New national long-term care standards enter public eye

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This article was published 28/01/2022 (1358 days ago), so information in it may no longer be current.

Over her two decades working on and off in Canada’s long-term care sector, retired registered nurse Joyce Kristjansson saw the needs of residents “have changed dramatically.”

A couple of years ago, the former executive director and director of care at Golden West Centennial Lodge was revamping the Salvation Army facility’s resident bill of rights to better protect privacy, considering the number of residents with dementia who were prone to wandering.

She was reminded the main concern when the bill of rights was drafted 25 years earlier was: where would residents park their cars and would they have to pay for parking?

“Such a huge difference in the types of people in long-term care, in the needs of those people, and yet the funding and the models haven’t really changed, so it becomes hard to meet the standards,” Kristjansson said.

The former Winnipegger is the lone Manitoba resident working on a national committee to create new standards for long-term care homes across Canada.

The updated draft standards were released for public review this week through the Health Standards Organization; the final version is expected to be released by the end of the year.

The federal government tasked a technical committee, chaired by National Institute on Ageing director of health policy research Dr. Samir Sinha, with updating standards first developed in 2012 and revised in 2020. A call went out in March 2021, seeking policy makers, physicians, long-term care staff, and residents and their families to take part.

Kristjansson was getting ready to retire, and the timing seemed right. “It was something I was passionate about, so I put my name forward,” she said.

The committee worked on the draft standards over the course of seven months, with input from 18,000 Canadians.

Kristjansson was one of the 32 members advocating for “home-like” care and good working conditions for staff, with appropriate management in place. She said many of the regulations already in place, including in Manitoba, make it difficult to treat residents as individuals, and the goal of these standards is to focus on what’s best for residents.

“We call them long-term care homes, but they are so regulated that really they aren’t a home. They can’t be and meet all the rules. And here in Manitoba, many of them, built many years ago, have three- and four-bed rooms,” she said.

The 42-page draft standards have new focus on diversity and inclusion in the workplace, data collection, accountability measures, and the rights of residents to live with a certain amount of risk that doesn’t harm others (such as accepting visitors or choosing not to be restrained despite their risk of falling).

The standards have been intentionally left broad, for example: “The team communicates complete and accurate information to residents about their care in a way that is timely and understandable.”

The next step, after the 60-day public consultation that began this week, is developing guidelines that will set out how the standards can be measured or enforced.

During a technical briefing this week, Sinha said he hopes it will lead to meaningful change. Accreditation Canada, which accredits 68 per cent of long-term care homes across the country, has agreed to use these standards in its process, but there’s no requirement for provinces and territories to adopt them or change legislation accordingly.

“I am hoping, my God, I’m hoping, that this will be a clear blueprint that really can enable provincial and territorial and federal action to move long-term care to where all Canadians are demanding it to go,” Sinha said.

The standards can’t be upheld without increased funding, improved working conditions, and accountability in facility ownership, he added.

Manitoba hasn’t committed to adopting the new standards.

The committee invited all deputy ministers responsible for long-term care across Canada to be part of a government advisory table. When asked if a provincial representative participated, a spokesperson for the Manitoba minister of seniors and long-term care didn’t answer the question.

Tory MLA Scott Johnston (Assiniboia) was appointed to lead the newly-minted department Jan. 18.

The spokesperson also did not answer when asked if Manitoba will adopt the standards, saying only the department will review the draft report.

Instead, the spokesperson said the province is “already working on resulting modernization and adaptation” in long-term care, via the Stevenson report it commissioned following deadly COVID-19 outbreaks at Maples personal care home in 2020.

Kristjansson has requested a meeting with Johnston.

She said social change is necessary for ending the ongoing long-term care crisis. “For me, if these standards are adopted nationally, that would be wonderful. If they’re adopted in Manitoba, that would be even better.”

What’s critical, she said, is to “continue to keep the conversation going about the need for reform in long-term care. Because I’ve been part of discussions like this for 20 years, and I knew that many of the reports I’d worked on had just sat (unused).”

katie.may@freepress.mb.ca