Growing Older

Senior care sags in Saskatchewan as an elderly boom looms

by Gregory Beatty

santamaria

provinceAccording to a government website on seniors’ health, one in seven Saskatchewan residents is 65 or older. By 2020, it’s projected that the ratio will be one in six. The challenge this demographic reality poses for the province is profound. All facets of society, from housing and the economy to social programs and the labour market, will be affected by a bigger elderly population.

And then there’s the additional imperative of providing compassionate care for seniors as they age, and experience declining physical and mental health.

Graphic evidence of the last challenge can be found in the tragic story of Margaret Warholm. Following her death at age 74 at a Regina long-term care home, her family went public, saying she had died prematurely because of poor care. Untreated fractures from a drop, malnutrition and bed sores were three concerns cited.

Three employees from the home subsequently appeared at the legislature to confirm the family’s accusations that short-staffing, plus top-heavy management at the expense of front-line workers, made it impossible for them to provide proper care and attention to residents.

“For well over a year we’ve been raising concerns around seniors’ care,” says NDP leader Cam Broten. “This government is completely failing to listen and to recognize that there’s a crisis in the province.”

In 2013, says Broten, the government conducted a CEO tour of long-term care facilities.

“While it was a sanitized version of what was going on, it did provide some insight into the problem,” says Broten. “There were stories of seniors soiling themselves because there was no one to help them get to the bathroom, and call buttons not being answered, and people missing baths. Apart from that general description of problems, there’s been many individual cases raised in the legislature where families have had the courage to share their stories.”

In response to the CEO tour, the government committed an additional $10 million to address urgent shortcomings in care.

Much more needs to be done, though, says Broten.

“This government eliminated the minimum care standards that were in place which would’ve provided a base level of care. We believe those regulations needed to be strengthened as opposed to scrapped. The other thing I hear as I travel the province is how chronic short-staffing is ensuring that families don’t have the type of care for their loved ones that they need.

“Instead of this government fixing the things that matter most such as frontline care for residents through care aides, LPNs and other staff, they’re completely obsessed with their pet $40 million lean project with John Black & Associates.”

Trouble Ahead

Saskatchewan isn’t the only province facing the demographic challenge of an aging population. Recently, Jonathan Harris completed his Masters of Public Policy in Health Services Research at Johnson Shoyama Graduate School of Public Policy in Regina. He did his thesis on eldercare, and he says governments of all stripes have been slow to respond to the looming crisis.

“When you look at policy and planning documents from the early ’90s, we’ve been talking about the same thing for 25 years,” he says. “There’s been some small changes, mostly at the margin, but there seems to be the assumption that [the problem] will resolve itself and that things such as home care can be used to keep people out of institutions as they get older.

“That’s worked and it hasn’t,” says Harris. “When people enter a nursing home now, they’re entering later in life and in poorer health. You could argue the system’s working as it’s designed to, as we’re supporting people in the community longer. But there’s a demographic bulge coming and more and more people will be requiring that care and we haven’t really prepared for that.

“Investment needs to be made across the continuum of care,” he says.

“We can’t just say we need more home care, or assisted and independent living, or nursing home beds. It needs to be in all areas, and it can’t be a one-size-fits-all as older adults have different needs.”

Some seniors, when they enter care, have the benefit of supportive families who visit regularly and monitor their condition and bring potential problems to the staff’s attention. Others, for various reasons, don’t. Likewise, some residents are mentally sharp enough to communicate their health concerns to staff. But if they suffer from dementia, they generally lack the capacity to do that.

Throughout the 25-year period Harris mentions above, governments at the federal and provincial level have generally sought to narrow the scope of public services. Instead, through tax-sheltered savings vehicles such as RRSPs and TFSAs, they’ve sought to provide tools for Canadians to cover their own future care needs.

While there’s been little growth in publicly subsidized care facilities in recent decades, the number of private for-profit care homes has mushroomed. As evidenced by the fee structure, which in Regina ranges from $1800 to $5000 a month, the quality of care provided varies widely.

“There’s absolutely an inequality to it,” says Harris. “If you have the ability to pay you have a broader range of options, which is somewhat incompatible with the way we think about health care as Canadians.

“I feel strongly that there’s a moral imperative to do better by our elders,” he adds. “I’ve certainly had people disagree with me and say that Canadians should be expected to contribute to their care. Right now, I don’t see the system being fundamentally overhauled so that home care and long-term care are included under medicare in the Canada Health Act. So people need to understand that there is a cost and it’s something you have to plan for.”

Health Minister Dustin Duncan has asked the ombudsman’s office to investigate Warholm’s case. Broten, meanwhile, says the NDP will keep the heat on in the legislature.

“We’re not letting up on this. It was so painful for Margaret’s family to talk about such a raw and personal matter,” says Broten. “But they said, ‘We’re here for justice for our mom, but more importantly, we’re here so that this stops happening.’

“And they were very clear that not only did the system fail them, this government failed them,” he says.

2014-11-27