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The accepted belief is that health care in Canada is free. Not so, say those whose loved ones have to pay for long-term care. Advocates say society should take better care of its elder members.
Norma Silverstein has fond memories of her grandparents and great-grandparents from when she was a child.
“I loved those people. They were wonderful people and I wouldn’t be here without those people,” said Silverstein, who lives in Sydney, N.S., with her husband Robert.
“You know, since I grew up appreciating the elderly people in my family, I think it’s a tragedy when they aren’t treated properly.”
How older people are treated struck tragically close to home for the Silversteins a year and a half ago. Norma Silverstein’s father, John Ferguson, 93, died of septic shock in October 2017 when his bedsores became badly infected while he was a resident at Harbourstone Enhanced Care in Sydney.
“I grew up valuing all stages of life and all people.”
— Norma Silverstein
A recently concluded investigation by the provincial Health Department determined that Harbourstone failed to provide adequate care for Ferguson under the Protection of Persons in Care Act.
While Silverstein doesn’t doubt the facility failed her father, she said society in general must take more responsibility for the elderly.
“A lot of people in society just write them off. They aren’t as important, they’re not worth looking after. It’s very sad, I think.”
That disregard extends to the costs borne by people who must go into nursing care, as well as by their families, according to Ron MacNeill.
The Charlottetown man has spoken out about dramatic increases in nursing home fees recently implemented by the former P.E.I. Liberal government (the Progressive Conservatives recently took over in a minority government election win).
MacNeill learned in January that the accommodation charges for his father, who lives in a government-run nursing home, would jump by over 30 per cent, from $77.60 a day to $102.73 by April 1.
“As to why the increase, the response I got back — and it’s in writing — (was), ‘Well, we have to be comparable to the private sector,’” MacNeill said in a recent interview. “In P.E.I., the majority of our service in long-term care is delivered by the private sector. That’s just the way it evolved. They’re finding themselves in a pinch right now because of the aging population, trying to keep up with the demand for long-term care with beds and such.”
As for what his father gets for roughly $100 a day, he shares a room, a bathroom and a closet with another resident, MacNeill said.
“He should have a private room, he should have a private bathroom, he should have the dignity of privacy.”
— Ron MacNeill
“He’s living in about 40 square feet and that will now cost this year $38,000 out of his income. After taxes. He’s not eligible for any subsidy.”
MacNeill said he doesn’t knock the care his father gets but “he should have a private room, he should have a private bathroom, he should have the dignity of privacy — a man who’s worked his whole life. Now you’re charging $38,000 a year and that’s not from the medical side. The medical side, in theory, is paid for by government. It’s just room and board.”
MacNeill said he questions the whole concept of charging elderly people because they’ve gotten too sick to take care of themselves.
“We don’t regard long-term care as health care. If you’re medically determined, you get into nursing care, but that’s where it seems to come to an end. Now you have to pay for that.
“I thought we were entitled to medical services, health care. Canada’s health act guarantees lifetime medical service but no, not for long-term care.”
Given the extent and severity of the problem, Norma Silverstein said there should be more of a public outcry. She noted the poor attendance at a recent community meeting in Sydney organized by the group Families for Quality Eldercare, which she and her husband founded.
“I think too many people are so distracted (with what) goes on in the world today, with the sports and the computers and everything else, they don’t pay too much attention…
“I grew up valuing all stages of life and all people. I had a blind aunt. She taught me that no matter what your disability, whether it’s dementia, your life is valuable. People should honour that, people should honour life at all stages.”
Eighty per cent of Canada’s 3.2 million federal and provincial public sector workers participate in defined-benefit pension plans… For those within Canada’s private sector, however, less than 30 per cent of employed workers have a pension plan. — National Seniors Strategy.ca
“If I’m 75 and healthy, I should be able to set up an appointment with a VON nurse to come into my home, check my blood pressure and my pulse. … In lots of European countries, that’s what happens, you can call up and get a nurse to go to your home and visit without going through all of the rigour that we now have to get VON services in our home.” — Janet Hazelton, president, Nova Scotia Nurses Union
Private sector in a public long-term care system
The long-term care system may be funded from the public purse but the private sector plays a big role in Atlantic Canada.
It’s not clear whether that’s a good or bad thing in the Atlantic region when it comes to the well-being of residents, said Janice Keefe, who chaired an inquiry into the state of long-term care in Nova Scotia last fall.
“I know my colleagues out West have done examinations of resident outcomes via for-profit versus not-for-profit and found no difference in residents’ outcomes...”
— Janice Keefe
“I know my colleagues out West have done examinations of resident outcomes via for-profit versus not-for-profit and found no difference in residents’ outcomes,” Keefe said in a recent interview.
“I would love to be able to do that in our region. But we don’t have the data.”
The role of private companies in the system has raised transparency and accountability concerns in recent years. For example, in Nova Scotia, the Shannex group fought a successful legal battle to keep its financial information under wraps.
The case arose from requests for information about Shannex’s budget to the Nova Scotia Department of Health from an unknown member of the public under the provincial Freedom of Information and Protection of Privacy Act.
Shannex owns and operates 15 nursing homes in Nova Scotia and recently won contracts to build four nursing homes in New Brunswick.
“We’re paying over $1,000 a day for keeping people in hospital (in Nova Scotia). But it costs about $300 a day to keep a person in a long-term care facility. So it’s penny-wise and pound foolish.” — Gary Burrill, Nova Scotia NDP leader
BIG BUDGET BITE
In 2016, 49% of Newfoundland and Labrador’s health budget was required to care for people over 65, who represented 19.1% of its population at the time. Prince Edward Island spent 51.4% of its health budget on seniors (18.8% of population); Nova Scotia spent 49.9% (19.3% population) and New Brunswick spent 50.3% (19.5% population). — Canadian Institute of Health Information
The average life expectancy in Canada for those born in 2018 is 84 for females, 80 for males. — Statista.com
IN HIGH DEMAND
Canada will need an additional 199,000 long-term care beds by 2035, nearly doubling current long-term care capacity. — Conference Board of Canada