People living in long-term care (LTC) homes in across the globe have been far more likely to die of COVID-19 than the rest of the population. However, the effect of COVID-19 on residents in LTC has varied widely within countries. Here are some of the lessons that can be learned from Covid-19:
The Government Needs to Reprioritize Long-Term Care Planning & Also Focus on Community-Based Home Care Services
The lack of pandemic planning in the sector, outdated building standards, poor staffing practices and the reluctance by government to hold service providers accountable to ensure quality resident outcomes has contributed significantly to the high death rates in long term care. Government policy and funding support for long-term care needs to be reprioritised from the built environment to community-based supports into the homes or dwellings where people live. Adopting a planning framework based on population demographics and socio-economic status of people over the age of 70 in a defined geographical area should be adopted. For every 1000 people over the age of 70 there should be 65-70 residential care (nursing home) places and 75-80 community care (packaged care) places. This shifts the focus and priority to care at home.
Building Standards and Living Arrangements Need to be Reimagined for Long-Term Care Facilities
LTC residents in many countries are more likely to reside in shared rooms. In Ontario, Canada for example approximately 63% of residents are in shared rooms. Rates of infection associated with the LTC and the health care sectors are lower where facilities have single patient/resident rooms.
Shared resident living arrangements have contributed significantly to the spread of Covid-19 and other outbreaks such as influenza in LTC. In Ontario, Canada for example, the maximum resident home area (RHA) caters to 32 residents, but the standards do not specify that all must be single rooms. It is not mandated that resident ensuites or shared washrooms have showering or bathing facilities, instead there must be a shower/bathroom within each RHA.
Building standards for long-term care must provide for single resident rooms with a full ensuite to include showering facilities and resident home areas (RHA’s) should be no greater than 16 resident care places. Single rooms with ensuites should be 250 square feet as the minimum standard.
Staffing Levels for Long-Term Care Need to be Addressed as Part of a Broader Quality of Care Standards Framework
A high quality of nursing home care requires adequate levels of competent staff, but mandating staffing levels does not ensure quality resident outcomes. A sophisticated quality of care standards framework in itself can ensure appropriate staffing based on the resident care mix and measured against legislated resident outcome standards. Mandated staffing profiles or hours of direct care in long term care will never ensure quality of care.
What is Long-term care?
Long-term care (LTC) is a range of services that helps meet both the medical and non-medical care needs of people who need assistance with basic daily activities such as dressing, bathing and using the bathroom. Long-term care can be provided at home, in the community, in assisted living facilities or in residential care facility. Long-term care may be needed by people of any age, although it is a more common need for older people. Long-term care involves providing a level of medical care that requires the expertise of skilled practitioners to address the multiple chronic conditions associated with older populations.
To learn more about the impact of COVID-19 in Long-Term care in Canada and across the globe please contact Mr. Greg Shaw, Director International and Corporate Relations for the International Federation on Ageing (IFA) at the IFA Expert Centre, which is a unique resource for those interested or involved in the areas of ageing, vision health, human rights, vaccination and more.
Greg Shaw Director of International and Corporate Relations
Mr. Shaw represents the IFA at the United Nations, works closely with governments, and maintains the IFA’s elder abuse initiatives