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COVID-19 has exposed some of the most systemically deficient aspects of Canadian society, including unjust treatment of marginalized and vulnerable citizens, such as older adults (the most well-known evidence of this are the military reports about residential long-term care in Ontario and Quebec).
Despite largely symbolic moves by the Manitoba government (including a $200 payment to seniors), it has remained at best passively indifferent, both pre- and post-COVID-19, to the need to address missing pieces of effective seniors care policy. If this government truly wants to respect and recognize older adults, it can take one particularly important tangible first step toward creating more equitable, responsive and accountable seniors care — by creating and implementing an Office of the Seniors Advocate.
A seniors advocate would serve many purposes in the quest for better care across the continuum for older Manitobans, their families and our communities. In particular, the roles and responsibilities of the advocate could improve access, transparency and accountability in long-term care in this province.
More broadly, the advocate could monitor the provision of a range of services designed for older adults, analyze issues of importance to the welfare of older adults, and generally advocate in the interests of seniors. They could identify and analyze systemic challenges facing seniors, collaborate and work with service providers, raise awareness of available resources and service gaps and make recommendations to government to improve delivery of services and the welfare of older adults.
We already have a good example to look to in this regard — our current Manitoba Children and Youth Advocate in the province, who has the ability to investigate, has dedicated funding and is independent from the government, with a duty to report to the legislature as a whole.
As an independent office of the Manitoba legislature, a seniors advocate would have a duty to report publicly. Investigative power and independence are crucial. Notably, although some community-based seniors advocacy groups (such as the Manitoba Seniors Coalition) exist, there is no singular appointed provincial office to investigate serious concerns or grievances about seniors care.
Almost 90 per cent of all reports submitted to Protection for Persons in Care Office (PPCO) relate to incidents in personal care homes (PCHs), and the Manitoba government has no obligation to publish details from these reports. Indeed, even critical incidents reports are not currently reported per facility, as is the case in other provinces. A seniors advocate could lift the veil of secrecy surrounding seniors care and propose a better path forward.
Additionally, a centralized, coordinated Office of Seniors Advocate could identify and amplify best practices and resources to all older Manitobans and their families who seek information and advice on programs, resources and supports. The province’s Seniors Resource Guide was last updated in 2015/16. A formalized advocate with the ability to collect information, investigate and report independently would help effectively guide both research and policy, while providing an independent way to identify and contextualize serious incidents without fear of politically motivated reprisal from the government of the day.
In 2018, several Portage la Prairie families who had concerns with Lions Manor PCH had no other recourse but to write to the minister of health; a seniors advocate would have been able to support these families and resolve their concerns.
In 2013, British Columbia established an Office of the Seniors Advocate through legislation, following an Ombudsperson’s report which made clear that there was not simply a collection of otherwise-isolated incidents of abuse or inappropriate care, but rather widespread systemic problems which directly pointed to the need for a seniors advocate. The advocate was hired in 2014 after an exhaustive search.
Additionally, the Office of the Seniors Advocate would ensure seniors are part of the conversation. Aging advisory councils have now been disbanded. These operated both municipally in Winnipeg (Mayor's Age-Friendly and Seniors Advisory Committee) and provincially (Manitoba Council on Aging). When they were operating, they were constrained in their ability to effectively advocate due to their advisory mandate. What we need are feasible, "ground-up" solutions based in comprehensive understanding of challenges facing Manitoba seniors, including those faced by marginalized groups of older adults, in both rural and urban areas.
A seniors advocate office could reinstate advisory councils for older adults to effectively and proactively participate in democratic governance. Group work can be transparently documented and can engage key decision-makers and organizations.
In summary, we believe that there are vast possibilities for an Office of Seniors Advocate in Manitoba that is an independent voice for older adults, and has both the funds and investigative powers necessary to generate real-time data and make real change to benefit older adults in this province.
As our population continues to age, and given the patchwork nature of care services for older adults in the province, it is imperative to prioritize public solutions that ensure that the older adults that have contributed, and continue to contribute, so much to this province are provided the necessary supports, resources and services so they can age with dignity.
Trish Rawsthorne is a retired registered nurse and former research manager, an advocate for long-term care reform and an advisory-council member and public-engagement member for health policy. Laura Funk is an associate professor in the department of sociology and criminology at the University of Manitoba. Brianne Goertzen is the provincial director of the non-partisan Manitoba Health Coalition and a Canadian Centre for Policy Alternatives - Manitoba steering committee member.
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