CCBI News – Long-Term Care, Long Term-Problems; Francis: To the elderly—Knowledge Without Action is a Wasted Gift

May 27, 2022

Dear Friends of CCBI,

Long-Term Care and Long-Term Problems

Ontario’s Financial Accountability Office reported that the number of LTC beds in Ontario increased by 0.8 percent from 2011 to 2019, yet the number of people over age 75 grew by 20%. Math does not need to be one’s strong suit to see a major discrepancy. Report after report have been made about Long-Term Care, but responses have never matched the urgency of the need. The Canadian Association for Long Term Care forecast in 2018 that at least 42 000 beds would be needed by 2023, yet an editorial in The Globe and Mail recently warned that even with the worst of the pandemic behind us, even after the number of deaths in long-term care shocked people into awareness of the need for its drastic overhaul, and even after vowing to remedy the situation, so little has been done to provide more beds or to improve the system to the extent needed.

According to The Globe, in pre-pandemic 2019 Ontario already had a waiting list of 43,000 people for long-term care and the situation in Quebec was already desperate. The toll on residents in care before vaccinations became available was dramatic, and we learned that crowding, room-sharing, lack of staff, low wages, multiple workplaces and, in some cases, general neglect were to blame. The armed forces were called upon to provide basic services in some care homes, signaling that Canada was dealing with not just a dangerous pandemic but a tsunami of defects in long-term care. It became increasingly clear that not only were many more beds needed, but also increased supervision and monitoring, even the revoking of licenses where applicable. In many ways the federal government seems to be able to avoid responsibility for long-term care since enforceability of monitoring and licensing depends on the provinces. Why not, even if possibly cumbersome, demand a federal level of inspection and monitoring of care homes, thus providing another set of checks and balances? There have been too many mistakes, mistakes that have caused lives to be lost needlessly.

Political/Economic Questions RE: Care Homes

Many questions were raised early in the pandemic about the respective roles of for-profit and not-for-profit nursing and long-term care homes, concluding that residents in not-for-profit homes fared better overall. It was all the more surprising to learn that in Ontario, Bill 124 threatens the improvement of conditions and better wages for care workers, since management’s offers must comply with the provincial government’s proposed wage-restraint legislation, especially when low wages were such a feature in hiring needed health and personal care workers in so many care homes.

Another questionable policy decision is that, according to The Globe, the long-term care act no longer requires licensing decisions to be based on an applicant’s record in providing care. Critics say this change gives for-profit homes with poor track records the opportunity to continue without making some needed changes. Ontario currently has a higher proportion of for-profit homes than any other province and long-term care residents accounted for two thirds of the province’s death toll from Covid-19. The majority of those who died lived in for-profit homes, yet the Ontario government has awarded 36 percent of 31,705 new beds to 10 for-profit chains. Not-for-profit care homes were awarded 43.4 percent of the beds, which sounds reasonable, but critics alert us to obstacles facing these homes through difficulties in financing new building, while for-profit homes have better access to capital. Many smaller not-for-profit homes, including some planned by religious denominations, are struggling to qualify, ceding ground to for-profit groups and companies, as well as real estate developers. 

A report on long-term care in light of the pandemic by former Associate Chief Justice Frank Marrocco strongly recommended a new model of long-term care. The report has not been implemented, sharing the same fate as other such reports delivered over the last twenty or thirty years. One wonders at the time, expertise and money spent by all levels of government on such ventures that could bring about real change but are then sidelined or only semi-implemented. Perhaps government can then claim it did its bit! Dr Rory Fisher uses the term ‘warehousing’ to describe how our elderly and vulnerable are treated at later stages of life. Warehousing? Of people? Where did we lose our way? This bioethical and social justice dilemma is proving well-nigh impossible to solve politically, yet other countries are showing some success. We all professed shock at the death toll of people in long-term care and vowed matters would improve, yet here we are again: stalling in making improvements, ignoring important recommendations, perpetuating the same old problems.

Pope Francis: Knowledge without Action

As if on cue, at this week’s papal audience, Pope Francis challenged the elderly to recognize the limitations of a viewpoint that shows “…indifference, when we see that our efforts seem to produce no results and reality appears to turn everything – both good and bad- into nothingness.” He reminded us that the modern-day approach to truth has separated from the path of justice, leading away from moral responsibility and towards what he calls a ‘paralysis of soul.’ Strong words! The theological term for this is ‘acedia,’ by which the Pope means “… a surrender to the knowledge of the world devoid of any passion for justice and consequent action.”

Pope Francis is advising the elderly to help younger generations through demonstrating their store of experience, wisdom and humour, i.e., that, knowing what they know, they must act on it and not enable further ‘paralysis’ by thinking it’s not worth even trying to make a difference. Those of us who are not-quite-elderly-but-getting-there as well as middle aged and even younger people should keep this in mind. Knowledge without action is a wasted gift.

The Pope himself is at work in Rome and abroad every day, currently using a cane or a wheelchair to get around. He’s a good example of practising what he preaches! Nobody could ever accuse him of indifference, resistance to justice or any kind of ‘paralysis.’ If synodality means listening to each other, listening to the Pope’s wisdom is a good place to start and to put our knowledge into action, as he does.

Globe editorial: The biggest issue in Canada’s long-term care homes? A desperate lack of beds – The Globe and Mail
Pope at Audience: Elderly must resist temptation to knowledge without action – Vatican News

Pope Francis’ Intention for May

For Faith-filled Young People
We pray for all young people, called to live life to the fullest; may they see in Mary’s life the way to listen, the depth of discernment, the courage that faith generates, and the dedication to service.

Moira and Bambi