleton professor who co-authored a 2019 report on long-term care in Saskatchewan, believes the state of LTC in Saskatchewan is a deliberate choice by governments as a way to ‘get out’ of the business of long-term care.
As demographic trends suggest, demand for LTC homes will increase in the coming years. Therefore, it is critical that every viable option is considered to ensure that older persons in Canada have access to adequate LTC homes. “This is a sector that many governments have doomed to fail. I mean, this is about getting out of this business [of long-term care], and one of the ways to do that is to erode it so that there’s no longer public confidence. That’s a strategy. That’s a plan, not an accident.” (https://briarpatchmagazine.com/articles/view/the-slow-crisis-in-saskatchewans-long-term-care) According to author Alex Birrell’s 2021 article, in May 2013, the Law Reform Commission of Saskatchewan published a report on civil rights in long-term care. They urged a mandatory bill of rights for people living in long-term care and the creation of an independent advocate, but the province never acted on it. Nor have they truly addressed the recommendations put forward by the ombudsman following the death of 74-year-old Margaret Warholm in Santa Maria in 2015.
Sociologist Pat Armstrong is quoted in the same article as saying, “In North America, we see nursing homes as a last and worst option, as an indicator of failure. You failed to look after yourself. Your family failed to look after you. The doctors failed to fix you. Rather than seeing this as one stage in our lives that is still worth living.” She goes on to say that a shift in cultural thinking needs to happen with a greater valuation on the older person. Long-term care is for many, equated with end-of-life care rather than supported care for another phase of life, and underscoring this perhaps is the reality that for many in Saskatchewan, they are stuck waiting in hospitals before they can be moved to a long-term care bed. These people are often called alternate-level-of-care (ALC) patients who languish in hospitals waiting for somewhere to call home.
To quote Maya Angelou, “Do the best you can until you know better. Then, when you know better, do better.” Sadly, as Birrell writes, the social, cultural, and political shifts that need to occur in the long-term care sector are massive and expensive, and societal memories are as short as government’s purse strings
By Carol Baldwin, Local Journalism Initiative Reporter
Original Published on Oct 13, 2023 at 11:24