Following recommendations from a report released this week reviewing Alberta's continuing care system, the province announced incoming changes that will include a greater emphasis on home care and elimination of shared 'ward' rooms in long-term care facilities. While the government will start implementing changes this summer, critics say the report barely begins to address longstanding issues around continuing care in the province.
Review panel chair and MLA Richard Gotfried acknowledged reshaping Alberta's continuing care system is a huge undertaking, but Health Minister Tyler Shandro said learnings from the impact of COVID-19 have resulted in a report that offers "a concrete plan to strengthen and modernize continuing care. We’ve all learned the importance of physical distancing to help to reduce transmission. Multi-resident rooms are among the biggest factors for infection control in continuing care, for COVID-19, for influenza and for any other communicable disease."
The report from the Facility Based Continuing Care Review Panel makes 42 recommendations, the first to be implemented July 1 with a phasing out of shared room admissions in long-term care. Other early changes include offering support for couples and companions to remain living together in continuing care facilities, funding to support Indigenous groups for continuing care services in their own communities, and expanded home care.
According to the report, the need for continuing care services in Alberta will grow by 62 per cent by the year 2030. Having home care represent 70 per cent of services by that date — up from 61 per cent — is expected to save $452 million per year.
Following a first look at the review, Sandra Azocar, executive director of The Friends of Medicare, said "This has been a harrowing year for our seniors. Albertans have been anxiously waiting to see if the grim lessons of this pandemic will actually have been learned by this government. The primary strategy we see offered by this report is the further offloading of care costs and responsibilities onto residents and their families."
“Heavy workloads, insufficient staffing, and over-reliance on part-time positions are very real problems in the continuing-care industry,” said Alberta Union of Provincial Employees (AUPE) Vice-President Mike Dempsey in reaction to the review. The AUPE, which represents about 50,000 healthcare workers, advocates nationalizing all parts of the healthcare system. "As long as the government subsidizes care companies, they’ll find ways to profit off the pain of everyday people. And I don’t see anything in this report calling for an end to that."
Dempsey points to the recently-announced temporary bed closures at the St. Therese-St. Paul Healthcare Centre and Elk Point Island Health Care Centre, where government has cited difficulties recruiting staff as reason for the action.
“And earlier, eighteen residents from the Galahad Care Centre were relocated to alternative facilities due to staff shortages, disrupting their lives and the lives of those who care for and about them. We've been hearing from members for months now that they’re stretched to the limit. Many are on workers’ compensation or disability leave because they are overworked to the point that they are injured on the job or they just can’t take the constant stress and exhaustion anymore.”
“The fact of the matter is that the public health system has been strained for years, well before the pandemic hit last year,” Dempsey added.
While Patrick Dumelie, CEO of Covenant Health, says the review "will dramatically improve the quality of life and care for seniors," Azocar and Dempsy point to recommendations that do not make mandatory any consistency of staffing or address using public funds for private, for-profit facilities. On the plus side, Azocar said expanded public reporting on facility performance is a good step to alleviate some of the immediate concerns for seniors and their families.
Andrew Jaremko, a resident of Colonel Belcher Retirement Residence in Calgary (A Chartwell, for-profit facility) gave his input for the review, something he said was critical for a thorough report. "I think implementing appropriate legislation will improve Alberta’s continuing care system," he said.
The government says it will develop an action plan for implementation based on the report’s findings over the coming months and years.
Over 7,000 online surveys were completed in the review process. Citizen and interest group engagement included feedback from residents and family members, continuing care staff, care home operators and the public.