November 3, 2021
The COVID-19 pandemic has emphasized the long-standing desire of many Canadians to age-in-place.
In recent months, surveys conducted to better understand the perspectives and concerns of Canadians on the state of Canada’s long-term care system have resulted in a clear consensus: Canadians, especially those over the age of 65, wish to live safely and independently in their own homes for as long as possible.
While this desire is not newfound, it has been exacerbated by the COVID-19 pandemic. In turn, it has fueled a national conversation about the causes of, and solutions to, the challenges faced by the long-term care system.
Yet, despite mounting written reports and recommendations by experts over the decades, the desire to age-in-place is barely, if at all, reflected in our policies and actions. Calls to fund a broader spectrum of health and social services that will allow Canadian seniors to age at home have been regularly overlooked by successive governments. In 2021, even after a year-and-a-half of heartbreaking stories about the suffering of our oldest and most vulnerable citizens in long-term care homes, the conversation remains fixated on institutional settings as seemingly the only option for aging Canadians.
Even worse, reports show that Canada spends a disproportionately low amount on home care compared to the OECD average. According to Ageing Well, a report released by Queen’s University in November 2020, Canada spends a mere 0.2% of GDP on home care, the lowest outlay in the OECD.
Another report, published by the Canadian Medical Association this spring, urged an enhanced use of home care to allow thousands of Canadians to move out of long-term care, which would save the health care system millions of dollars – $794 million a year by 2031, to be exact.
In September 2020, I launched an inquiry in the Senate of Canada, calling the attention of our institution, and that of my colleagues, to the weaknesses within Canada’s long-term care system, which have been exposed by the COVID-19 pandemic. The Senate, with its obligation for independent, sober second thought and the benefit of futuristic thinking, was the ideal host for this discussion.
Over the course of nine months, the Senate engaged in a thought-provoking conversation about long-term care reform. Some of my colleagues shared deeply moving, personal anecdotes about their experiences with long-term care homes. Others highlighted policy recommendations that should move us to action.
In my own speeches, I spoke about attainable short-term solutions that are already being implemented across the country: namely, the creation of national standards, expanded recruitment of personnel, and the renewal of infrastructure. At the same time, I cautioned that these short-term solutions should not over-shadow longer term ones.
I argued that these actions, alone, will not adequately respond to the long-term care crisis. The fundamental issue is the chronic underfunding of senior home care and community services that will allow seniors to age within their communities, in the homes of their choice.
The key question? Why is so much of our collective effort and money being spent on care that our seniors do not even want?
Canada is not short of visionary ideas for long-term care reform. My own research yielded a number of community-led initiatives whose primary focus is to support healthy aging-in-place through the integration of age-friendly housing, health and social support services, transportation, volunteering, telemedicine, and emerging technology.
We are faced with a problem in our public conversation over aging. A focus only on the long-term care sector cannot meet the needs of the growing population of Canadians seniors. We must shift the status quo away from a system that prioritizes acute hospital care and towards one that focuses on the housing, social, and health needs of our seniors.
One thing is certain: suffering is avoidable, systemic reform is long overdue and desperately needed, and the urgency is now.
Senator Judith G. Seidman is an epidemiologist and health researcher. She lives in Montreal, Quebec.
This OPED was published in the Ottawa Citizen on Monday, October 25, 2021.