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Major Canadian survey calls for new national long-term-care standards featuring emotion-based care

New national long-term-care standards must create homes staffed by “caring, compassionate and competent” workers focused on injecting life into residents’ final years, a survey of 16,000 Canadians overwhelmingly concluded.

Results of the survey released Friday by the Health Standards Organization — with 70 per cent of respondents from Ontario — called for “emotion-based care that emphasizes social connection (rather than the completion of tasks).”

Opinions collected through detailed questionnaires between March 31 and July 31 will help inform the organization’s new “National LTC Services Standard,” which will be open for review early next year and finalized by the fall, said the report, called “What We Heard.”

The message from the public is “loud and clear,” said Dr. Samir Sinha, chair of the National Long-Term Care Services Technical Committee.

“We need long-term care where residents are living in homes that feel like homes, where staff are valued and supported and we are thinking of the value of residents’ lives and not just meeting their basic care needs,” said Sinha, director of geriatrics for Sinai Health and University Health Network.

While the Health Standards Organization already has standards to accredit Canadian nursing homes, the federal government promised it would upgrade them after the pandemic exposed deep flaws, with residents left in soiled briefs or workers given mere moments to awaken and dress people in their care.

Advocates are now calling for new standards to be made mandatory. Without saying exactly how it will spend the money, the federal government has promised $9 billion over five years to help provinces improve long-term care.

The majority of the survey respondents were women. Roughly one-third were both over the age of 65 and identified as a family caregiver or friend.

Many called for the end of for-profit homes, the survey said. They wanted long-term care to be safe but also to create conditions for residents to remain as independent as possible. Respondents wanted more funding to give care that “reflects the value and respect that older adults living in homes deserve.”

Most of these demands echo calls for resident mental and spiritual wellbeing from Ontario’s two nursing-home industry associations, along with the Long-Term Care Commission into COVID-19.

The commission’s final report recommended the province fund models that put resident needs first. Industry associations say they want a new focus on jobs of value for employees and regulations that support person-centred (or emotion-focused) care.

Ontario is opening its 2007 Long-Term Care Homes Act this fall.

It is promising to legislate four hours of daily care by 2025. Last week, Long-Term Care Minister Rod Phillips announced $270 million to hire another 4,000 front-line workers by next year, saying it can help a 160-bed nursing home hire six more registered nurses, 12 new registered practical nurses and 25 personal support workers, increasing care to about three hours a day. The industry and unions noted that new staff won’t fill the hole left by the recent worker exodus.

The survey results came out strongly in favour of emotion-focused care, but Ontario’s plan to increase hours of care without a commitment to these resident-first approaches “just won’t cut it,” Sinha said.

“If you are not going to fundamentally address the (institutional) working conditions within long-term care it is going to be hard to make sure that whatever is being provided will really meet the residents’ needs, around their quality of life.

“Residents don’t want to just exist,” Sinha said. “They want to live.”

Phillips said the new legislation for four hours of daily care “provides the opportunity for innovations such as relational or emotion-focused care.

“Our priority will always be the best quality of life for our seniors living in our long-term-care homes,” he said.

Donna Duncan, CEO of the Ontario Long-Term Care Association, which represents for-profit and not-for-profit homes, said the survey results show that “creating the conditions for more emotion-based care” is key.

“This is an opportunity (for the minister) to realize these findings and move away from task-based systems, to an environment that cultivates innovation to respond to how seniors want, and need, to receive care,” Duncan said.

Lisa Levin, CEO of Advantage Ontario, which represents municipal and not-for-profit homes, said the survey results show “Canadians are increasingly awakening to the need for emotion-focused care for seniors, and we are so pleased this has come through loud and clear.”



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