Quebec’s private seniors’ residences a source of concern for second wave

Click to play video 'Glaring flaws in Quebec long-term care homes repeatedly flagged before COVID-19 crisis, says ombudsman' Glaring flaws in Quebec long-term care homes repeatedly flagged before COVID-19 crisis, says ombudsman
The Quebec Ombudsman report released Thursday is unequivocal: years of neglect by the provincial government is what lead to the high number of COVID-19 deaths in Quebec long-term care homes. As Global's Raquel Fletcher explains, the ombudsman wouldn't go so far as to suggest the deaths could have been prevented.

COVID-19 cases are increasing slowly but surely in private seniors’ residences in Quebec — a source of concern for authorities and experts who want to avoid repeating the disaster in long-term care homes during the first wave of the pandemic.

On Wednesday evening, the government counted 180 cases of COVID-19 spread across 39 private residences on its website. The situation was deemed “critical” in four of them, where more than 25 per cent of residents were infected.

By comparison, only 20 residential and long-term care centres (CHSLDs) reported cases, including just one in a critical situation.

Read more: Quebec releases scathing reports into long-term care homes where dozens died

Yves Desjardins, who heads a group of hundreds of retirement homes, says the number of establishments affected and the total number of COVID-19 cases remain low across the network. But managers are watching the numbers carefully, he added.

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Unlike the first wave of infections, which was concentrated in long-term care homes, the virus is now spreading throughout the community, health officials say. According to Desjardins, this poses a risk for residents of private homes for the elderly, who are generally more active than those in CHSLDs.

“We have a much more independent clientele, who have families who come to visit, workers who come to the residence,” he said in a recent interview. “The virus is circulating in the community, and we are in the community.”

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Health Minister Christian Dubé expressed concern over these reported cases in private seniors’ residences, known as RPAs. On Sept. 15, he tightened sanitary guidelines in these establishments, requiring masks in common areas such as hallways and elevators. Residences must also keep a register of visitors, who are required to cover their faces.

The four private residences listed as critical are located in the Capitale-Nationale (the greater Quebec City area) and Chaudière-Appalaches regions. The Villa Ste-Rose residence in Laval has also increased to 18 cases from four cases in recent days.

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That’s cause for concern, according to Louis Demers, professor at the National School of Public Administration.

By increasing the wages of workers in CHSLDs, the government risks having hijacked workers, he said. This attempt to remedy the shortages of personnel in CHSLDs could, he suggested, increase the dependence of private residences on employment agencies.

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“If you are understaffed and you have to choose between not giving a lady a bath or giving her one by someone who might have the virus, what do you do?” he asks.

One factor that contributed to hundreds of long-term care home deaths this spring was employees working at more than one facility, bringing the virus with them from place to place.

According to Desjardins, it is virtually impossible to ensure “100 per cent” that the staff are working in a single residence, especially when some health professionals come and go to provide services.

Read more: How cold air could make the coronavirus spread more easily this winter

However, owners generally ask employment agencies to avoid staff turnover between establishments, he says.

Demers and Desjardins both believe that private seniors’ residences are better prepared to deal with the second wave of COVID-19 than the CHSLDs were last spring.

Administrators have a clear set of guidelines explaining what action to take based on alert levels in their area. Infection control measures are now well known, and personal protective equipment such as masks are more widely available, Desjardins says.

Demers also points out that seniors living in private residences are healthier than those in long-term care facilities and generally live in their own small apartment, which makes it easier to distance themselves. They are also less likely to suffer from cognitive problems such as dementia.

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He believes the government’s biggest challenge in this regard will be finding the right balance between restrictions that protect people from the virus, but also give them the right to a social life, essential for their mental health.

— This report by the Canadian Press’s French-language service was originally published on Sept. 25, 2020. It has been edited by Global News for clarity after being translated into English.