The Concerns with Covid-19

In March 2020, long-term care (LTC) facilities all over Canada were closed to family and visitors. Now, in August, family caregivers and legal representatives are still being denied access to provide physical care and to support disabilities and mental well-being by maintaining consistency in an environment that we felt was struggling with many inconsistencies.

I am deeply concerned about the negative impact on the health and well-being of our most vulnerable seniors living in long-term care at this time of the Covid-19 pandemic. I am especially distressed that my 94-year-old father, who has mild dementia and is rapidly declining with the loss of his consistent physical caregiver and the most significant person in his life – me, his loving daughter – leaves him feeling a profound sense of abandonment because he doesn't understand why I am no longer caring for and helping him.

Why are family caregivers and advocates being denied Essential Visitor access to provide essential care? Why are we not allowed access to partner in their care? I am being denied Essential Visitor access by the facility with their reason being that my father’s "care needs are being met." I respectfully disagree. It's not enough and the rate of my father's decline is alarming to me. Ironically, the very people who were denying my access are the very same people within the facility that I've been communicating my concerns to in letters, emails, and meetings. Is my being denied reflective of my advocacy? Or is there a perception among those managing long-term care facilities that family is a risk and therefore unsafe to grant Essential Visitor access or to partner in care?  

The family members I meet are deeply committed to the care and safety of their loved ones and advocate to exhaustion in order to offer them a better quality of life in LTC.

I have not seen any statistics connecting family contact with outbreaks in long-term care facilities. Have you? Family were locked out of the facilities here in B.C. on March 17, 2020, while some staff were still working in multiple facilities. Some long-term care facilities were so short-staffed pre-Covid that even by April 17, a full month after family members were locked out, staff were still working multiple facilities. Care aides also worked in different areas of the facility, taking shifts on different floors and different wings. I haven’t seen actual statistics published showing where the contracted risk came from, but I think it’s fair to say that these practices were a significant risk.  

Covid-19 may be an ongoing issue, with perhaps a second outbreak, and I fear that LTC facilities may be restricting or denying family caregivers and/or legal representatives for a long time to come.  We want to support and help our loved ones during this most vulnerable time in their lives.

"Including family deemed as essential care during and beyond Covid-19 could be a landmark policy change we can all be proud of, honouring true companionate care for our most vulnerable during this challenging and unprecedented time."

— Herbie's daughter

Covid-19 has exposed systemic issues in long-term care facilities, drawing them out into the public eye. Are these issues being tucked back under the protection of Covid-19 to shield them from view? Are facilities using Covid-19 to shut out family, and in doing so protecting their reputations rather than admitting that they too harbour some of those same systemic issues now under the microscope?

"When the culture of any organization mandates that it is more important to protect the reputation of the system and those in power than it is to protect the basic human dignity of the individuals who serve that system or who are served by that system, you can be certain that the shame is systemic, the money is driving ethics and accountability is all but dead."

— Brené Brown

I am truly alarmed for our vulnerable seniors, shut into facilities that have, in a matter of months, become self-contained, autonomous institutions with what seems like very little outside oversight. Systemic problems such as fragmentation, understaffing and inconsistent care practices cannot be addressed if no one is there to observe what is happening. To me this raises serious concerns.

It does appear as though long-term care facilities are not willing to acknowledge the systemic issues under their collective roof and choose instead to pretend that everything is OK. It seems contradictory for long-term care facilities to present themselves as "meeting care needs, supporting physical and mental well-being," while also requesting more funding from our government to increase staffing levels and provide appropriate training and supports to meet its residents' needs.

Where are the reasonable standards and boundaries around what is adequate care and what isn't for the care, health, and safety of our seniors living in long-term care? Where is the line? How do families care for and protect their loved ones at this time of Covid-19 from the effects of staffing shortages and with no national standards in place?

“Eldercare in this country is so disorganized and so poorly regulated, the staffing so inadequate, the infrastructure so outdated, the accountability so non-existent and ageism so rampant, there seems to be no limit to what care homes can get away with.”

— Neglected No More, book by André Picard

I feel that long-term care is in a deep crisis that isn't going to be fixed any time soon and creative solutions need to be considered. Facilities are managing to mitigate the outside risk with staffing, pastoral care, activity aides, music therapists, etc. Why are those few family members who are able to help with physical care, feeding, and supporting disabilities and mental well-being not deemed Essential Visitors for their vulnerable loved ones, or allowed access to partner in their care? What is really preventing the inclusion of family as essential visitors during Covid-19?

It’s not ok that residents of LTC are housed in broken systems, inadequately cared for, and stripped of their human rights without residents and families having a voice. The draconian measures to protect seniors from infection should have never been imposed without residents and families having a say.

My plea is to stop dehumanizing elders. Our days with our elderly loved ones are understandably numbered by their age, and I feel allowances need to be considered for family inclusion in their care during this precious time in their and our lives. Including family as essential care during and beyond Covid 19 could be landmark policy change we can all be proud of, honouring true companionate care for our most vulnerable during this difficult, challenging and unprecedented time.

I fear that policies and decisions made are creating a two-fold harm during Covid-19: a paradoxical situation of trying to keep seniors safe from Covid-19 while denying them the very circumstances that have been keeping them cared for and safe — their family advocate.

Seniors living in long-term care facilities who have a family advocate or legal representative to oversee their health and personal care should NEVER have this right denied them. Seniors cannot protect themselves; they need our voices. No long-term care facility should have the right to remove this care, oversight, and legal duty for any reason, especially during Covid. 

Please help family advocates to:

RESTORE the human right of seniors living in long-term care to access their family advocate or legal representative.

GRANT family advocates and legal representatives Essential Visitor status in a federally and provincially mandated process that is fair and transparent.

View the Petition

For more on this, see read the blog entry Is the Elder Voice Heard?