As the novel coronavirus continues to spread, Canadians may be considering whether they should take their elderly loved ones out of long-term care homes.
Seniors have been identified as a high-risk group, with the majority of COVID-19-related deaths in Canada being among those 80 years of age or older.
And, despite stringent physical-distancing measures in place across the country, a number of nursing homes have reported outbreaks.
In the hardest-hit province of Quebec, one-fourth of nursing homes have confirmed COVID-19 outbreaks.
Ontario — which has the second-highest number of COVID-19 cases — has reported outbreaks at 36 of its seniors’ centres.
Does this mean you should consider taking your loved one out of a nursing home amid the COVID-19 pandemic? Here’s what experts say.
A ‘serious commitment’
While it is possible for families to take nursing home residents out of long-term care, Dr. Barbara Liu, executive director of the regional geriatric program of Toronto, said it is “challenging.”
In an email to Global News, Liu said people living in nursing homes have high care needs.
“They may need physical support and/or cognitive support,” she wrote. “They may need continuous supervision, some require more than one person to transfer from bed to chair. Some may not be able to leave the bed. Some with dementia have behaviours that may be challenging for families to manage.”
She said the move would need to be thought through “very carefully” by families.
“Having said that, there are families at home and not going to work who are now freed up and could potentially look after an older family member in their own household,” she said. “It is not something to take on without careful consideration — it is a serious commitment.”
Liu said, though, that it “is doable” if the family has enough support from home care and enough “physical, psychological and emotional stamina.”
Dr. Samir Sinha, director of geriatrics at Sinai Health System and the University Health Network in Toronto, said most often families were already caring for elderly loved ones before they entered nursing homes.
He said if that’s the case, they may already possess many of the necessary skills to care for them again.
Sinha said, though, that they will need to consult with their loved one’s care providers to determine what may have changed.
“The first question to ask is, what’s changed?” he said. “How have her needs, for example, evolved? What are special considerations that you may not be aware of or you now need to be aware of? And then how would you accommodate those needs?”
Sinha said every circumstance will be different.
“What we’re trying to say right now is we just want to help families, make sure that they’re making the right decisions that are right for them and their loved ones. And we want to support them whatever decision they want to make,” he said.
Sinha noted the responsibility of caring for a loved one must be taken seriously.
“The last thing we want is anybody to really pursue this, to bring someone home and then not be prepared, which could put them and their loved one at greater risk and add in greater problems,” he said.
Sinha added those considering this as an option should know what government help is available to them.
Currently, the federal government has a number of supports available for caregivers, including the disability tax credit and the family caregiver credit.
The disability tax credit is a non-refundable tax credit that helps those with disabilities, or their caregivers, reduce the amount of income tax they may have to pay. Similarly, the family caregiver credit is another non-refundable tax credit available to Canadians supporting someone with a physical or mental impairment.
In a statement emailed to Global News, the office of Deb Schulte, federal Minister of Seniors, said long-term care falls under provincial and territorial jurisdiction, but the government is “working with all levels of government to ensure seniors have the supports they need.”
“By providing help with everyday activities for those who need it, long-term care plays a vital role in our communities,” the statement reads. “Families must make their own decisions about what is best for their circumstance.”
Global News also reached out to the finance ministry to determine if any additional aid will be made available to families who choose to take their loved ones out of long-term care facilities, but did not hear back by time of publication.
‘Legitimate fear’
Dr. George Heckman, a physician specializing in geriatric and internal medicine, said when it comes to COVID-19, families are experiencing “legitimate fear.”
“I think that there are fears, and I think the response to fears is let’s get our parents out of a nursing home,” said Heckman, who is also a professor at the University of Waterloo’s school of public health and health systems.
According to Heckman, the main way the virus has been entering nursing homes is through staff members.
“It’s a sneaky virus and you may have it and you don’t know,” he said. “And if you come to work and you shed it on to people, these patients are going to get it.”
He said health-care workers should focus on addressing this fear and must implement measures to stem the spread of the virus.
Heckman said within nursing homes, there are steps that can be taken to reduce staff and patient contact.
Sinha said health-care workers and long-term care facility staff are implementing measures based on the best available information, but that with guidelines changing day by day and PPE shortages, things have been “tough.”
But he said long-term care facilities are now conducting active screening, have ramped up testing and have banned all non-essential visits.
They are also following the most up-to-date advice when it comes to PPE, he said.
According to Sinha, health workers are screening residents for atypical symptoms, as the virus can also appear differently in the elderly.
“We’re trying to make sure that we get all of that caught up so we can try and make sure that people are safe as possible,” he said.