When a gym becomes a home: Highlighting the need for long-term care reform

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  1. Darren Cargill

    Well done Dr. Kennette. You and WRH should be very proud of the Windsor Field Hospital. Enough cannot be said about the staff and administration who made this possible.

    While solutions for LTC are still required, it is inspiring to see friends and colleagues do what needed to be done to take care of a vulnerable patient population.

  2. Ediriweera Desapriya

    Dr Kennette thanks you indeed for sharing your valuable thoughts. COVID-19 has disproportionately affected our senior citizens lives in many ways, especially, those who are living in the long-term care. The statistics would reflect the reality. One percent of Canadians reside in long-term care; however, they represent 80 percent of Covid 19 deaths in Canada (1).

    Fall 2019, the National Institute on Aging warned long term care homes were plagued by conditions that increased the risk of spreading infections: people living in close quarters in residences faced with chronic shortages of staff, with little space or ability to enforce proper physical distancing measures, where poorly paid employees often work on a part-time basis at multiple facilities, increasing the risk (1).

    In Canada, provinces are responsible for health and long term care services. Long-term care is not covered by the Canada Health Act, so there are no federal or national standards or guidelines. Therefore, health care community should advocate for adequate funding to provide safer, more effective care. It is our huge obligation to support to the national call to bring long-term care under the Canada Health Act, which would include targeted federal funding, national standards of care (including an increase to 4.1 hours of care per day), and place limits on private, for-profit care. Previous evidence based literature including a systematic review published in the CMAJ, shows clearly that the for-profit care model is not a good idea. Fifteen observational studies, involving more than 26 000 hospitals and 38 million patients, with adjustment for potential confounders, private for-profit hospitals were associated with an increased risk of death (relative risk [RR] 1.02, 95% confidence interval [CI] 1.003-1.038; p = 0.02). This meta-analysis suggests that private for-profit ownership of health care institutions, in comparison with private not-for-profit ownership, results in a higher risk of death for patients (2).

    I also wanted to emphasize that blame should not be ascribed to any individuals or a particular government after a loss of so many of our beloved parents and grandparents, instead, we all should accept the critical lessons learnt to avoid future outbreaks in these institutions, and strongly advocate for appropriate systems changes. If we are to learn anything from these disturbing statistics, it is that older people require special assistance not only to prevent and respond to COVID-19 outbreaks, but for the optimal management of other acute and chronic conditions, including the mental illness, social isolation, overall well being and during the pandemic. This is clearly the responsibility of our health care community.


    (2). Devereaux PJ, Choi PT, Lacchetti C, Weaver B, Schunemann HJ, Haines T, et al. A systematic review and meta-analysis of studies comparing mortality rates of private for-profit and private not-for-profit hospitals. CMAJ 2002;166(11): 1399-406.

    • Wendy Kennette

      Thank you very much for you comment Ediriweera. I agree with you that it is time that we all step up and strongly advocate for appropriate systems changes.

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