Ideas and Impressions: ‘The unfortunate reality of long-term care homes’

By Jason Moscovitz

I recently lost my mother Norma to COVID-19 – but I really lost her five years ago to Alzheimer’s disease. That’s when she stopped calling me on my birthday. We are not the first family to endure the pain that goes with Alzheimer’s, and unfortunately, we won’t be the last. It is beyond description to see how a person deteriorates physically and mentally as the years start adding up. What’s painful is knowing it never gets better, that it never can get better. Life is about living and hoping. When there is life without hope its not living, its exiting.

My visits to Maimonides in Montreal over the last years opened my eyes to the unfortunate reality of long-term care homes. The whole country, if not the whole world, is now noticing because COVID-19 is ravaging so many of these places like a wildfire. Maimonides is probably better than most, but the reality is that long before this killer virus showed up, there were gaping holes in a system that couldn’t cope with the number of sick, elderly, and helpless people who needed far more than anyone, in anyone of these places, could give them.

I will be forever haunted by my visits to see my mother. It wasn’t my mother that haunted me, it was everything else I saw on my way to her room. Getting off the elevator on her floor was like walking into a twilight zone. Many residents in hospital gowns in wheelchairs, many in dirty diapers, many crying out for help, others dazed and oblivious. I remember there was a woman who was actually more aware than most because she could put a sentence together. She repeated over and over again, “Would someone please give me a pill so I can kill myself.”

I would get to my mother’s door, I would knock and go in, and there was my mother all dressed and coiffed, which was the last thing she clung on to. It wasn’t a miracle. It’s that my mother wasn’t alone in her room. She could afford to provide for her own private care, and either Tess or Esther, her truly loving care-givers were there to help her look beautiful, change her, and ensure she wasn’t alone. That is the definition of private medicine in Canada, but no one calls it that.

Our system is not designed to care for the needs of the elderly who can’t function on their own. All these years of budget cuts and reorganizations have hit long-term care homes in the gut. They have left a bare minimum of low-paid employees on each floor to cope with all the people they are responsible for. It is not their fault. They do their best. But their best fell short long before COVID-19 hit our shores. The pandemic blew away the last pretence that the system worked.

While I respect the tough environment facing our political leaders during this terrible time in our country, I draw the line when they express shock and dismay over conditions in long-term care homes and residences. Where have they been? Who have they talked to? Do they not have family and friends who have experience visiting these places? Were health ministers across the country unaware of reality? The fact is they didn’t want to know too much because if they did, they couldn’t have afforded to do anything about it.

Do we all forget what our healthcare system was like before COVID- 19? The emergency rooms were already filled to capacity with seasonal flu and all other ailments. There was corridor hospital care years ago, waiting lines for tests and surgeries years ago, the health care system was gobbling up money faster than governments could provide it years ago. Somehow, today, our leaders are realizing how bad it is in long-term care homes. It is disingenuous at best. The elderly in long term-care homes were not a priority in a health care system already strapped for cash.

I acknowledge it is easy to be critical and I would even acknowledge our leaders deserve the benefit of the doubt right now, but there is a point to be made. I suspect serious inquiries will be made into long-term care facilities when our present crisis ends, but how will money be any more available then? One would think with the hundreds of millions of dollars being spent and borrowed or printed to survive the crisis, there will be less money later when those bills have to be paid – but we can leave that to the economists.

I recall at a dinner party a few years ago telling friends whose parents died at a younger age what life was like inside long-term care homes and how cries for help were routinely ignored. I have been to other places, so my judgement is not solely based on the one I am most familiar with. The look, the feel, the sounds, and the smell of long-term care homes is pretty standard. The friend at the dinner party said if children were neglected like that, the police and the authorities would be all over it. Interestingly, there is now the first police investigation, and neglect is part of the Quebec investigation – but consider how many elderly people had to die first.

My mother’s illness opened my eyes to conditions in long-term care homes and I lament the fact I see no better future for the many, many more baby boomers, who soon enough, will be overcrowding the same corridors. I would like someone to tell me that my analysis is wrong – but if no one can, then I wonder if government can tell the truth.