With air conditioning scarce, Quebec's long-term care homes struggle with heat during pandemic
Critical to balance needs of long-term care residents even in COVID times, says Montreal gerontologist
When it gets as hot as it is in Montreal this week, with humidex values expected to reach 40 Wednesday, Mendy Fellig becomes all but helpless.
Fellig, 43, has multiple sclerosis. He can't leave his room without help from the staff of Maimonides, the long-term care home in the Côte Saint-Luc borough where he lives.
"The heat is terrible for me. I can't function," Felig said. "I become completely disabled — even more so disabled. I can't move. I can't move my hands, so as soon as there's no air conditioning, I shut down."
Environment Canada has issued a heat warning for much of southern Quebec, and meteorologist André Cantin said temperatures in Montreal are expected to be higher than normal, on average, all summer.
People with chronic physical or mental health conditions and the elderly are especially vulnerable to high heat and humidity.
With the COVID-19 pandemic also affecting people with disabilities and those over 70, long-term care homes are facing a doubly challenging situation: how to deal with the heat while preventing further spread of the novel coronavirus.
1/3 of rooms with A/C
Fewer than a third of the rooms have air conditioning in the province's long-term care institutions (known as CHSLDs), where the majority of cases with complications and most of the COVID-19 deaths have occurred.
Premier François Legault has said 97 per cent of CHSLDs have at least one zone that is air-conditioned — but shared spaces indoors are off-limits in the institutions, because of the risk of spreading the virus.
Health Minister Danielle McCann acknowledged the pandemic makes it difficult to offer residents a place to cool off.
"It's going to be more complicated this year," she said.
Facilities will have to be careful not to mix those who have COVID-19 and those who don't, she said.
Although there are questions about whether air conditioners or fans could spread the coronavirus droplets that carry the virus, Montreal's public health director, Dr. Mylène Drouin, said new directives from Quebec's public health research institute, the INSPQ, address that possibility.
"They have to be placed in specific places so they're not placed in the faces of the residents or toward an exit door ... to ensure droplets are not spread," Drouin said at a news conference in Montreal Tuesday.
On Wednesday, Legault said with the new INSPQ guidelines now in place, CHSLDs would move as quickly as possible to install more AC units in residents' rooms.
Fellig is one of the lucky ones. At Maimonides, air conditioners have been installed in more rooms, and Drouin said many other CHSLDs are rushing to do that now.
'The whole-person care, not just the COVID care'
Seniors residing in long-term care facilities are especially vulnerable to dehydration and heat stroke, said Dr. Ruby Friedman, the director of geriatrics at Montreal's Jewish General Hospital.
"People with cognitive problems, dementia, sometimes need assistance to drink," Friedman told CBC Montreal's Daybreak.
He says with the hot days ahead, it's important to weigh the balance of needs to care for residents.
"We have to pay attention to the whole-person care, not just the COVID care. If we neglect these other issues, there will be immense suffering," Friedman said.
He recommends residences take steps to quell the effects of the heat on seniors, such as helping people dress in loose clothing, installing fans in rooms without air conditioning and opening windows.
Some other measures will be more difficult but possible with proper organization, Friedman said, such as regular sponge baths several times a day and ensuring proper water consumption.
Making sure all that happens is further complicated by the labour shortage that CHSLDs are still grappling with, which impacts the quality of care.
"If we don't pay attention to these matters, there's suffering," said Friedman. "Things will become more labour-intensive if someone is sick and needs round the clock care."
WATCH: How the heat is complicating the response in long-term care homes:
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With files from Simon Nakonechny
