It’s time to overhaul long-term care, advocates say. Here’s what they suggest.

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Eddie Calisto-Tavares’ father, Manuel Calisto, entered a long-term care home in Winnipeg in 2019.

He died there, at the Maples Long Term Care Home, in November 2020, in the middle of a COVID-19 outbreak — and just days after his 88th birthday.

“He tested positive for COVID on Oct. 29,” Calisto-Tavares said. “His birthday was coming up on Nov. 1. And my first thought was, there’s no way I’m going to allow him to have his birthday alone.”

Starting Oct. 31, she said, she moved into a hotel room nearby and spent every day at the home, working in three-hour shifts. After three hours, she’d return to the room to eat and use the washroom, then would put her PPE back on and head back to the home.

She was trying to make her father’s last weeks as comfortable as possible, she said, until he died on Nov. 11 of COVID-19.

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“I was blessed that I was able to be there with my father,” she said.

Manuel Tavares in long-term care
Eddie Calisto-Tavares watches her father, Manuel, at a long-term care home in Winnipeg. He had COVID-19 at the time. Courtesy, Eddie Calisto-Tavares

Other residents weren’t so lucky. “It was very scary for me to see how so many people, so many of the residents, were left to their own devices,” she said.

None of the regular staff, nurses or aides were there, Calisto-Tavares said, leaving elderly residents, many of whom suffered from dementia, all alone.

“It was like a ghost town. Everybody was closed in their rooms,” she said.

“I still have nightmares. I still can hear the people’s cries, whether they wanted water or somebody saying, ‘I’m burning, I’m on fire.’ That’s what still haunts me.”

Fifty-six deaths were linked to the outbreak of COVID-19 in the Maples Long Term Care Home, according to an external review posted on the Manitoba government’s website. And the experience in this long-term care home was repeated across the country, with even the Canadian Forces called to some homes to help.

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Calisto-Tavares believes things need to change. “Our governments need to be held accountable for this disaster and for all the lives we lost during COVID.”

Other advocates and experts agree — and they’re hoping that all the attention the long-term care crisis has gotten so far in the federal election could finally lead to real change.

Election promises

As the federal election campaign continues, the pandemic has shoved long-term care into leaders’ debates and onto party platforms.

The Liberals are promising to give provinces money to hire more personal support workers and improve conditions for seniors.

The NDP and Greens are calling for the end of for-profit long-term care homes, with both parties calling for national standards of care and improved training, benefits and pay for workers.

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The Conservatives say they will provide more money to the provinces through the Canada Health Transfer and increase tax benefits for seniors and their caregivers.

More money is a good start, says Dr. Samir Sinha, director of geriatrics at Sinai Health and the University Health Network in Toronto.

“I think the biggest challenge with the provision of long-term care in Canada is that compared to other countries from around the world, we grossly underfund the system that we actually have,” he said. This means that not only are there not enough beds, but the facilities are underfunded too — resulting in worse care for residents, he added.

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Developing standards on how money gets spent is important too, according to Sandra Azocar, executive director of Friends of Medicare, an Alberta-based advocacy organization.

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“What we want to see is legislation coming from the federal government that will oversee how long-term care is delivered across the country,” she said. This legislation should include standards on the hours of care provided, staff training and staffing levels and measures to ensure accountability and compliance, she said.

She’d also like to see an end to for-profit care homes.

“We have actually turned seniors into a commodity and we sell them off and they’ve become ATM machines for these corporations. And that’s not right,” she said.

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Pat Armstrong, a professor emeritus of sociology from York University, would like to see more attention paid to staffing levels and working conditions.

“There are a host of issues related to those working conditions,” she said, which causes a high rate of absence due to illness or injury. “We need to do something about the health and safety of those workers. We have higher turnover rates in long-term care than anywhere else,” she said.

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Ultimately, Sinha believes that Canadian governments should dedicate more funding to keeping people in their own homes for as long as possible.

“It’s about bringing care flexibly to where they are and as they need it,” he said. This isn’t just what many individuals want, but it can be more cost-effective as it doesn’t require building new facilities, he said.

Read more: Military teams raise concerns about conditions at Ontario care homes

While acknowledging funding long-term care homes is important too, he said he’d like governments to focus on other options where possible.

“Right now, when we spend only 13 cents on every long-term care dollar on providing support into people’s homes, I think we need to move towards the Denmark approach where two-thirds of our long-term care funding is actually spent on supporting people in their own homes.”

Traditional long-term care homes, where several residents share a room, have been banned in Denmark and were phased out in the 1980s, according to a WHO report — though they still exist in Canada. Home care and day programs are also options, in addition to residential facilities.

Sinha’s advice has been sought abroad, too. He recently returned from a trip to Iceland, where he advised government and health-care officials on how to develop a national strategy for seniors. “They’re very much looking for international guidance and support to say, how do they not repeat the same mistakes that, frankly, we’ve been making in Canada?”

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Manuel Calisto of Winnipeg in happier times.
Manuel Calisto of Winnipeg in happier times. Courtesy, Eddie Calisto-Tavares

Advocates hope that this time — because of the pandemic, and now an election campaign — things finally change for seniors in long-term care.

Above all, Azocar hopes things don’t go back to “normal” as memories of the pandemic fade.

“Normal was not working in this area. Normal is what caused the death of those people.”

Calisto-Tavares agrees.

“Some days I just I just want to cry because I think, my God, you know, all of these voices together and no one is listening,” she said.

“It’s not just what happened in those two weeks that I was at the Maples,” she said. “This is still happening. There’s still people crying out for help and there’s no one there to help because there’s not enough staff, there’s not enough trained staff.”

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— with files from Jamie Mauracher, Global News

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